Deaths in Dublin’s single homeless population increased by over 60 per cent last year compared with 2019, and almost doubled since 2018, a report published on Wednesday finds.
The report, by Dr Austin O’Carroll, a north-inner city GP specialising in healthcare to marginalised groups, recommends the establishment of critical incident reviews following the deaths of homeless people to learn whether steps could have been taken to save them.
It finds those homeless more than 18 months have a mortality rate eight times that of people who have been homeless less than six months.
Dr O’Carroll finds 47 single adults known to homeless services died last year - an 80 per cent increase on the 26 who died in 2019 and a 147 per cent increase on the 19 homeless single adults who died in 2018.
“However, over that same period of time there has been an increase in the number of single people experiencing homelessness so one would expect more deaths.”
Titled ‘Interim Report on Mortality in Single Homeless Population’ the report will not be finalised until all coronial inquests are complete. It was commissioned by the Dublin Region Homeless Executive (DRHE) in the wake of an apparent upsurge in deaths among homeless single adults last year.
While the deaths of 79 people were reported to the DRHE in 2020 Dr O’Carroll removed 22 from the data-set for reasons, including that the deceased had not been registered as homeless, had been in accommodation not included in homelessness statistics, or had been a parent in family accommodation.
This resulted in a data set of 47 people, of whom seven died in hospital; 23 died in supported temporary accommodation, ten died in privately operated emergency accommodation, and, seven died outdoors.
“Of note over half of those who died on the street had been in emergency accommodation the previous night,” says the report.
Though the proportion of those dying outdoors increased, from 8.4 per cent of homeless deaths in 2015 to 9.3 per cent last year, this proportion remains “low by international standards”.
Appearing to suggest figures from the twice-yearly ‘rough sleeper count’, co-ordinated by the DRHE, may underestimate the true numbers of people sleeping rough, the report says if the November 2020 count finding of 127 people sleeping rough were taken as the denominator, “the CMR would be 23.6 but this would be a significant overestimate”.
Noting a “clear association” between longer duration of homelessness and “higher the mortality” the report says “mortality becomes particularly steep” after 18 months. “A person who was over 18 months homeless had a crude mortality over eight times higher than a person who was homeless for six months or less”.
The report recommends critical incident reviews be held following deaths that could potentially have been prevented, and the investigation of clusters of deaths “to identify if the clusters were products of statistical chance or were a result of a preventable cause”.
It calls for reviews of all non-fatal overdoses among drug users. “Prior non-fatal overdose are predictive of subsequent fatal drug poisonings,” it says. “People with a history of drug poisoning have been found on average to have two non-fatal overdoses per year.”
