Dying on the Streets

on Saturday, 05 July 2003. Posted in Issue 38 Dying on the Streets, 2000

Bill Toner, SJ

November 2000

Introduction

During the summer two young men from overseas, both English-speaking and white, were taking part in a Catholic ‘renewal programme’ in Dublin.   Part of the programme provided opportunities for getting in touch with the reality of poverty.   The two men chose the option of staying in a hostel for the homeless overnight.

 

When the day came, they set off, separately, both ‘dressed for the part’.  But they never actually got to stay in a hostel.  They spent the day walking the streets and standing in queues.  They were turned away from some hostels because they were only looking for  short-term accommodation or because the hostels had no emergency beds.  They were directed to a homeless unit operated by the Health Board which directed them to another hostel where they were intimidated by young drug-users.  At 9.30 p.m., still without accommodation, they gave up and went home, feeling very fortunate that they did have a home to go to.

When I recounted this story to people who work with the homeless none of them were surprised.   Some of them estimated that there are about 250 hostel beds short in Dublin.   As a society we were saying to about 250 people in Dublin each night, ‘Sorry, but you have to sleep on the street’   Yet almost everyone we consulted insisting that more hostel beds, while urgently needed, were not an adequate answer to homelessness.  The situation is dire, but it is also complex.

Sleeping Rough

Although there are people to be found sleeping rough in a number of large Irish cities and towns, the problem is most acute in Dublin, and this article is devoted mainly to the problem in that city.

Estimates of the numbers sleeping rough in Dublin each night vary between 200 and 275[i].  If all of these people actually attempted to gain access to a hostel at the same time, only about a dozen of them would be successful, because there are so few emergency beds.   There is a certain amount of circulation among the population sleeping rough.   For instance one popular hostel operates a policy of allowing ‘emergency’ applicants to stay one night in four, with the likelihood that the other three nights are spent on the street.

Many of those sleeping rough never attempt to stay in a hostel.  There are various reasons for this:

·        Some do not have the energy or motivation to spend the day seeking accommodation, particularly as hostel staff may insist that they first visit the Homeless Unit in Charles Street.    Many of these will have been discouraged by earlier lack of success or are disorganized and do not know how to access hostels.  Many suffer from depression.

·        Some are afraid of being beaten or robbed in a hostel and prefer to take their chances sleeping rough.

·        Couples are separated in many hostels, and prefer to stay together on the street.

·        A few are barred from hostels;

·        Some are drug users.   A heroin user may need to spend the day ‘tapping’ (begging for money), then finding a dealer, and then finding a place to ‘shoot up’.  This daily routine makes it difficult to spend time looking for a hostel bed.

·        Most hostels do not allow clients to leave the hostel (except for some exceptional need) once they have booked in.  This may be as early as 5 p.m.  and at the latest about 8.30 p.m.   Many people find this far too restrictive.   Heavy drinkers are not allowed either to bring drink into the hostel, or to go out to a pub, so many prefer to sleep rough.

·        Conditions in some hostels are still very unattractive, with only dormitory accommodation in some cases, especially for emergency beds, and little privacy.  Since many hostel dwellers have psychiatric problems dormitories can be noisy and sometimes intimidating.

·        The better hostels are relatively expensive, about £9 a night for an emergency bed.  The Health Board will usually pay, but this involves a visit to Charles Street early in the day.  Heavy drinkers or smokers, or drug users, will find it hard to put £9 aside for a bed.

·        Some hostels insist on searching clients, and many object to this.

·        Some homeless people keep dogs for company or protection, and these are not allowed in hostels.

Some of the hostels are homely, and do what they can to provide recreation for clients, such as snooker and videos.   A few of the hostels have a strong religious ethos, though there is no evidence that this in itself makes the hostels unattractive.   But some of these hostels are anxious to retain their independence, and are therefore reluctant to accept funding from public agencies that might improve their facilities, but could also put constraints on their style of operation.  For instance, Dublin Corporation regards 8.30 p.m. curfews as unacceptable and would probably seek to change this if it offered funding.  The commitment of volunteers in these hostels is huge.

At any rate, for all the reasons mentioned above, many people, about 250 in Dublin, are unable or unwilling to access hostels and for that reason end up sleeping rough.   As stated, if they all did actually attempt to stay in a hostel, only a few would be successful.

Until recently one voluntary group in Dublin distributed blankets as part of a late night drop-in service.   The pressure on this has been so great that in September it had to be discontinued, as the overnight supervisors could not handle it along with the rest of their duties.  In the depth of winter the agencies provide a few extra emergency beds, perhaps 30 in all, but this winter things are looking particularly bad for rough sleepers.

Why the Shortage of Emergency Beds?

The shortage of emergency beds in hostels is due to the fact that currently very few single homeless people are being placed in permanent accommodation.   This is causing back-up in the system.   Long-term hostel beds are being occupied by people who should be living independently, and short-term and emergency beds are being occupied by long-term clients.   In Cedar House, the principal provider of emergency places in Dublin, 45 of the 60 beds are occupied by regulars.  The women’s refuges are now full, and their long-term occupants are being referred to hostels instead of being placed in permanent accommodation.

The reason few single men are being placed is that, firstly, they were never a priority group for the local authorities, but, secondly, there is a severe shortage of suitable accommodation.  In 1997 Dublin Corporation housed 160 (130 M; 30 F) hostel-dwellers in its own housing stock.   In 1998 this figure had come down to 90 (77 M; 13 F), and in 1999 to only 30 (23 M; 7 F).   One voluntary agency estimates that currently Dublin Corporation only houses one hostel-dweller per month on average.    In spite of the pressure on housing, the number of homeless families housed by the Corporation in 1999 was still 80% of the number housed in 1997.  The comparable figure for single people was only 35%.   As Dublin Corporation increasingly runs short of accommodation, it is single people who are being squeezed out.

The pressure on local authority housing is currently enormous.   Although the housing programme has increased substantially, demand outstrips supply.  In 1996, 27,000 households in the state were assessed as in need of social housing;  by 1999 this had risen to 39,000 families.  Some local authorities, particularly Dublin Corporation, are rapidly running out of building land, and are also more likely to run into planning difficulties and local objections when they attempt to build, especially special purpose housing.

There is also a severe shortage of private rented accommodation, particularly at the lower end of the market:

·        Because of the economic boom in Ireland many young people have moved to Ireland to work, many to low paid jobs in catering and retail.  Dublin is a particular magnet for young workers from overseas and from other parts of Ireland.  Most of these young workers seek private rented accommodation.

·        The number of third level students seeking accommodation has been increasing.  In 1988-89 there were 11,015 university students living in the private rented sector countrywide.  By 1997-8 this figure had increased to 21,430.[ii]

·        The increasing number of asylum seekers and refugees has put additional pressure on this sector.  There were approximately 4,000 such families in private rented accommodation and a further 2,800 in bed and breakfast accommodation at the end of February 2000.

·        The dramatic escalation in house prices means that many young people who would formerly have bought houses or flats are now competing at the middle level of the private rented sector, with knock-on effects at lower levels.

·        The demolition of large flat complexes by the Corporation is beginning to put pressure on the sector through a knock-on effect.

The end result of this pressure is plain to see on the streets of Dublin and other cities.    The people at the very end of the queue end up sleeping in church porches, in doorways and in alleyways.

Which People end up on the Street?

People can end up on the street through sheer bad luck, but there are certain predisposing factors that increase a person’s chance of becoming chronically homeless.  Separation from wife or partner was the most frequently cited reason for homelessness[iii].  After leaving the family home, many were not able to afford private rented accommodation.

Many people working with the homeless cite alcoholism as the most common reason for homelessness.  But alcoholism is often a factor in separation so the two factors can be interconnected.   Alcoholics can lose control of their life and are often evicted by landlords for non-payment of rent or through barring orders.   They may not be able to hold down a job and their disorganized life-style makes it difficult for them to secure accommodation.  They may prefer to sleep rough because hostel curfews interfere with their drinking patterns.

One group with a high risk of becoming homeless are those who have been in care.  This includes periods in reformatories or orphanages or in foster care.  In one survey[iv] fifteen per cent of homeless men interviewed had been in care.  People from a traveller background who were taken into care are at particular risk because they have become alienated from their own community.

People who spend periods in prison are also at risk of becoming homeless.  Some prisoners do not declare the fact that they are homeless because they feel this may block their chances of temporary release.   They then present themselves to referral agencies only on the day of release and do not always get a place to stay.

Apart from these factors, and the general shortage of accommodation, the increase in the numbers of homeless people has other, contemporary, reasons:

Drug addiction has led to many people leaving home or being evicted, and their chaotic lifestyle and lack of finance leads to many sleeping rough.  Unfortunately if they have no fixed abode it is very difficult for them to get treatment, so their situation gradually becomes chronic

There has been an increase in family breakdown.  Part of this is due to the introduction of divorce, but, additionally, spouses, especially females, are now more ready to take out barring orders against aggressive or violent spouses or partners, or to leave the household.

The number of evictions of tenants by local authorities has risen sharply because of the new anti-social legislation and the way it is interpreted.

The economic boom has put upward pressure on rents and many people who could just about manage can no longer afford to pay.

Many landlords are doing very well providing accommodation for asylum seekers.  The Health Boards pay top rates, and block book many facilities.   In general asylum seekers are very good tenants, paying their rent regularly or having it paid for them.  In this situation there is direct competition arising between homeless people and asylum seekers.  Many landlords will not now accept deposits or rent allowances paid by the Health Board Homeless Unit, as they regard ‘homeless’ people as trouble, and there are plenty of asylum seekers and students to take their rooms.  There is no sign of any agency block renting houses and apartments for the conventional homeless.

Health and Homelessness

Not all homeless people are sleeping rough.  The term ‘homeless’ is used to cover many categories of people, namely:

persons living in temporary insecure accommodation,

persons living in emergency B&B accommodation, hostels, or health board accommodation,

victims of family violence

rough sleepers.

There are about 3,000 people in the former Eastern Health Board area who are homeless, with about 300 sleeping rough at any one time, though there is considerable circulation among this 300.

The health of people who sleep rough all or most of the time suffers more than those living in hostels.  Unfortunately it is hard to determine this exactly, as the only surveys available have been carried out among hostel dwellers, most of whom only sleep rough occasionally.   The Centre for Housing Policy in York estimates that many men who sleep rough live only until their mid to late forties.  The prevalence of infection, physical disease, and particularly mental health problems are very high.   Tuberculosis is very common among those sleeping rough, and younger men have high levels of HIV and hepatitis infection.   Prolonged exposure to cold puts strains on the heart, and high levels of stress is associated with a raised incidence of cardiovascular disease and cancer.

But hostel dwellers too suffer from poor health.  In the SLAN survey only 58% rated their health as good or excellent, compared with  84% in the general male population.  In the York survey 55% of hostel-dwellers reported health problems.

In examining the health of homeless people, it is not easy to disentangle cause and effect.  Sometimes an underlying health problem may be a major factor in making a person homeless in the first place.

In Ireland, a majority of hostel dwellers have mental health problems.  A 1999 survey of   hostel-dwelling men in Dublin[v] revealed that 64% suffered from depression, chronic anxiety, or other mental illnesses.  This is much higher than comparable figures in the U.K.    In a survey carried out by the Centre for Housing Policy in York only 21% of hostel dwellers were found to have mental problems.[vi]  In a Northern Ireland survey the comparable figure was 37%[vii].  The difference may be due to the fact that people with chronic mental illnesses are better looked after in Britain.  In Ireland the trend towards so-called ‘community care’ meant that many people were discharged from the traditional mental hospitals with nowhere to go, and no back-up from the health services.  In the last couple of years there have been harrowing cases of people suffering from schizophrenia being evicted by local authorities onto the side of the street where they were immediately reduced to sleeping rough.  Some of the hostels for homeless are effectively providing a service that the larger mental hospitals were doing a few decades ago.   But hostel wardens also admit that they have had to bar some mentally disturbed clients because they are unable to handle them.

Alcohol addiction is also a problem.  Again, for reasons that are less clear, it is much higher among hostel-dwellers in Ireland than in England.  In Ireland the 1999 survey showed that 50% of hostel dwellers were dependent on alcohol, with 29% suffering severe dependence.  The comparative U.K. figures are 16% (dependence) and 11% (severe dependence)[viii].Hostel superintendents stated that alcohol abuse is a frequent reason for evictions in Ireland.   People who abuse alcohol may annoy and abuse their neighbours, fail to maintain their houses or flats in good order, and are unable to pay their rent.  Again, eviction may be carried out by local authorities, with no back-up from health or social services.   In the U.K. there may simply be a more caring attitude towards those suffering from alcohol dependence than in Ireland, which accounts for the smaller numbers of them that end up on the street there.

Of course it goes without saying that being homeless is also likely to precipitate or aggravate alcoholism, depression or anxiety.   Most homeless people wander the streets all day.  This is true whether they are in a hostel or sleeping rough.  Most hostels will not allow clients to stay between 10.00 a.m. and 6 p.m.  In many cases hostels do not allow clients to leave any belongings in the hostel so that they are forced to spend the day “carrying their home in two carrier bags” until it is time for them to seek readmission to the hostel.

Homelessness of families is particularly hard on the children.  For instance parents may be confined to one small room with young children for prolonged periods.  Poor diet, stress, cold, damp, along with inadequate sanitation and food storage or preparation facilities increase the risk of health problems for all the family.  There is an increased risk of accidents because of limited play space and difficulties in making things such as kettles and irons safe.  Homeless children are reported as showing behavioural disturbance, depression, disturbed sleep, bed-wetting, toilet training problems, and violent mood swings.   Stress among parents often leads to violence against their children.[ix]

One group of people not usually categorized as ‘homeless’ are members of the Travelling Community.   Yet 6,500 of them live in unserviced sites on the side of the road.  These lack access to regular refuse collection, running water, toilet, baths and showers, access to electricity and fire precautions.  Needless to say, their health suffers in these conditions, and travellers have a notably lower life expectancy than the settled population.  What is not often adverted to is the number of travellers who would much prefer to live in a house if they could get one.   About 1,400 traveller households (representing about 8,800 of the traveller population) are currently seeking houses.[x]  However it seems clear that they are not a priority homeless group, partly because the local public support which is needed to house them is lacking.

Role of Housing Associations

Professionals involved in the housing of the homeless assert that voluntary housing associations have a key role to play in providing accommodation for homeless people.  Many housing associations, like HAIL or Focus, have the ethos of caring which is needed to make a success of a challenging task.  However their role in this is hampered by the lack of support from government and various agencies.   In the first place there is a shortfall in the capital provision in respect of single dwellings.   Housing Associations often have to provide 5-10% of the capital cost of single dwellings, whereas they can generally secure almost 100% funding for family units.

More serious than this, however, is the fact that there is no defined stream of funding for the ongoing costs associated with housing homeless people.  The support that many homeless people need to make a success of independent living is considerable.   Many of them have multiple problems, such as depression or alcoholism, lack of funds, poor physical health, no domestic skills and so on.  They usually need ‘professional’ befriending, support from mental health groups, attention from social and community workers and so on.   Voluntary housing organizations such as HAIL are forced to devote considerable resources to fund-raising to provide the services needed for vulnerable tenants.  Crucially, there are very few psychiatric social workers in Ireland.   Although the will seems to be there on the part of state agencies to improve this situation, there are now serious recruitment problems.  However, voluntary groups such as Schizophrenia Ireland and Aware could fill many of the gaps if  the state would give them adequate funding.

The Mental Health Association of Ireland, through its local network, is one of the main providers of accommodation for people with mental health problems.   It maintains hundreds of houses and flatlets in various parts of the country and is in a good position to give the kind of  support its tenants require.

Nevertheless, given the lack of funding for housing and servicing single people, it is not surprising that most housing associations tend to concentrate their efforts on family housing, for which there is also strong demand.

What Can be Done?

Like many other problems in Ireland, the attitude of state agencies to people sleeping rough has been beset by fatalism.  One hears comments like:  ‘You will always have people sleeping rough’ or ‘people sleep rough prefer it because they find it too difficult to live in a house’ or ‘It is all due to drink’.  Sometimes structural rather than personal reasons are adduced, such as ‘It is impossible to get sites for local authority houses’.

Nevertheless it is striking how forcefully accommodation problems have been tackled in other cases.   For instance, the Health Boards have managed to house with reasonable success about 15,000 asylum seekers in the past four years.   The reason for this is that the government has decided that they will not have it said that they are leaving asylum seekers on the street.  For one thing, if they did, the UN High Commissioner for Refugees would have something to say about it, and Ireland would get a bad international press.  But there is no High Commissioner for Rough Sleepers.  So the will is simply not there to find a solution to that particular problem.

Another accommodation problem that has been addressed with more vigour than rough sleeping is that of Affordable Housing.   Because of house price inflation many young couples can no longer afford to buy their own house.  As one aspect of this a system has been introduced whereby developers have to make available for low-cost housing up to 20 per cent of residential zoned land at ‘existing use’ value i.e. at the going rate for agricultural land if it was formerly used for agriculture.   This required the passing of the Planning and Development Bill 1999, which was radical enough to be referred by the President to the Supreme Court.  But nothing radical has been devised to address the problems of the mentally ill who are dying prematurely on our streets.

And if the problem is so intractable, why have other jurisdictions had more luck with it?  For instance in London in 1991, just over 1,196 people were found sleeping rough on Census night.  By February 1996, under an initiative of the Labour government, the figure had fallen to 270.  This is about the same as the current number of rough sleepers in Dublin, which has only one eighth the population of London.  In Glasgow, not only has sleeping rough been almost eliminated, but hostels are being closed as well, as people are rehoused in conventional accommodation.   Finland is another country that has had spectacular success in tackling its serious homelessness problem.   Much nearer home, there is no official evidence of anyone sleeping rough in Northern Ireland in recent times.[xi]

In order to address the problem of rough sleeping, a number of initiatives have to be addressed in parallel:

Firstly, there is an urgent need for some additional hostel beds to get people in from the cold and rain.   Some of these would need to be ‘wet’ hostels, where heavy drinkers are tolerated, and something similar, such as ‘crash pads’ is required for drug addicts.  There is also a particular need for family hostels.

Secondly, additional housing needs to be provided more urgently by Local Authorities and Housing Associations, in a variety of unit types, to allow people to move on from hostels into permanent accommodation.  A number of initiatives have been taken by local authorities in this regard, but the pace is simply too slow.  It is reckoned that about 500 people could move from hostels to conventional accommodation, if they were given adequate support.  Housing Associations should have no disincentives put in their way in relation to the housing of single people.  Accommodation, whether in hostels, conventional units, or rented accommodation, should also be provided or encouraged in the suburbs, as there is a drift of homeless people into the city centre, where they have no support networks.

Thirdly, the planned support services need to be implemented with greater urgency.  At the moment the Eastern Regional Health Boards are recruiting people for multi-disciplinary outreach teams to deal with homelessness.  These would include a public health nurse, drug addiction worker, psychiatric nurse, and social worker.  These will try to link the homeless with the mainstream health services.  Action to prevent people becoming homeless in the first place is also to be a priority, with a named Health Board person coordinating responses of the agencies.   This would, for instance, prevent the practice already alluded to where people suffering from schizophrenia are evicted on to the street for ‘anti-social behaviour’.    Particular attention needs to be paid to those being released from prison or discharged from psychiatric hospitals to prevent them drifting into homelessness.   The general lack of treatment and resources for drug addiction is a wider issue that contributes greatly to homelessness.

Fourthly, in order to help people move on from hostels to conventional housing there is a pressing need for transitional housing, such as Cuas, the unit operated by the Simon Community in Dublin.   In this type of small unit people are given a chance to prepare for reintegration through support such as counselling, help with addiction, and sheltered employment.  There is also a need for more sheltered accommodation for specific groups, such as those suffering from mental illness.

Fifthly, the local authorities and health boards will have to rethink current policies in regard to eviction of families for anti-social behaviour.  There are signs that this is already happening.  Other solutions must be sought.   Indeed, other solutions have to be sought where an ‘anti-social’ family owns their house, which happens more often now in local authority ‘areas’.  In this case they cannot be evicted. This is not in any way to understate the degree to which individuals from a few families can destabilize whole communities, for instance through drug-dealing or intimidation.

There are currently a few pilot schemes in train to try to help ‘anti-social’ families to deal with their problems. But at any rate, the policy whereby neither the local authority nor the Health Board have any responsibility to re-house an evicted family is simply unjust, because it amounts to a contemporary form of ‘debtors prison’ and puts peoples lives in danger.    Moreover, innocent members of families can be badly damaged by evictions. And in some cases people evicted for ‘anti-social’ behaviour have simply been mentally ill. Some alternative accommodation must be offered to evicted families where, as generally happens, they cannot afford private accommodation.   Being forced to move house is still a considerable sanction, and if their new accommodation is known, it is easier for drug-dealers to be tracked.  There may also be the possibility of instituting some type of ‘barring order’ against an individual rather than evicting the whole family.

Acknowledgments:

Many thanks to the many hostel superintendents and workers, and officials in state agencies, who kindly gave of their time to discuss these issues with me.  This is not to imply that they are in agreement with all the points made.


Notes

[i] Recent studies have been carried out by the Dublin Simon Soup Run, Focus Ireland, Dublin Corporation, and the E.S.R.I.  See Department of the Environment and Local Government, Homelessness - An Integrated Strategy for an official overview.

[ii] Emmet Oliver, ‘Number of students renting accommodation doubles’.  Irish Times, 11September, 2000.

[iii] Anne Feeney et al., The Health of Hostel-Dwelling Men in Dublin, Royal College of Surgeons in Ireland and Eastern Health Board, March 2000, p.18

[iv] Anne Feeney et al., The Health of Hostel-Dwelling Men in Dublin, Royal College of Surgeons in Ireland and Eastern Health Board, March 2000, p.19.

[v] Anne Feeney et al., The Health of Hostel-Dwelling Men in Dublin, Royal College of Surgeons in Ireland and Eastern Health Board, March 2000.

[vi]Centre for Housing Policy, University of York, ‘ Health and Homelessness in London’. www.york.ac.uk.

[vii] McGilloway, Sinead and Michael Donnelly, The Impact of Environmental Factors on Mental Health.  Health and Health Care Research Unit.  The Queen’s University, Belfast.

[viii] Gill B. et al., Surveys of Psychiatric Morbidity in Great Britain, Report No.7: Psychiatric Morbidity among Homeless People. London, HMSO. 1996.

[ix] Centre for Housing Policy, University of York, ‘ Health and Homelessness in London’. www.york.ac.uk.

[x] National Economic and Social Forum, Social and Affordable Housing and Accommodation: Building the Future. Forum Report No. 18, September 2000.

[xi] Committee on Economic Social and Cultural Rights, ‘Implementation of the International Covenant on Economic, Social and Cultural Rights, - United Kingdom of Great Britain and Northern Ireland’.  www.hri.ca