The Homeless Agency recently launched its action plan1 to eliminate long-term homelessness2 and the need to sleep rough3 in Dublin by 2010. This article will discuss the elements of the plan that relate to homeless individuals with addiction problems in the context of the wider policy framework on drugs and homelessness. 

The plan contains three strategic aims, relating to prevention, local access to quality homeless services and long-term housing options with support when required. The plan contains 10 core actions (high priority) that cover more than one strategic aim and 74 additional actions (lower priority). Individuals with mental health problems, addictions (alcohol and drugs) and dual diagnosis (addiction and mental health) needs have been identified as needing healthcare and other interventions as part of the strategic aim to prevent homelessness and reduce the risk of becoming homeless. 

As part of the development of the action plan, a total of 105 men, women and children, both current and past users of homeless services, were interviewed. The principal immediate causes of their becoming homeless were identified by those interviewed as family breakdown, and alcohol, heroin and mental health problems. Several studies have shown the prominent role played by drug use in exposing individuals and families to homelessness in Ireland.4,5,6,7 

When asked to comment on existing homeless and housing services, interviewees mentioned the shortage of treatment/detox beds, as well as the impossibility of giving up drink or drugs while on the streets. The importance of appropriate accommodation, including transitional housing, after treatment and/or detoxification was emphasised as a first step in relapse prevention. There were repeated calls for ‘dry’ hostels for homeless people wishing to be drug or alcohol free and ‘wet’ hostels for those unable or unwilling to remain abstinent. 

By way of addressing some of these issues, the action plan states:  

The Health Service Executive and National Drugs Strategy Team (with the Department of Community, Rural and Gaeltacht Affairs) will develop a national plan for the expansion of detox and rehabilitation services for active drug users, arising from the recommendations from consultations currently taking place. (p. 51)  

The issue of residential treatment capacity also arose during the recent deliberations of the Working Group on Drugs Rehabilitation. In response, the Health Service Executive (HSE) established a working group in September 2006 to examine the issue in depth. As an interim measure, the Working Group on Drugs Rehabilitation recommends an increase in the current stock of residential detoxification beds from 23 to 48.8 

Also essential, in terms of relapse prevention and progress towards social reintegration, is the provision of transitional housing supports following treatment/detox and, indeed, this was stressed by those participating in the development of the action plan. Action 61 of the National Drugs Strategy identifies the need to provide a range of respite places and half-way houses.9 

However, the mid-term review of the Strategy10 noted that ‘considerably more progress’ was required on this action. Nonetheless, some efforts have been made to provide transitional housing for individuals coming out of residential treatment, for example those by Merchants Quay Ireland and the Arrupe Society. A pilot step-down housing programme, set up in 2005 in a partnership between Focus Ireland and the Keltoi project, is to be evaluated shortly. The recent report of the Working Group on Drugs Rehabilitation recommends that the Department of Environment, Heritage and Local Government take the lead in providing transitional and half-way housing for recovering drug users. 

Individuals with mental health problems, addictions (alcohol and drugs) and dual diagnosis (addiction and mental health) have been identified in the Homeless Agency plan as needing healthcare and other supportive measures to prevent homelessness and reduce the risk of becoming homeless. Courtney (2005),11 in a review of temporary accommodation services for homeless people, noted an increase in referrals of those with multiple needs, usually involving substance abuse and physical or mental health problems. 

The Homeless Agency’s action plan and Preventing Homelessness,12 as well as the Report of the Working Group on Drugs Rehabilitation, emphasise the challenge of improving inter-agency working between the statutory, voluntary and community sectors in responding to the needs of individuals with addiction and accommodation problems. In addition, there is a requirement for structural changes to housing and accommodation provision, to cater for people who have been through the mental health and addiction services and are moving towards independent living. The challenge facing the Homeless Agency and its partners in delivering on the strategic aim of providing long-term appropriate housing and supports is acknowledged in the plan: 

The success or failure of the Homeless Agency Partnership Action Plan is dependent on a dramatic increase over the next four years of secure and sustainable housing for people who are homeless. (p. 53) 

1. Homeless Agency (2007) A key to the door: the Homeless Agency Partnership action plan on homelessness in Dublin 2007–2010. Dublin: Homeless Agency.

2. Long-term homelessness is defined as the state of being homeless for over six months. For a definition of homelessness, see the Housing Act 1988, section 2.

3. The need to sleep rough occurs when there is a lack of emergency accommodation appropriate to a person’s needs.

4. Houghton FT and Hickey C (2000) Focusing on B&Bs: the unacceptable growth of emergency B&B placement in Dublin. Dublin: Focus Ireland.

5. Feeney A, McGee H, Holohan T and Shannon W (2000) Health of hostel-dwelling men in Dublin. Dublin: Royal College of Surgeons in Ireland and Eastern Health Board.

6. Halpenny AM, Keogh AF and Gilligan R (2002) A place for families? Children in families living in emergency accommodation. Dublin: Homeless Agency.

7. Lawless M and Corr C (2005) Drug use among the homeless population in Ireland: a report for the National Advisory Committee on Drugs. Dublin: Stationery Office.

8. Working Group on Drugs Rehabilitation (2007) Report of the working group on drugs rehabilitation, May 2007. Dublin: Department of Community, Rural and Gaeltacht Affairs.

9. Department of Tourism, Sport and Recreation (2001) Building on experience: National Drugs Strategy 2001–2008. Dublin: Stationery Office.

10. Steering group for the mid-term review of the National Drugs Strategy (2005) Mid-term review of the National Drugs Strategy 2001–2008. Dublin: Department of Community, Rural and Gaeltacht Affairs.

11.Courtney R (2005) Review of temporary accommodation. Dublin: Homeless Agency.

12. Pillinger J (2006) Preventing homelessness: a comprehensive preventative strategy to prevent homelessness in Dublin, 2005–2010. Dublin: Homeless Agency.