Ms Louise Loughlin:

Deputy Ellis is correct on housing. Some 40% of our casework involves housing in some shape or fashion. When we talk about housing, we include people living community group homes or who are quite often stuck in group settings, whether mental health settings or a more general hospital ward; people living with family members, even though they want to live independently; and people who are waiting allocation of housing because they may have acquired a disability, so it might be very difficult for them to find appropriate housing, and that can extend to younger people under 65 living in nursing homes, of whom we have a large cohort in Ireland.

An issue that come up for us is that people may be offered social housing but it often does not meet their needs in terms of accessibility in that it has not actually been designed properly. It might be standard local authority-type housing. The cost and the necessity of making it fit for their needs is not always met. With the huge pressure on housing at the moment, that is exacerbated further.

The other piece Deputy Ellis mentioned was the number of people still living in group homes and that is absolutely true. We have a very good Government policy, Transforming Lives, which I think must be ten years old and yet the delivery of that is still very slow. There are still several thousand people living in community group homes and, as the Deputy said, they were not given an option or were not involved in the decision-making as to how they ended up living there in the first instance or whether or not they wish to continue living there. There are huge issues around Ireland's compliance with the UNCRPD around autonomy and decision-making. Even when we have the commencement of the Assisted Decision-Making (Capacity) Act and when we have the reform of the Mental Health Act, it is unlikely that will be addressed because it is about the delivery rather than the legislation itself.

Deputy Ellis also mentioned employment. To secure a job and feel good about getting up and going to work in the morning, one has to feel safe, secure and happy in one's environment. It is very difficult to do that. When one joins the dots between people living in the types of settings we just described or still living in homelessness, being able to secure employment is really challenging. The other thing to note is the levels of discrimination that people still face. A lot of surveys have been done on people's attitudes towards disability and about having someone with a mental health working alongside them. There is still a lot of stigma associated with it.

We have more to do. We have a lot of talk about mental health but it can be a bit fluffy at times in society at large. We talk about mental health but when one really gets down to people with enduring psychosocial mental health conditions and the supports they need, that is where I would like to see the focus. If we really put the structures in place both in terms of policy and legislation but also in how we design services, we would see more people able to take up employment.

Another point is that many people with multiple diagnoses can also end up in addiction because they are not getting the requisite supports. They can often also fall into homelessness. Particularly in Dublin, we know our homelessness services are not designed to support people with those additional issues. They are just not set up for the complexity of having, for example, an intellectual disability, an enduring mental health condition and an addiction issue. They are under too much pressure. There is a lot of work to do.