Homeless deaths can be reduced through risk analysis, committee told

In 2020, 79 homeless people died across the state.

Risk analysis must be carried out to tackle further deaths in homelessness, an Oireachtas Committee has heard.

The Housing Committee was discussing the Interim Report on Mortality in the Single Homeless Population 2020, by Dr Austin O'Carroll who called on all agencies involved with the homeless population to work together in order to learn from deaths among the homeless.

In 2020, 79 homeless people died across the state.

Eight people died outdoors, of those seven were listed as "single homeless", four of which had their own emergency accommodation in the months prior to their death, and three were regular rough sleepers.

"What happens particularly with homeless deaths, you get an outburst to the media, and you get people returning to a defensive position but the critical risk analysis is where you basically say to people; This is not about blame,'" Dr O'Carroll said.

"It's about learning and improving services, and there are processes already, the HSE would have similar processes for critical incident analysis as part of the quality and safety element of the HSE, so it has to be just a question of applying those systems."

Early childhood intervention

Dr O'Carroll called for early childhood intervention for those living in poverty in order to avoid further mortality in the future but says enough is not being done to learn from homeless deaths now.

"The main determinants of early death and people experiencing homelessness are structural causes related to poverty, causing the lower life expectancy, and poverty is also associated with drug addiction and drug addiction is one of the main determinants of death, is probably the main determinants of early death due to overdose and spread of blood-borne virus infections, as well as other causes," Dr O'Carroll said.

"The effects of poverty, in terms of addiction is higher, higher illness and higher mental health are the main causes of early death."

He called on the State to gather information on deaths in homelessness to monitor the situation long-term.

"We should gather information like this on death every three to five years," he said.

"There are interventions to reduce overdoses that we know of, we just need to expand such as supervised injection centres, so just make sure they happen.

"Also increased support in private emergency accommodation in terms of health supports.

"Another would be the mental health team for dual diagnosis, which we've been asking for for a long time and the last one is the critical incident analysis that we can start learning from individual deaths."

Mortality rates

Dr Austin O'Carroll also looked at the mortality of private emergency accommodation (PA) versus state temporary accommodation (STA) and the mortality rate in state facilities' is higher.

"This would be expected because the Dublin Region Homeless Executive tends to put people who are sicker in STA, because there are higher medical and social supports," he added.

"However, you can see that the mortality rate in PA is becoming close to that of STAs and that's important in terms of recommendations."

Ireland is on the "lower-end" of the scale for homeless deaths internationally, the committee also heard.