Homeless people experience a similar range of mental disorder to their domiciled counterparts, but on average they have a greater health and social care need. There is clear evidence internationally that the extent and complexity of their need results in a diminished access to health services, including Mental Health Services.
This paper, like many other health and social policy documents in Ireland over several decades, restates the right of mentally ill homeless people to have their needs robustly addressed by mainstream health and social care services. Given that general Mental Health Services are delivered on the basis of address, such services must often make a greater effort to address the needs of such patients. Such Mental Health Services must take the lead role in the prevention of homelessness in the mentally ill. In this regard, ‘A Vision for Change’, recommending a local team designated in all areas to address this issue, should be followed.
In addition to the right to mainstream services, homeless mentally disordered people have a need for Specialist Mental Health Services in urban areas with a higher prevalence of homelessness. In these areas of high prevalence, Specialist Mental Health Services for homeless people make sense and are effective.
We recommend the establishment of an Irish Clinical Network for mental health professionals in Specialist Mental Health Services, offering mutual information, support and education, to underpin best practice in such services throughout the country.