Homeless struggling with reduced access to toilets and counselling services

Disruption to services causing rise in drug relapses and suicidal ideation, study finds

Disruptions to services due to coronavirus have led to an increase in drug relapses, suicidal ideation and loneliness among homeless people struggling with mental illness and drug use, a new study warns.

People sleeping rough have had reduced access to toilets, been unable to wash and have found the loss of in-person counselling supports difficult, according to the report from Merchants Quay Ireland (MQI) published on Wednesday.

Author Kathyan Kelly, who interviewed 10 people accessing the charity's services during the pandemic, found that "social isolation, housing and limitations around access to services [including] services needed for daily life (food, shelter, washing facilities etc) were the main concern of all of the participants when asked about their experience of Covid-19".

Ms Kelly, an independent research consultant, spoke to six women and four men, aged between 32 and 58. Seven were homeless at time of the interviews, in October 2020, and three had been.



Half reported a severe mental illness such as schizoaffective disorder or bipolar affective disorder and half suffered from depression. Eight were taking one or a combination of substances, including alcohol, cocaine, heroin, crack, MDMA, methadone and benzodiazepine.

All had been accessing face-to-face counselling, either through the HSE or MQI, pre-coronavirus, and found the loss of personal interaction difficult.

Online-only services was an obstacle for most, with just three of the 10 able to access the internet. Of the remaining seven, four had mobile phones without internet access and three had no facilities to charge their phone.

A woman in her early 30s said her online counselling “was fine, but it wasn’t the same”.

Of the four interviewees who had been in recovery, three had relapsed. Another, a woman who had been in recovery for two years and on methadone, was struggling. “My health is deteriorating. I’m on the verge of going back on drugs and I don’t want to. Because there’s nothing there, there’s no one there for me, there’s no support for me.”

Three noted a serious deterioration in their mental health. Some had almost acted on their suicidal thoughts and one feared she was vulnerable to act on it.

Several, especially those sleeping in tents, said how important visits from the MQI outreach team were to their mental health.


Lack of access to the MQI building meant many people sleeping rough had nowhere to go to the toilet, shower or wash clothes, while access to hot meals became sporadic.

A woman in her 30s said: “I get by with the soup runs at night. I’d do anything for a proper dinner of potatoes, bread and a bit of meat. It’s that long since I had a dinner like that.”

Among the report’s recommendations are that outreach services be increased immediately, drug-free recovery hostels be established, and gender-specific drug services and hostels be established for women.

Kitty Holland

Kitty Holland

Kitty Holland is Social Affairs Correspondent of The Irish Times