The Challenge  

The life expectancy in Ireland for the general population is 82 years, the average age of mortality among the homeless is just 42 years. With increasing levels in youth homelessness it is anticipated that this average age is likely to decrease. National and international figures reveal a dramatic increase in homelessness for the last number of years, and Ireland is currently experiencing a housing crisis of unprecedented levels. Between 2014 and May 2018 there was a net increase of 6,988 people recorded as homeless. The reasons why people enter homelessness are varied and complex, however a key cohort of people enter homelessness and stay within these services on a long term basis. Practitioners report these Service Users struggle to navigate services and systems, and have the highest levels of disengagement from critical social and health services. This ultimately increases the likelihood of poorer outcomes and early death. Advances in neuro-psychological research in the last number of years identified that exposure to early life adversity impacts on brain development and consequently on later life outcomes. Cork Simon Community were anecdotally aware that a number of long term Service Users were exposed to traumatic adverse events in childhood and adulthood and this was impacting on their clients abilities to navigate services but that this had not been studied in a systematic way

The Research 

Dr Sharon Lambert, Applied Psychology, UCC, HSE’s Adult Homeless Integrated Team and Cork Simon Community created the largest Trauma Informed research project within a social care setting in Ireland. The research collected data in three waves. Levels of adverse childhood experiences (ACE) were collected from 50 Service Users (SU’s). The scale measures 10 specific developmental traumas and scores of 4+ have been linked to increased likelihoods of later life negative functioning. SU’s reported high levels of exposure to childhood neglect, abuse and household dysfunction, over 77% of Cork Simon SU’s had more than 4 ACE’s in comparison to a level of 12.5% in the general population. Second wave data analyzed the levels of secondary trauma within 50 staff members. This indicated that staff were impacted by exposure to trauma with approx. 25% indicating high levels of burnout.  The third wave of the research involved an ethnographic study. The PI completed an SU journey through the organization, presenting as homeless, completing intake paperwork and moving from emergency shelter to transitional housing. This facilitated a deep understanding of the barriers facing people experiencing homelessness in terms of administrative requirements, national policies and local practices. The ethnographic agency audit identified the organizations capacity for trauma informed care.

The Impact

The impacts of this research are many and take place across diverse realms including producing new knowledge, social impacts increasing public understanding about homelessness, new policy/public service impacts on homelessness and health/well-being.

This project and results has had Knowledge and Socio/Cultural impacts by shifting narratives about homeless Service Users via acknowledging and producing evidence that people who are experiencing challenges are not ‘badly behaved’ but are struggling to manage their trauma symptoms and that mental health and addiction issues are an adaptive response.

Multiple outputs include a report, articles, conferences and print/broadcast media coverage. The report was formally launched at a joint School of Applied Psychology/Cork Simon conference in UCC on research in homelessness attended by over 60 practitioners and community stakeholders as part of UCC’s community engagement week.

The project has also had Policy and Public Service impacts Cork Simon has reviewed their service and policies to ensure to work towards changes that no aspect of the service poses a risk of re-traumatisation. The report was presented to 120 staff, Board of Directors and a small group of Service Users. All levels of the organization have committed to implementing the findings. Further public service and professional impacts will arise as the research has generated interest from other front line organisations. The project will be replicated in other organisations and public services including NOVAS Ireland, An Garda Síochana Youth Diversion.

Additional future Health and Wellbeing Impacts will arise as the PI has been invited to sit on the National Ambulance Services Staff Wellbeing committee. The collaboration with Cork Simon continues, the original project identified high levels of staff burnout amongst the staff and a second project has investigated this further. ‘Trauma Contagion: the impact of working in homelessness’ was recently completed by Megan McGinley and Dr Sharon Lambert, this project has been presented nationally and internationally and has been the recipient of two best post-graduate research project awards (Psychological Society of Ireland & International Street Medicine Conference in Rotterdam). In these ways this research aligns with UCC’s strategic goals 2017-2022, in particular by developing ‘new and stronger relationships with employers, professional bodies, industry and the community in framing responses to local and global issues’. In the words of Prof P.O Shea, UCC President “We are a University in the community, of the community and for the community”.

For More Information

The report is available to view on https://www.corksimon.ie/aces-at-cork-simon/

An example of media coverage is located here https://www.irishexaminer.com/breakingnews/views/analysis/homelessness-is-not-bad-behaviour-but-the-legacy-of-a-traumatic-childhood-820011.html

“Good to ask these questions, I always wondered if I was born an addict, it makes sense to my experiences in education and with addiction”.

• Service User, Cork Simon Community
• Graham Gill-Emerson, HSE Adult Homeless Integrated Team

“We came to realise while we are tasked with supporting recovery from homelessness we are indirectly drawn into trauma management”.

 “the research will benefit some of Cork’s most       marginalised and excluded people and in doing so has instigated a very important shift in understanding and organisational culture at Cork Simon with clear positive social benefits

• Dr Dermot Kavanagh, Director, Cork Simon Community