Last October, Finn Irwin faced eviction. The stress made his existing mental health issues much worse, he says.
Irwin suffers from clinical depression and post-traumatic stress disorder.
He has been on antidepressants and sleeping tablets for years, he says. “I literally was at the end of my tether.”
Irwin was on the Dublin City Council social housing waiting list, though, and had been for 17 years.
To try to strengthen and speed up his case, he applied for medical priority which, if granted, moves applicants to a different, shorter list.
His application was refused though, he says, as was his appeal.
That’s not uncommon, council figures show. In the last three years, more than 80 percent of those applying for medical priority have been turned down by the council.
But councillors say that it isn’t always clear why and how those decisions are arrived at.
“It’s not in the least bit transparent,” says independent Councillor Cieran Perry. “I’ve had people that I’d have thought met the criteria who were refused.”
Medical-priority status is for “exceptional medical circumstances”, says a spokesperson for Dublin City Council.
“This is only if it relates to the applicant’s housing conditions and the accommodation is deemed unsuitable by reason of disability or illness,” they said.
Figures from Dublin City Council show that the vast majority of applications for medical priority are not granted. (The figures include appeals and requests for more bedrooms from existing social tenants.)
In 2018, Dublin City Council got 1,376 applications for medical priority and accepted 135 of them – around 10 percent.
In 2019, the council received 1,557 applications and accepted 288, or 18 percent.
In 2020, the council received 1,155 applications and granted medical priority to 219, or 19 percent.
When Irwin applied, he submitted letters from his GP outlining his illnesses.
He never got a satisfactory answer as to why he was refused but believes it was because it was mental health rather than physical health. “Mental health isn’t taken seriously here,” he says.
He’s not the only applicant to say that. Two months ago, a family with a child with a mental illness launched a petition to get Dublin City Council to re-examine their application for medical priority – which it then did.
A spokesperson for the council says that applications are considered case by case.
“The impact of housing conditions is taken into consideration for both mental and physical illnesses,” says the council spokesperson, and equal weight is given to both.
Decisions are made by an independent medical examiner, she says. The council will only submit written medical evidence received from healthcare professionals.
An applicant can appeal or make a new application if there is a change in their circumstances or condition, she says.
Irwin eventually got a social home, and avoided homelessness. “I’m blessed where I am,” he says.
Perry, the independent councillor, says that in his experience medical-priority applications from people with mental-health problems are rarely accepted.
Mental illness can be hard to diagnose and the severity of it can be difficult to assess, he says.
Sinn Féin Councillor Máire Devine says she can’t think of anyone accepted for medical priority on grounds of mental illness.
There is a definite difference between the treatment of applications from those with physical disabilities and illnesses compared to those with mental-health problems, she says.
But “a lot of medical issues are psychiatric”, says Devine, who is also a nurse.
She has seen applications rejected from families with severely autistic children who were “confined in really unsuitable, overcrowded flats up at the top of the stairs”, she says.
Sometimes people get lots of letters from GPs, the school principal, social workers and others but those will not be taken into account, says Perry, the independent councillor.
The decision is made by a panel of doctors and they are only interested in medical evidence from a doctor of consultant level, he says.
The letter must clearly state that the medical condition is being made worse by the issues with the person’s accommodation, he says.
Sinn Féin Councillor Anthony Connaghan says that medical priority is only awarded in cases where moving house will help to heal the medical problem.
Some people who have very serious illnesses, like cancer, expect they will be granted medical priority, he says.
But moving house probably can’t cure cancer so those people will be refused, he says. “I always tell people that the move has to improve your health or at least stabilise it.”
Connaghan asked for clarity recently around whether autism and intellectual disabilities count for medical priority after several constituents with autistic children were refused, he says.
In those cases, parents had been advised by their occupational therapists that their autistic children needed their own rooms, but then their applications to qualify for a larger home with an extra bedroom had been rejected by Dublin City Council, he says.
In some cases, families are overcrowded, while others don’t have access to any outside space, which makes caring for an autistic child much more difficult, he says.
Council staff told him, he says, that “the guidelines say that if the kid has access to a space locally then they don’t need a back garden or their own room”.
He took that to mean that if there was a park nearby the family won’t be granted a transfer to a home with a garden, he says.
“That is easy for someone to say if they are sitting behind a desk, but if you are dealing with a child you have to keep your eye on all the time … ” he says.
In some cases the family was refused medical priority but advised that they could apply for priority for “exceptional social grounds”, he says. But then that application was also rejected.
The criteria for “exceptional social grounds” are even less transparent than the medical priority, says Perry. “It is really exceptional cases that get the go-ahead.”
Perry says there is such a severe shortage of housing now that some people who should be entitled to priority are not getting it.
For those who are accepted onto the medical priority list, it is still a two- or three-year wait for a home, says Devine, the Sinn Féin councillor.
The problem is that there is not enough new supply of housing coming on, she says. “Where are the units?”