Mental health and addiction issues 'exacerbated' by housing crisis

Homelessness is exacerbating mental health and addiction across Mayo while those suffering are more likely to find themselves homeless, say several of those helping those without homes.

Appropriate, if not dedicated, shelter is needed to reduce the risk of homelessness exacerbating other conditions, says Noel Lyons, a tireless campaigner and advocate for homeless and migrant populations in Mayo. He wants a halfway house -a place for those coming out of care or treatment - for Mayo and wants the county to adopt the system of ‘wet’ and ‘dry’ shelters, which is operated by Dublin City Council to segregate alcoholics from the general homeless population.

Lyons is frustrated that those with mental health issues are referred by social workers to the emergency homeless desk at Mayo County Council. 

“People being released from treatment need somewhere to go,” explained Lyons, who has also noted that emergency homeless shelters - operated by the private sector and paid for by Mayo County Council - are often under-resourced to deal with individuals who have mental health issues.

The shortage of homes has exacerbated the difficulties faced by those with mental health issues, pushing them into emergency facilities that are unsuitable to their needs, Lyons believes. 

“Cooking facilities are provided in emergency shelters but it depends on the building. Many of them are dormitories with several people to a room.” 

One of those he helped, a middle-aged man with bipolar disorder, was referred from hospital. 

“He has been in the system since being evicted in May, staying in properties in Balla, Glenamaddy and Knock owned by the same provider. He’s currently sharing a room in Balla with a young eastern European man who struggles with addiction.” 

The prevalence of drugs in rural society means addiction - often combined with mental health problems - is also frequently a cause of homelessness, said Lyons, who encounters addicts in his work with Latwest, a Claremorris-based organisation he co-founded to help the local Latvian population but which is now helping homeless people of all backgrounds.

Lyons tells a story of anxiety and depression aggravated by contact with addiction, offering a specific case to illustrate his point. Sadly, this case ended in the death of a woman at a relatively young age.

The situation described by Lyons is a “microcosm” of what we’re seeing nationally, said John Dermody, senior services manager at Depaul, a Dublin-based charity helping the homeless nationwide. 

“There is an obvious intersection where we see people with mental health and substance abuse problems,” he said.

Dermody estimates that 40% of those going through the homeless shelter system have been hospitalised at one point or another for mental health issues. That’s informed by research conducted by Depaul which also shows people presenting as homeless are more likely to have experienced trauma as youths. 

“People with disabilities in general are more prone to slip into poverty," he explains.

While various organisations working with the homeless try to provide safe, individual spaces, the reality is when a person is in a homeless shelter they are in a congregated setting. 

"You may be sharing a room. Private rooms within a supported setting are rare. Therefore, there’s an absence of control. You are no longer in control of who shares your space. You’re bouncing off staff and other residents.

“That has implications for people with mental health problems. It’s an incredibly stressful thing to find yourself without a home.” 

The only remedy to the interrelated challenges of homelessness and mental ill health is more housing. 

“The thing that makes you positive is stability, it’s diet, it’s connection,” explains Dermody. “And it’s all that easier to achieve in a stable home. Tragically, very few have access to mental health services, less than five percent have access to a psychiatric nurse.” 

The availability of specialised shelters is limited in Mayo, though there is some long-term housing. 

“As far as I know there isn’t any emergency accommodation in Mayo specifically for people with mental health issues,” explained Joanne Gibbons, resource worker at Mayo Mental Health Association which is an approved housing body offering social housing for 40 people across Mayo in partnership with the HSE and St Vincent de Paul.

“We have 12 houses and eight apartments,” explained Gibbons. “We are tiny fish in a big pond. If someone comes out of acute care they access the housing through Mayo County Council. It can trigger people; people can be very vulnerable in situations like that.

Those providing emergency homeless accommodation speak well of Mayo County Council. 

“They do a good job in difficult circumstances… Everyone who looks for emergency accommodation is facilitated,” said the operator of several smaller properties offering shelter paid for by the local authority.

Mental health and addiction are frequently causes of, but also exacerbated by, homelessness. Getting their own room and cooking facilities makes a big difference, said the provider, who is paid by Mayo County Council to house homeless people in rooms in four separate houses across the county. 

“People who have come to our care have improved," he says.

The provider talks of a homeless man he took in a week ago who was severely depressed and has “blossomed” since being given a room. 

“He just needed a warm room, some space and a place to cook.” 

The man can remain in the property as long as necessary, said the shelter provider.

“It’ll be a while before that man will be able to rent on his own.” 

Another case where a woman who spent four months in Galway getting treated for alcohol addiction can return to her previous shelter when she’s finished. 

“That gives her comfort," he says.

The provider also speaks of a case where a man self-harmed, prompting a major medical emergency involving several ambulances.

“After three weeks in hospital he was let out but no one is following where he is going. He ended up in a shed out the country, frozen. He was in a terrible state. Someone should have got him to me from the hospital.” 

Another case he cites involves a disabled construction worker who took to alcohol to numb the pain of his injuries sustained in a fall off a building site. 

"After a string of petty crime convictions and a jail term he was sent to me. He’s a positive person, it helps to beat the alcoholism. For five weeks now he hasn’t touched drink and to keep away from the temptation while repairing his relationships with his family.

“I’m not faulting Mayo Co Council. They rang me, said you might be able to help him. The Council pays for his room. He gets €250 a week in social welfare which he can live off.” 

Clearly helpful to the homeless, appropriate emergency shelters are however, like houses, in limited supply. Noel Lyons believes this is due to the difficulty of opening a homeless shelter in Mayo. Properties which were being used as homeless shelters have closed - Lyons points to a former hotel in Ballinrobe – in part due to protests from local residents who objected to residents with drug and alcohol addictions congregating outside the premises. 

“It’s difficult unless you can buy a B&B," he says.

John Dermody at Depaul is keen that Mayo moves away from congregated settings for homeless who may have mental health issues. He praises the philosophy behind the government’s Housing First policy “which is to get people out of homelessness first, then bring the supports to the person". As described by the Department of Housing, the policy focuses on giving people a permanent home first without requiring them to deal with addiction or mental health issues before getting housing as was previously the case.

Alas that policy remains only a notional aspiration while the number of homeless nationally has hit 17,000. 

“Depaul continues to see people coming into homelessness,” said Dermody. “Now the exit is not easy to find because of the paucity of housing supply.”