Health & Homelessness Health Snapshot Study of People using Simon Projects and Services in Ireland
There are many different reasons why a person becomes homeless, but generally the explanation lies in a combination of structural factors (such as poverty or unemployment) and personal factors (such as family breakdown or health problems). What is clear is that once a person becomes homeless, the deterioration in their physical and mental health can be both rapid and debilitating.
In Ireland there is a lack of specific information about the health of homeless people. This Health Snapshot Study attempts to address this deficit in relation to some of the people who use Simon services around the country. 2011 was the second year the Simon Communities have undertook this exercise at a National level. The 2011 Study builds on previous work and has incorporated much of the learning to date. It explores health status, both physical and mental health; drug and alcohol use and the health implications; and access to medical services amongst other issues. Understanding the health needs of people who become homeless is critical to developing, designing and improving, not only homeless services, but also health and other related services.
|Physical Health at least one diagnosed physical health condition 65%
|Mental Health at least one diagnosed mental health condition 47%
|At least one diagnosed physical health condition AND one diagnosed mental health condition 46%
|Intellectual disability 12%
|Alcohol use 50%
|Drug use 31%
|Attempted suicide (last six months) 17%
|Self harm 19%
What this study demonstrates
This Study demonstrates the many health and related needs experienced amongst people using Simon services around the country, in short people who are very sick and very vulnerable. 603 people who use Simon projects and services all around the country participated in this study, 75% of participants were male and 25% of them were female. The average age was 43 years.
Long term homelessness remains high
Long term homelessness which according to the government is more than 6 months was high in this study with 83% of people reporting being homeless for more than 6 months. Of these, 54% reported being homeless for more than 3 years and 39% reported being homeless for 5 years or more. This Study indicates that physical and mental health conditions deteriorate the longer a person is homeless with the numbers of conditions increasing amongst those who reported being homeless for more than 1 year, and highest levels amongst those who were homeless for 5 years or more.
Homelessness and many related needs
This study demonstrates the many related needs experienced amongst people using Simon services around the country; with 65% of people experiencing at least one diagnosed physical health condition, 47% experiencing at least one diagnosed mental health condition, and 46% of people experiencing a combination of one or more diagnosed physical and mental health condition. In addition, people reported alcohol use (50%), drug use (31%), self harm (19%) and attempted suicide in the last six months (17%). In addition, 12% of participants reported an intellectual disability.
Homelessness is about health as well as housing
Homelessness is not just about housing; health is a significant factor and needs to be addressed in tandem with housing. Access to appropriate healthcare is critical to ensure that people remain as healthy as possible and that they get the supports that they need. To support people to move out of homelessness accommodation must be provided with appropriate housing, health and social care support based on need and also high support housing for those who need more intensive, ongoing support.
What is needed
Availability of appropriate housing
It is widely acknowledged that access to housing is a major block delaying the implementation of the Homeless Strategy. It is critical that social housing provision is reprioritised to keep pace with increasing demands and pressures. We welcome commitments to increase the supply of permanent new social housing contained in the Housing Policy Statement (June 2011). In addition, we welcome the ‘Housing First’ approach which is endorsed in the Programme for Government 2011 and reiterated in the above Statement. This ‘Housing First’ approach will work for some once the necessary supports are provided simultaneously. However, such an approach will not work for all people who are homeless therefore a range of appropriate housing options must be provided through local authorities, voluntary housing, private rented accommodation, the Rental Accommodation Scheme and the leasing scheme. A portion of the CAS Special Needs funding needs to be ringfenced for housing for people with high support needs.
Housing with supports and high support housing
To tackle long term homelessness and to support people to move out of homelessness the provision of accommodation with appropriate housing support and health and social care support based on need is critical. In addition, high support housing for those who need more intensive, ongoing support must also be an option. The provision of both housing with supports and high support housing works and is working in Simon Communities all around the country.
Access to both mainstream and specialist services
Specialist services working in conjunction with mainstream services are effective when working with people who are homeless supporting them to manage and overcome their combination of health problems. Existing specialist services must be maintained and they must be developed in areas where they are required. Integrated approaches ensure people have access to the most appropriate healthcare, including mental health services and support therefore improving diagnosis, interventions and outcomes.
Expansion of alcohol and drugs services
Alcohol and drug services must be expanded including harm reduction, access to substitution treatment, detoxification, rehabilitation and aftercare all- around the country. These should be tailored and targeted to the needs of people who are homeless with alcohol and/or drug related problems,irrespective of location. The imminent Substance Misuse Strategy must include specific actions in relation to people who are homeless (Simon actively engaged in consultation processes on the development of same). In addition, it is timely to undertake research looking at drug and alcohol use amongst the homeless population. We recommend that the National Advisory Committee on Drugs (NACD) study (2005) is repeated and recommendations implemented as a matter of urgency.
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