Dr. Una Burns:

I agree that front-line staff, social care workers and social workers should be trained in trauma-informed care. It is a vital intervention to acknowledge the trauma faced by the people we work with and recognise that the consequence of that trauma is how they act. Their challenging behaviour is not specifically targeted at anybody and they are not trying to be difficult. It is actually a natural response to significant trauma they have experienced their whole life. It is often a protection element.

Novas is a trauma-care training organisation. All our staff from our CEO to our kitchen staff are trained in trauma-informed care. Anybody who has interaction received enhanced training to support people who have had significant trauma and who come into our services. We have done some single site research on this which has proved that it has significantly reduced the number of serious incidents in our services so that staff are able to de-escalate incidents more quickly and support people to get into safe space, which is really important. It would be really helpful if that trauma-informed care approach were broadened out to the ancillary services that homeless people access.

For example, if someone is going from residential services to addiction services, mental health services or, as Deputy Gould said, social welfare, the local council or accessing housing, it is really helpful if they get the same treatment across the board. What is helpful for the clients is empowering for the staff because it gives them a sense of ability to do the job in a better way to support people.

In tandem with that, we need practical responses to support people and prevent unnecessary deaths in homeless services. As Professor O'Sullivan said, more deaths are occurring in homeless services than on the streets. We need naloxone to be rolled out to all homeless services, including low-, high- and medium-threshold services, so that we can prevent more people from dying from overdoses.

Given the significant increase this year in the number of people in our services who were self-harming, who had suicidal ideation and who were attempting suicide, we had to implement ligature training among our staff. Our staff members and front-line workers have ligature knives in the small first aid kits around their necks that they carry everywhere. They have had to use them and have had to cut people down. We need a broad spectrum of supports and they need to go across private service providers and emergency service providers. I will come back to the point on addiction.

I will leave it there because I am conscious of the time. I am sorry because I seem to have missed the email to submit my paper in advance. In any event, Deputy Gould is absolutely right. We need more targeted interventions and supports for people who come out of addiction treatment centres. If they have worked hard to recover and then go back into low threshold emergency accommodation, the risk to sobriety is serious. There is no progression for them and the risk of overdose is really high because the tolerance of drugs will have diminished in that period. We need more targeted services for people. We need small, integrated services that are attached to the treatment service for people who come out of treatment. This can give them a sense of progression and a chance to maintain sobriety and exit homelessness.