Mr. Aaron O'Connell:

On the issue of complex needs, most people would agree that emergency accommodation is in no way suitable for somebody with complex needs. Emergency accommodation should be for the shortest possible time. It is important in terms of the housing first approach that where possible, we normalise housing offers to people as much as possible. Some people will require round the clock care, and that should be catered for, but high support emergency accommodation is not a normal place for most people. Fractious behaviour in such an environment is exacerbated because there are people from 18 to 80 with a range of different complex needs all under the same roof. Discharge from hospitals to accommodation like this is not appropriate either. In some cases, there is no choice but people should be moved on as quickly as possible.

We work through the HSE's adult homeless integrated team which supports hostels in terms of psychiatric support through community psychiatric nurses, a consultant psychologist and so forth. This approach helps enormously in terms of allowing staff to manage some situations regarding people with complex needs. Part of the approach is training for staff. We must recognise the nature of the issues people present with and must train our staff to be able to assess risk so as to promote inclusion rather than exclusion. The better trained one's staff, the better able and more confident they will be in dealing with people with challenging issues.

The key to dealing with these people is to move them on as quickly as possible. However, the difficulty is that those with complex needs tend to be those who are hardest to house. All the more reason to try to get them housed as quickly as possible is the fact that they take up a disproportionate amount of bed nights in emergency shelters, which compounds the problem of rough sleeping and access to beds as a result.