Dr. Austin O'Carroll:

I will share the slides with members and speak quickly so that I can get through them. I thank the committee for the invitation to speak today. I will summarise the report to outline the main findings and highlight what I think are the main issues.

First, the report is an interim report because I could not get access to all the data. The data from the coroner and the CSO will not be available until next year. There should be a complete report next year.

It is important to highlight what we already know from the literature on homelessness. Internationally, we know that people who experience homelessness die younger than they should. The reason for this is that among people experiencing homelessness, there are high rates of physical and mental illness, suicidality, substance misuse and accidental and violent death. There is also the influence of poverty. Poverty is associated with a lower life expectancy, as is childhood adversity. We know that people who are experiencing homelessness tend to come from poverty and have high rates of childhood adversity, as well as being affected by all the other issues.

We already know that there are interventions that can reduce mortality such as providing a multiagency response and improved access to primary care. The two big preventable causes of death in homelessness are suicidality and overdose deaths. There are interventions that help reduce those two particular causes of death.

I was asked to review 2020, specifically. There were 79 deaths in 2020. However, we reduced that figure down. I need to explain why, because it is important for people to understand. First, of the 79 deaths, four were not known to the DRHE, so those people had not accessed their services and were not technically DRHE service users so were excluded. Second, the DRHE reports on deaths that occur in tenancies that it funds. People in tenancies are not homeless people, so we excluded the deaths of people in tenancies such as Housing First tenancies or supported tenancies. Third, long-term accommodation tends to house people who are older and very unwell. These people are not counted by the census as being in homeless accommodation because, in a sense, they are almost in the nursing homes of the homeless sector. As they are not counted by the census as homeless, we excluded the number of deaths in that group from the figures. I have reported on those deaths separately, because they do come under the DRHE. Lastly, in 2020 only one death occurred in family homelessness. Looking over the past five years, very few deaths have occurred in family homelessness. By including the deaths in family homelessness and the numbers, and the numbers of homeless families are very high, you are artificially deflating the mortality rate. The mortality rate among those in family homelessness is very low. We excluded that figure because it was diverting attention away from where the real issue is, which is among single homeless people. In the end, we were left with 47 deaths in 2020 among people who were experiencing homelessness, of whom 44 were in emergency and three were rough sleepers.

Looking at the deaths, there does seem to have been an apparent significant increase in deaths in 2020.

Sorry, did the slide disappear?