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Dáil
‹ Leaders' Questions

Homelessness and addiction services

Summary

Maureen O’Sullivan seeks supported, drug-free accommodation and adequate staffing for homeless people recovering from addiction. The Tánaiste supports moving people who become drug-free into homes, while a heated exchange highlights a recovering addict unable to secure accommodation because of rent-support limits.

We know there is a relationship between homelessness and addiction.

Organisations working with people in Dublin say that as many as 72% of those who are homeless are so because of their addiction. We know that the exit from homelessness for them is through tackling the addiction, engaging with services, and having housing plans, care plans and treatment, whether on a residential or day care basis. When discussing this before Christmas, I stressed the need to commit to supported drug-free accommodation for those in recovery in order that they would not have to mix with those who are actively using. One such facility not far from here was described by the 18 persons in recovery there as having been a rock of stability, but because of pressure to take homeless persons off the street, which is very important, there has been a reconfiguration and that accommodation is no longer drug free. The changing of the culture to a mixed one has undermined the recovery journey of those in the facility, especially those who are at the early stages of recovery.

I take no pleasure in saying that what has happened has been disastrous. As a result of that reconfiguration, there is now widespread heroin use. There is dealing and chaotic behaviour. There are multiple relapses. There has been at least one serious overdose and there are debt issues as well. In spite of all of these warnings being brought to the attention of Ministers, Dublin City Council and the HSE, in spite of findings from a report on homelessness and addiction and in spite of recommendations from the users' forum, this went ahead. I consider that a serious breach of duty of care to those in recovery. Were risk assessments done and were there contingency plans in the event of this going wrong? I ask for a firm commitment to the principle of separate accommodation for those in recovery who are drug free and those who are actively using or - the term they now use - "stable", which still means those who are actively using. I also ask that the few who remained on their recovery journey are given proper accommodation in order that they can remain on that recovery journey.

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The object of the action plan to address homelessness, which was launched before Christmas, is to end involuntary long-term homelessness before the end of 2016. In the action plan, which was introduced over the Christmas period, a very large number of additional beds were provided. Up to the Christmas period and the end of December, not all of the beds were taken up and used. Subsequently, as we came into January, the beds were used. From my own conversations with the many I know who work in this area, the initiatives, such as the night café, the bus and the transport supports, seem to have helped significantly those who, unfortunately, are out of home and on the streets.

Deputy O'Sullivan correctly identifies drug addiction and substance abuse issues as being at the heart of many of the difficulties with which those in that unfortunate position must contend. I do not know if the Deputy named the institution. I am not aware of exactly where she is referring to, but if she would give me the detail, I will undertake to have a look at the situation.

The Deputy has raised an important point, and it is a very difficult point for those dealing with both homelessness issues and addiction issues. Different organisations in this city and the country have different approaches. For instance, in the Coolmine centre in my constituency and in town where it also supports various facilities, no doubt the approach is for addicts to become substance free and then to enter into an intensive programme of therapy and rehabilitation. There are also other approaches which involve addicts being on a controlled intake, most frequently of methadone. In the context of not knowing exactly the location or the institution of which the Deputy speaks - I would be happy to talk to her about it in private - I am not quite sure what the situation is. However, for quite a lot of homeless persons, having others, some of whom may exhibit difficult behaviour and may have mental health issues, come into their space in a situation where, with difficulty, they are addressing their issues is certainly a difficult issue to address. I understood that the different organisations, under their different remits and mandates, were approaching it in line with their particular philosophies. If Deputy O'Sullivan believes that some group has been impacted on in a negative way by that, I would be happy to ask the organisations and the Departments perhaps to have discussions around it.

On Monday last I visited one of the community employment schemes which assists persons. There are 1,000 ring-fenced community employment places in the Department of Social Protection with which we support, throughout the country but particularly in the larger cities and towns, those who have substance abuse difficulties and who are rehabilitating. Some of those places are entirely drug free. Others have a different policy, for instance, to allow for methadone maintenance along with treatment. It is a very important issue and I thank the Deputy for raising it.

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One of the issues in respect of what the Tánaiste said relates to staffing. There has to be properly trained and adequate staffing in these places which are taking in homeless persons who also have addiction issues.

I refer to a couple of points made by somebody who was living in that hostel. He was a heroin addict for a long time and 15 years on methadone. However, two years ago, because of going into a treatment centre, he became drug free, and for the past 20 months he has been alcohol and drug free and living in this hostel. He makes the point that the past month, when all of this reconfiguration was being discussed, has been the most difficult and challenging. He states that the change has left many at great risk and that the timing of the changeover was disastrous, given that it was at Christmas which alone presents a high rate of relapse. His great fear is for his fellow addicts in the house, that someone will lose his or her life through relapse. He states that he has been through many services in his time and has learnt what works and does not work, and the house where he resides is a perfect example of what does not work. He attends 12-step meetings which tell him to avoid persons, places and things connected to drug use, and that has been impossible to do with the reconfiguration that has taken place.

We accept that there are different models for recovery. Harm reduction has a place. Giving the homeless a bed has a place, but they have to be fearless going into a place to take up that bed. However, the harm reduction model cannot be at the expense of the recovery model. I ask that the recovery model is what we aim for. Harm reduction has a place but not at the expense of recovery for addicts.

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I very much share Deputy O'Sullivan's view that the best resolution for an individual who has serious addiction problems is to try to get himself or herself completely clean. Given my experience down the years and knowing many who have made that journey as well as many now working in the sector, I agree that such is the best model.

On the organisations which are involved in delivering the services and the decisions they make around how they approach that, something I would like to see developing more strongly is that when addicts are clean, aside from being in hostel accommodation, which should be a transitional phase-----

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It is not, and that is the point.

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-----the hostel accommodation should recognise the stage that they are at. What should happen then is that we should seek to find homes for such persons. Not only have I been in many centres throughout the country-----

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I was in Cork before Christmas-----

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The Tánaiste is talking herself into eternity.

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-----at the invitation of Simon. Simon in Cork, if I may say so, has an excellent approach to providing long-term homes-----

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A Deputy

Does the Tánaiste want to attach it to a vow of silence?

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-----for those who have come through a certain treatment situation.

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The Tánaiste does not have a clue.

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The Tánaiste should stop talking.

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Michael P. Kitt An Leas-Cheann Comhairle Fianna Fáil

Quiet.

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What does Deputy Mathews mean, "Stop talking"?

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It is meaningless.

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I spent last Monday talking to 15 or 16 very fine persons, as good any day as the Deputy or any of his colleagues who sit beside him-----

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Bernard Durkan Deputy Bernard J. Durkan Fine Gael

Hear, hear.

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-----who have substance problems which they are battling to overcome.

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I have a brother who is homeless. He is a recovering heroin addict-----

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The Deputy should not dare lecture me.

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-----who cannot get accommodation because of the cap on rent allowance.

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Michael P. Kitt An Leas-Cheann Comhairle Fianna Fáil

The Tánaiste should be allowed to continue without interruption.

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Deputy O'Brien should not dare lecture me.

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That is exactly what is happening.

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Michael P. Kitt An Leas-Cheann Comhairle Fianna Fáil

Order please.

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Deputy O'Brien should not dare lecture me.

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He has been forced to go back into a hostel where drug taking happens in front of him.

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Michael P. Kitt An Leas-Cheann Comhairle Fianna Fáil

The time is almost up.

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I have just said that the approach of getting a home for people and getting people substance free is the correct approach.

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Michael P. Kitt An Leas-Cheann Comhairle Fianna Fáil

I thank the Tánaiste. That concludes Leaders' Questions. We will now move on to the Order of Business.

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