Dan Neville (Limerick, Fine Gael) | Oireachtas source

I welcome the opportunity to contribute to the debate. I want to deal with the area to which the Taoiseach referred yesterday, namely, the rough sleepers on the streets. There are different types of homelessness. I would like to give special recognition to the Simon Community for the work it does. I know of the work it has been doing in Limerick, Clare and north Tipperary for decades with people who are sleeping on the streets.

The Simon Community did a survey in 2011 of people who use its services. It explored physical and mental health status, drug and alcohol use, health implications and access to medical services among other issues. Some of its key findings were as follows: 65% of those who were rough sleepers had one diagnosis of a physical health condition; 47% had at least one diagnosis of a mental health condition - that is, approximately half of the people; 46% had at least one diagnosis of a physical and one diagnosis of a mental health condition; 12% had an intellectual disability; 50% had alcohol abuse issues; 31% had drug abuse issues; 7% had attempted suicide in the previous six months; 19% had self harmed; and 55% had used an accident and emergency department in the period prior to the survey. That gives an indication of the experience of people on the streets. It is not just sleeping day-to-day. There are a lot of difficulties. The study demonstrates the many health and related needs of those using the Simon Community's services. People who are very sick and very vulnerable - 603 people who had used Simon projects around the country - participated in the study.

We should recognise the difference between the broad homeless, whose situation it is crucial we discuss and deal with, and the particular difficulty of those on the streets. The study referred to the number having mental health difficulties. Having a mental health problem can put people at risk of homelessness for various reasons. After discharge from hospital, they are at risk of homelessness for various reasons. Without proper mental health support after discharge from hospital, a homeless person may fall out of treatment and end up relapsing. In other words, a person coming out from a mental health institution requires very careful treatment, often supervised by carers and family. How can a person on the street have that level of service? There is mistrust there.

There is often dissatisfaction with an overly medicated treatment regime that can put people off seeking assistance and support, leaving them to struggle alone. There are more barriers to accessing mental health treatment for those with addiction until the addiction has finally been brought under control, which puts those people in a catch-22. They are told that before their mental illness can be treated in an institution, they must overcome their alcohol problem, but alcohol is a disease in itself that requires treatment. Often they are told that they cannot get the treatment they need because of their alcohol problem.

Being homeless puts people at risk of developing mental health problems. I have dealt with those who can become homeless because of a mental health issue, but being homeless puts people at risk of mental distress. It exposes people to the risk of trauma, violence, low self-esteem and serious difficulties because of the chaotic lifestyle on the streets, and this makes it difficult for them to access mental health services in a crisis.

Homeless services too often are unable to get mental health support for clients in crisis and are forced to turn to busy hospital emergency departments where the individual in distress often cannot afford to wait the many hours it might take to get help. Somebody coming off the streets who is in extreme distress and is seriously agitated because of their mental health now must wait for hours to get the service. They are more likely to leave and not wait for the service.

According to a good piece of US research, people with mental health difficulties are seen in greater numbers among the prison population. Many among the prison population suffer from mental ill health and difficulties and many of them have intellectual difficulties as well. This group is not for debate in this motion but it is linked to the difficulties people with homelessness experience.

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