Homelessness in Ireland: An Unhealthy State

Problem

The link between homelessness and poor health is well established. Homeless people have much worse physical health than the general population and are much more likely than the general population to suffer mental health conditions. A review of the literature demonstrates higher mortality and health risk taking behaviour among homeless populations compared to housed populations. Improving the health status and service usage of homeless people may lead to a reduction in their excessive suffering and may also help them to exit homelessness. Improvements in this area may also lead to a reduction in costs to the health services.

Approach

In late 2013 we assessed the health status, service utilization and risk behaviours of homeless people in two Irish cities Dublin and Limerick. We compared findings with two studies utilizing the same methodology but conducted at very different time periods with respect to national economic conditions: 1997 and 2005. The cross-sectional interviewer administered survey utilised the same design as the previous two studies. The quantitative data were analysed using SPSS version 20.

Findings

A total of 601 (64%) people staying in the targeted accommodations participated in the study. As with previous surveys the 2013 sample was mostly male (68%), Irish (84%) single (72%) and in receipt of social welfare payments (96%). Family and relationship problems (49%), drugs and alcohol addiction (38%) featured heavily as reasons for homelessness. Report of diagnosed illnesses increased significantly over the three surveys (68%, 84%, 90%; P<0.01). This increase as well as an increase in prescription medication (34%, 48%, 61%; P<0.01) is thought to be a result of increased access to diagnoses. Anxiety (39%) and depression (52%) diagnoses were commonly reported. Stark findings on report of attempted suicide (36%) sees a strong association between mental health diagnosis report of attempted suicide ( P<0.01). More than half (55%) the sample reported current drug use, with poly drug use as the default drug using style. Homelessness in Ireland is synonymous with a high burden of poor health and addiction. Addressing health in particular mental health and addiction problems is likely to remove barriers to exiting homelessness. Equally a move away from the homeless situation will improve health and wellbeing.

Consequences

The findings point towards the need for strengthening and supporting a coherent approach that facilitates easy access to health services for homeless people, where possible linking in to mainstream services, and ultimately linking health care solutions with appropriate housing solutions. The interagency approach adopted to undertake this research offers an excellent model of collaborative working in an area where factors leading to homelessness are multifaceted and complex, and where ready solutions are not easily found.