Sorca Clarke (Longford-Westmeath, Sinn Fein)
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758. To ask the Minister for Health the specific measures being taken to improve access to trauma-informed mental health care for individuals who are experiencing homelessness, particularly outside of major cities such as Dublin; and if she will make a statement on the matter. [33624/25]

Mary Butler (Waterford, Fianna Fail)
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It is a key priority of government to develop and delivery recovery-focused, trauma-informed mental health services and supports for the whole population, and with a focus on the needs of the individual and those of priority groups, including people who are homeless.

Ireland's national mental health policy, Sharing the Vision: A mental health policy for everyone (2020-2030), details trauma-informed service delivery as one of four key service delivery principles of: recovery, trauma-informed, human rights and valuing & learning.

The Policy and the latest Implementation Plan 2025-2027 details trauma-informed service delivery as:

• Everyone at all levels of the mental health services and wider mental health provision has a basic understanding of trauma and how it can affect families, groups, organisations, communities and individuals. People delivering services recognise the signs of trauma, which may be gender-, age-, or setting-specific.

• Services respond by applying the principles of a trauma-informed care. Staff in every part of the organisation change their language, behaviour and policies to take into consideration the experiences of those who have trauma histories, including staff members themselves.

• A trauma-informed approach resists traumatising or re-traumatising service users and staff. Staff are taught to recognise how organisational practices may trigger painful memories for service users with trauma histories. Applying a trauma-informed approach does not mean that everyone with a mental health difficulty or everyone using mental health services has experienced trauma. It simply means that the service system needs to be aware of and respond to the presence of trauma in people who may be using a wide variety of supports.

The HSE’s Office of Mental Health Engagement and Recovery are currently developing a guidance document ‘Towards Trauma Informed Practice: A Guidance Document for Irish Mental Health Services’ which will provide a knowledge base to support the implementation of trauma aware services across mental health services. It is envisaged that this work should in future encompass all health services, and not just mental health services.

Sharing the Vision (StV) recognises the need for a whole-of-population, whole-of-government approach to the delivery of mental health services. It builds on the achievements of A Vision for Change, with a focus on a wider, cross-sectoral service provision appropriate to whole population needs. StV contains 100 specific recommendations of varying complexity and timeframes.

In line with Sláintecare, the policy aims to provide “the right care in the right place at the right time”. Sharing the Vision aims to enhance the provision of mental health services and supports across a broad continuum, from mental health promotion, prevention, and early intervention to acute and specialist mental health service delivery, during the period 2020-2030.

The prevalence of mental health difficulties and issues regarding access to services for people experiencing homelessness are well documented. Sharing the Vision contains two recommendations that seek to address the needs of people experiencing homelessness. Recommendations 58 and 59 are under the remit of the Mental Health Services Workstream. A mapping exercise is currently being undertaken for recommendations 58 and 59 to map the existing level of mental health supports and services across the country, e.g., where they are located, what is the nature of the support/service offered etc. This is being carried out via two surveys; one targeting specific mental health supports and services often provided or funded via regional HSE Social Inclusion functions and a second survey examining how general adult mental health services engage and work with service users experiencing homelessness. Initial findings indicate substantial regional variety and a diverse and uneven range of services of services available around mental health support for people experiencing homelessness. These include:

• Specialist mental health teams for people experiencing homelessness: There are two teams in the Dublin area that provide dedicated community mental health support to people experiencing homelessness.

• Inclusion Mental Health team: Based out of St. James Hospital, providing mental health supports (including outreach) to people experiencing homelessness.

• Adult Homeless Integrated Team: Cork based service that takes an integrated approach. Includes a Community Nurse, GP, Community Psychiatric Nurse, Consultant Psychiatrist, Clinical Psychologist, Counsellors and Addiction Counsellors.

• Safety Net: Primary care service for people experiencing homelessness as well as other vulnerable group in Dublin area. Includes in-reach and outreach services

• Other regional variations: Some areas have dedicated GP and mental health nursing supports.

• Housing First: Housing First (HF) is a recovery-focused, evidence-based approach to ending homelessness. It provides housing as a basic human right, without requiring preconditions such as sobriety or readiness. This approach supports individuals with long-term homelessness and complex health needs, including mental health.

• Counselling: Dublin Simon Community provides a Sure Steps counselling services part funded by NOSP and the HSE.

• General adult community mental health teams: In some areas, particularly outside larger urban centres, the general adult services provide mental health care to people experiencing services. These teams are currently being surveyed regarding their experience in this regard.

• De Paul Ireland

De Paul Ireland provides services to individuals experiencing homelessness or at risk of homelessness across Ireland (North and South). They offer a range of support including emergency accommodation, longer-term housing solutions, and various support services aimed at helping people rebuild their lives. De Paul Ireland partners with various mental health services to ensure that individuals experiencing homelessness receive the professional support they need.

In March 2025 DePaul launched Headstrong, De Paul’s framework for delivering Mental Health supports across the De Paul services.

De Paul receives funding from the HSE to support the delivery of the following services:

NFMHS - 4 Services

Dublin - 11 Services (8 w/ DRHE & 4 HSE alone)

Cork - 2 Services w/ Cork City Council

SE - Waterford, Wexford, Carlow w/ Local Authorities

Midlands - Longford w/ Local Authority

HHPA - Dublin & Cork

• ACCES team is a homeless mental health team set up in 2004. ACCES stands for Assertive Community Care Evaluation Services. The aim is to support patients’ mental health and advocate for housing.

The Department of Health and HSE are working closely with other Departments, including the Department of Housing, to ensure that wrap-around services and supports - including mental health supports - are available for people who are homeless. It remains a key priority for government to deliver improvements, enhancements and needed reforms to the state's health offering for people who are homeless, aligned with our national mental health policies and strategies.