Based on national data from closed coronial files, the report shows that 121 people who were homeless died in 2020 – equivalent to 10 deaths per month, and an increase on the 2019 figure of 92. The analysis shows that those who died while homeless were much younger than the Irish average at the time of their death, with a median age of 36.5 for women and 42 for men. Almost all who died had a history of substance use or dependency, and there was a high prevalence of mental health and medical conditions.

Commenting on the report, HRB Chief Executive Dr Mairead O’Driscoll said:

“Behind each of these numbers is a life lost. The findings of this report highlight the very difficult situation faced by some of the most vulnerable people in our community. The Health Research Board’s aim in capturing and analysing data on the nature and circumstances of these deaths is to provide evidence that can inform harm reducti

on strategies and future policies to support those experiencing homelessness.”

This study builds on the pilot requested by the Department of Health which looked at 2019 deaths in order to present a more complete national picture of premature mortality among people who are homeless. In addition to demographic data, the research includes information on the circumstances and cause of death. Figures were largely similar to those recorded for 2019.

Reflecting on the findings, Dr Suzi Lyons, Senior Researcher at the HRB, says:

“In 2020 we see the impact of problem substance use and mental health conditions, with the majority of those who died dealing with one or both of these issues at the time of their death. Our findings show that these cases are complex, and that a co-ordinated approach is needed between drug and alcohol treatment services, mental health supports and approaches to harm reduction.”

Key findings

Number of deaths, demographics and circumstances of death

• There were 121 deaths among people who were homeless in 2020, equivalent to 10 deaths per month. A total of 3 in 4 were male, and 1 in 4 female.
• Half of the males who died were aged 42 years or younger; for women, 36.5 years or younger – considerably younger than comparable figures for deaths in the population as a whole, where the majority of deaths are in the 65+ age group.
• Over half of the deaths occurred in Dublin. Over 2 in 3 were among people who were homeless and in temporary or crisis accommodation.
• A total of 23 people who died were known to have been sleeping rough.
• Almost half of deaths occurred in specific accommodation for those who were homeless, with a further 1 in 3 occurring in a public place.
• Of those who died, 1 in 5 females and 1 in 10 males were known to have spent time in prison.

Substance use

• Almost all (91%) who died had a history of substance use, with high levels of polydrug use. Heroin (61%) was the most common drug used by those with a history of drug use, followed by cocaine (56%), and benzodiazepines (36%). Of those that had used substances, over 4 in 10 were alcohol dependent.
• There was a high proportion of people who injected drugs, especially among men, and a high prevalence of hepatitis C (over 1 in 10 men, and almost 2 in 10 women).
• Almost half of those who died had ever accessed substance use treatment. 1 in 5 were receiving treatment for problem opioid use, mainly methadone treatment, at the time of death (35% of females and 17% of males).

Cause of death

• Poisoning was the cause of nearly 6 in 10 deaths. The most common drugs implicated in poisoning deaths were opioids (mainly heroin and methadone), followed by benzodiazepines and cocaine.
• Just over half of those whose death involved opioids had previously received substance use treatment, and almost 2 in 5 were in treatment at the time of their death. More than 2 in 3 deaths involving opioids occurred in accommodation for persons who are homeless, while 1 in 3 of the deceased were with other people at the time of their death.
• There were 52 non-poisoning deaths recorded among people who were homeless, with the majority (85%) among males. 1 in 4 non-poisoning deaths were due to hanging, with most of those who died by hanging having a history of mental health issues and/or drug use. Deaths due to cardiovascular conditions accounted for 1 in 4 non-poisoning deaths, with the majority occurring among males.
• There were 11 (9%) deaths among people who were homeless and who had no recorded history of drug or alcohol use. These were mostly males, and half had traumatic deaths due to hanging or drowning. Over half of the deceased had a known history of mental health issues.