Mr. Dermot Kavanagh:

I will talk a little about rough sleeping and long-term homelessness and the link between them.

Emergency accommodation is not a solution to homelessness. As Mr. Griffin pointed out, the response to the crisis of rough sleeping has involved the provision of a lot of extra shelter beds, often dormitory beds. As a strategy, this does not address homelessness. In the long run, it leads to institutionalisation and dependency and, over time, the solution itself becomes the problem. In terms of a solution that works, I am sure the committee has heard a lot about the concept of Housing First. This means housing people without preconditions or expectations of them being "housing-ready". People are put into housing and support is provided, including clinical and housing support as well as support towards community reintegration.

On the problem of long-term homelessness, it is interesting to look at recent analysis of shelter usage in both Cork and Dublin. Dr. Bernie O'Donoghue Hynes of the Dublin Region Homeless Executive presented a paper some months back entitled Patterns of Homeless Emergency Accommodation Use in Dublin. Her findings, which were consistent with international findings from the United States, Denmark, Canada and other places, suggest that the vast majority of emergency shelter bed nights are accounted for by people who are either long-term or episodically homeless. According to these analyses, homeless people can be divided into three groups: those who are homeless in the short term and have few episodes of homelessness; those who are homeless repeatedly and have a number of episodes of homelessness; and those who are long-term homeless and are in the shelter system long term. Dr. O'Donoghue Hynes found that between 2012 and 2014, 7,254 people used emergency accommodation in Dublin, of whom 13% or 924 people were long-stay shelter residents. They accounted for 52% of the emergency bed nights during the period. When Cork Simon looked at the data for our emergency shelter, we made remarkably similar findings. The proportion of people in 2015 who met the Government's definition of long-term homeless was 12%, and that group accounted for 51% of the shelter bed nights last year.

These statistics clearly suggest that a strong focus on housing people who are long-term homeless will have the greatest effect on freeing up emergency bed nights, thereby eliminating rough sleeping. The Cork Simon emergency shelter has 44 beds. On average, we have 50 people in per night and, on any given night, 25 of those meet the Government's definition of long-term homeless. Over the course of last year, 48 people in total met that definition. There are roughly 18,000 bed nights a year in the Cork Simon shelter. If we were to house those 48 people and provide support in housing them, we would free up 9,000 bed nights - an average of 25 beds per night. We have nine people sleeping rough in the city. We could go back to our official number of 44 in the shelter and have some spare room. What holds true for Cork on the micro-level holds true for Dublin as well. While getting the housing supply is crucial, targeting it at those who are long-term homeless is equally crucial. It provides the greatest impact in addressing the crisis of long-term homelessness and also the rough sleeping crisis itself. That is a core point for the committee.

Those who are long-term homeless tend, on average, to have more complex issues than those who are homeless in the short term. Very often we will be dealing with challenging issues relating to health, mental health, addiction and so on. There is a long list of well-documented international studies showing that the best way to address the housing needs and overall health needs of people with those issues is to provide housing first, and then to provide support in respect of those issues in the housing. We have been running a programme like that in Cork Simon, as have some of the other Simon communities around the country. They are very successful. We housed 34 people in 2013 and have tracked them each year.

By the end of 2015, 85% remained housed. This shows that this intervention can deal effectively with long-term homelessness and rough sleeping.

There is a challenge here in that there is a great deal of talk about homelessness funding, which is crucial, but much of the focus is on funding from the Department of the Environment, Community and Local Government. If we had the supply of houses tomorrow and took measures to ensure it was prioritised in respect of those who, as Ms Randall said, are long-term homeless - with 100% of allocations - and moved people into homes, we would need more than just housing support. We would also need clinical support and support in respect of mental health and addiction issues. There have been major cutbacks in those areas in previous years. The HSE will have to put the funding in place to ensure that this strategy will work. It could certainly have a huge impact.