Eoin Ó Broin (Dublin Mid West, Sinn Fein) | Oireachtas source

I thank the Minister of State, Deputy Smyth, who has stepped in at the last minute because the Minister of State, Deputy Burke, is detained elsewhere.

In 2019 and 2020 there was a significant increase in the number of media reports of tragic and premature deaths of people experiencing homelessness. As there is no count or record of such deaths, it was not clear whether those deaths represented an increase but, given the significant number of deaths, this House called on the then Minister at the time to commission a report to establish the extent to which this problem was growing, but also to try to understand the reasons for these premature deaths in order to try to ensure that, in future, the numbers would reduce, if not eventually be eradicated.

At the request of the then Minister, the Dublin Region Homelessness Executive commissioned an interim report on mortality among the single homeless population. Dr. Austin O'Carroll, who is one of the leaders in the field in terms of providing front-line supports to this cohort of very vulnerable men and women through his general practitioner, GP, practice in north inner city Dublin, produced the report. I have it before me. It is an important piece of work. I say this with no disrespect to anybody in the House, but we are talking about a group of people who, for the most part, the system does not care about. We need to be honest about that. These are single people, many of whom have severe levels of addiction, often interspersed with severe levels of mental ill-health. A significant number of them come from backgrounds of extreme poverty. That cycle of poverty, addiction, mental ill-health and homelessness has meant that, if we are brutally honest, they are at the very bottom of the list of political priorities for most people.

The publication of the report was groundbreaking because it acknowledged that although there were insufficient data to reach definitive conclusions, the age at which those in this group of people die is frighteningly young.

The deaths that have been occurring are, in many cases, eminently preventable if only we would learn from the mistakes of the past and improve the supports for this group of people into the future.

The report, I understand, created some considerable tensions between the Department of Housing, Local Government and Heritage, the Dublin Region Homeless Executive, DRHE, and the HSE, which led to it being downgraded to an interim report and a promise of a HSE-funded longer-term study that has never materialised and I am not even sure if it is being produced. That speaks volumes in itself.

There are very important recommendations in Dr. O'Carroll's report, such as, for example, an increase in trauma-informed care to ensure adequate supports for this very vulnerable group of people in great need and a far greater provision of appropriate step-down and move-on accommodation. It also crucially recommended that critical incident reports, or what some people call adult safeguarding reviews which look back at the circumstances that led to such untimely and premature deaths, are also carried out. This is not to apportion blame but to learn what failed in the systems to try to ensure that these types of deaths were reduced and, potentially, eradicated in the future.

Central to Dr. O'Carroll's report was a need for greater multidisciplinary interagency working. Very often the deaths that take place are in the transition of an individual from healthcare, to mental health care, to homeless services, and in those gaps, when there is a handover, the lack of properly co-ordinated and integrated interagency care led to crises and ultimately to deaths.

What provoked me to table this request was that at the very start of this week, as I am sure Members will know, there was yet another tragic death of a young man who died in a tent in the north inner city of Dublin. We still do not know the reasons for that individual's death but, like so many others, he died far too young. I want to express my condolences to his family and to his friends but let us take this opportunity to ask what we can do to tackle the causes of these premature deaths to try to ensure that they are reduced and, ultimately, eradicated into the future.

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