Dr. Una Burns:

I thank the committee for the invitation to join this meeting. We appreciate the opportunity to share the experiences of Novas clients. Since I last had the opportunity to present to this committee last year, the number of homeless people throughout the country has increased. The cessation of rent freezes and of the moratorium on evictions last May has contributed to a 9% increase in homeless figures. While the pandemic saw reductions in the number of families experiencing homelessness, it did not have the same positive impact on single people, who continue to spend protracted periods of time living in homeless accommodation.

Twelve months ago, I reported 13 deaths in our services during 2020 to this committee. In 2021, this figure was seven. This is most welcome news. However, the level of self-harm, suicidal ideation and suicide attempts among our clients is staggering, particularly among the women in our dedicated female services. Taking as an example the Abigail Women’s Centre in Dublin, from April 2021 to the end of January 2022, on 26 occasions our staff cut women down who had a cord or wire around their necks. This was in a period of just ten months and in just one of our services. Staff in our supported temporary accommodation, STA, service carry ligature knives in the small first-aid pouch around their necks at all times. While all staff in our STA services receive ligature training, the trauma of these experiences is unparalleled. It is fair to assume that the death rate among the homeless women we support would have been far higher in 2021 but for the interventions of our front-line staff.

Living in low-threshold, congregated accommodation is very difficult for people with complex needs relating to addiction and mental health who have experienced significant trauma in their lives. This is compounded by a number of issues. One of the them is the standard of accommodation in supported temporary services. We believe that everyone who lives in STA accommodation should have a single room as a minimum standard. We all agree that trauma informed practice is significant in supporting our clients and in delivering front-line services. It is something that Novas has pursued since 2016. However, if we expect people to live in dormitory style accommodation there is nothing trauma informed about this type of accommodation. It is very difficult for people with complex needs relating to addiction and mental health to share with strangers. When we lost the Abigail Women's Centre on a site in Finglas late last year we lost 40 single bedrooms. Now we have replaced them with 15 single bedrooms and the rest is shared accommodation. This makes it very difficult to support the most vulnerable people with the most complex needs who find it the most difficult to share rooms with others.

Another significant issue is the lack of dual diagnosis support for clients with addiction and mental health needs. They find it extremely difficult to access mainstream supports, as one issue blocks their ability to access treatment and support for the other. All the while their health and well-being deteriorate and their addiction becomes more entrenched, limiting their exit pathways from homelessness. Access to dual diagnosis support for homeless people has been long raised as an issue and considering the level of self-harm, suicide attempts and overdose among our clients, it is more pertinent now than ever.

Lack of appropriate move-on accommodation is stifling single people's ability to move from supported temporary accommodation. In terms of women, more gender specific move-on options, such as supported long-term accommodation, are essential. While we broadly welcome the new targets for Housing First, the figures are modest. For example, in the mid-west region, which has the largest homeless population per capitaoutside Dublin, just 52 clients will access a Housing First tenancy up to 2026. This precludes hundreds of homeless people from availing of the programme and also reduces the ability to deliver the programme on scale, to ensure it is economically viable to provide all the wrap-around supports to Housing First clients as per the model, including access to alternative accommodation should the first tenancy break down. As a final point relating to long-term housing options, HAP limits are too low and many of our clients are not even put forward for available accommodation by the Place Finder service, as the top-up to the landlords is so high it is unsustainable from the outset.

My final point relating to the difficulties and challenges facing our clients is reunification with their children. Many of the clients we work with are seeking to reunify with their children upon exiting homelessness, but this is an extraordinary challenge for them. For example, if a client does not have the primary care of his or her children, he or she is not entitled to more than a one-bedroom unit of accommodation on the social housing waiting list and, therefore, social workers cannot recommend reunification of a parent with his or her child. More discretion is required in the type of properties single people with children are entitled to. Reunification can be the overriding motive for the women who live in our services to recover from addiction and homelessness. Currently, it is incredibly rare for homeless women whose children are in care to regain access, despite their immense efforts.

I am conscious that much of what I presented here today is a repetition of my presentation to the committee a year ago. However, it is worth repeating. The trauma experienced by our clients and the vicarious trauma of our staff need to be understood. The epidemic in self-harm, physiological distress and suicide attempts among our client group in low-threshold services must be acknowledged, and the things we can change to improve matters must be changed.