Dáil Éireann Debate, Tuesday - 29 March 2022
308. Deputy Eoin Ó Broin asked the Minister for Housing, Local Government and Heritage for an update on the implementation of the recommendations of the Interim Report on Mortality in Single Homeless Population 2020 including on the proposals for adult safeguarding reviews and trauma informed care. [16444/22]
View answerA review of homeless deaths was undertaken on behalf of the Dublin Region Homeless Executive by Dr Austin O’Carroll. The review analysed the available data concerning deaths in homeless services for 2020 to identify learning for homeless and health services that could help tailor the provision of care to homeless people. This ‘Interim Report on Mortality in Single Homeless Population 2020’ was completed in June 2021.
In the report, Dr O’Carroll notes that the most important step in reducing mortality amongst the homeless population is the reduction of long-term homelessness. The report notes that the Housing First model is “the optimum approach to achieve this objective”. Housing First enables homeless individuals with high levels of complex needs to obtain permanent secure accommodation with the provision of intensive housing and health supports to help them maintain their tenancies. Housing for All commits to the continued expansion of Housing First, with more than 1,300 additional Housing First tenancies planned over the next five years. This will ensure that Housing First continues to operate and expand in every county of Ireland. It will involve an average of 264 new tenancies per annum, with the specific annual targets for each region now set out in the plan. This comes on the heels of the first Housing First National Implementation, which completed in December 2021, exceeding its four-year target by over 90 additional tenancies.
The report makes recommendations in the areas of data collection and analysis, and a pilot study on data collection of homeless deaths nationally is being undertaken by the Health Research Board on behalf of the Department of Health. The research is applying the methodology used to compile the National Drug Related Deaths Index, which is a census of drug-related deaths and deaths among drug users and those who are alcohol dependent in Ireland. The data collection for 2019 deaths, including deaths among people who were homeless, involves the review of approximately 17,000 files from all Coroner districts. My Department continues to engage with the Department of Health and the Health Research Board on this study.
Dr. O’Carroll’s report also identifies that co-operation between different agencies and service providers is of critical importance. Under Housing for All, a new National Homeless Action Committee has been established. All of the key Government departments, agencies and stakeholders are involved. The overarching objective of the Committee is to ensure that a renewed emphasis is brought to collaborating across Government to implement actions in Housing for All, along with bringing better coherence and coordination of homeless-related services in delivering policy measures and actions to address homelessness. Beyond this, the Committee will also have a role in addressing emerging homeless-related issues and in developing further responses.
The improvement of health outcomes for socially excluded groups in society is a key priority for Government. The HSE, through its National Service Plan 2022, has identified priority action areas with regard to healthcare services for people who are homeless. Among these are:
- the development of a single integrated homeless case management team for Dublin that will provide integrated individual assessment, case management, care planning and co-ordination;
- the implementation of the health actions in Housing for All for people who are homeless including those in addiction, in order to provide the most appropriate primary care and specialist addiction / mental health services for their needs;
- continued support of the roll-out of specific harm reduction approaches such as opioid substitution treatment and increased naloxone provision;
- the development of a stepped model of mental healthcare for homeless population in Dublin in collaboration with mental health services.
It is important to note Dr O'Carroll's report was interim pending the examination of Coroner's files, and it has been agreed that the DRHE and Dr O'Carroll should liaise with the Health Research Board to examine these files. The Health Research Board will be the first point of contact for future research in this area.
My Department is working closely with the Department of Health, the HSE and local authorities to continue to deliver the appropriate measures to support all individuals experiencing homelessness including those with complex needs.
