Oireachtas Joint and Select Committees

Wednesday, 5 July 2017

Joint Oireachtas Committee on Health

Link between Homelessness and Health: Discussion

9:00 am

Ms Niamh Randall:

I will just fly through some of the comments and queries. I absolutely concur with Deputy Murphy O'Mahony in respect of overcrowding and hidden homelessness. CSO figures will support that. We know there is a huge underbelly there. People often make temporary arrangements, which can break down. It is very stressful and a huge strain and these people may end up trickling into homelessness. If they do not, there is still a huge group of people living together, possibly in overcrowded conditions, in a setting which is not necessarily appropriate. As yet we do not have any measure of that problem. In other countries, such as Canada, there is a mechanism which attempts to count cases of hidden homelessness. We will be linking in with the CSO on that issue at the time of the next census to see if it might be possible to get some sense of the scale of that issue. It is a bit of a challenge, absolutely.

Deputy Durkan, who is not present, is absolutely correct that the response is housing, but it is housing and support. We do not emphasise the support element enough. It is about responding effectively to the issues people have to ensure they can maintain their tenancies and their housing. It is really important to include the support element. On the query about youth homelessness and the response to it, we recently published a report authored by Dr. Paula Mayock of Trinity College with a number of other homeless organisations. It is titled "Living in Limbo" and looks at youth homelessness. I am very happy to share that report and some of its recommendations with the committee if that would be considered useful.

On Deputy O'Connell's comments on the bespoke, tailored response to dealing with drug-related issues, we absolutely must have that tailored response to each individual. It is the only way we can deal with it effectively. In terms of responding effectively, prevention is the key element. It is prevention and early intervention and then it has to be rapid rehousing using a Housing First model. That is the only way we are going to effectively deal with this particular issue.

We spoke about children and the damage being done. The real danger is not only that we are working with people who are experiencing poverty but that there will be a poverty of expectation and aspiration for the future and a sense of fatalism among those who are growing up in such a challenging and limited situation. We really need to intervene as quickly as we can.

In terms of responding to rural homelessness, this issue is really complex to deal with in an urban setting where there is a greater range of services. Once we move out of an urban setting, it is really challenging. Either the services do not exist or they are really spread out and people have to travel great distances to access them. Again, we have published a paper on rural homelessness which we can share with the committee. It outlines some of the challenges and some of our recommendations for dealing with the issue. In terms of a response, it is about building houses or renovating vacant home. Vacant homes being renovated need to be those which are near services, supports and infrastructure because, critically, people need to be able to access those particular services.

In terms of the query about whether Ireland is unique and about similar experiences in other countries, we are quite similar to other countries in western Europe. Growing levels of homelessness are seen across most other European countries, including the UK, at this point in time. Regarding how things are done differently, quite progressive harm reduction and drug services responses are seen, particularly in Copenhagen where there is a very successful approach to naloxone treatment, a number of drug consumption rooms and a range of other things. There has been quite a successful approach using a housing-led model in Finland. There has been very strong local and national political and financial commitment to that model. It has been the most effective country in Europe in respect of addressing homelessness to this point in time. They are currently highlighted as quite a successful model of intervention on that issue.

There was a query about service fragmentation. There is a challenge in terms of intersectoral, inter-agency and interdepartmental working. It seems to be an ongoing challenge. Sometimes it depends on relationships to a great degree and if someone changes job or role, that relationship can then break down. We certainly need to have a stronger push in terms of guidelines and commitments to ensure that actually happens to ensure that we address people's issues effectively.

There was query in respect of Housing First in Usher's Island. I will refer that query to Ms Darcy for a response.