"Our homeless don't have a ID, they don't have money. Surely there are doctors willing to treat people with no money but there's not."
The South Auckland grandma, who has been feeding people living on the streets for the past eight years, said she found one woman crying in her car so she offered her a tea and a hug.
"Three hours later she messaged me saying 'thank you because I was thinking about killing myself'.
"If we don't help treat people who need a hug or need someone to talk to, we are going to start to see more and more suicides," Munroe said.
Health minister Andrew Little told the Herald the Government was serious about tackling homelessness and the best way to address poor health outcomes experienced by those without a home was provide them with one.
This is why the Government introduced the 2019 Homelessness Action Plan that included a significant expansion of the Housing First programme, Little said.
It supports up to 2700 people who have been homeless for a number of years by giving them a place to live as well as wrap-around services to help them address issues like physical or mental health, Little said.
"This is a difficult problem to solve and one that has developed over many years. It will take time to make a difference but we are on the right track," he said.
The NZMJ study found that the average age for a homeless New Zealander to die was 45 years. Of the 70 suicides, it was younger at 38 years.
Researchers of the study examined coroners' reports of 171 deaths of New Zealanders with "no fixed abode" when they died during 2008 to 2019.
More than three-quarters of the deaths (129) died from conditions that could have been avoided had they received timely and effective healthcare interventions, researchers said.
"The main findings of this study are the devastating and dehumanising consequences of homelessness that result in premature and preventable deaths," the report said.
Lead researcher of the study, Sandrine Fabre, who has a PhD in health development and policy, said "It's absolutely alarming and urgent action is needed to address it".
Fabre said one of the issues was the difficulty homeless people experienced accessing healthcare.
"They can't sign up to a GP because they don't have an address, let alone money. It's a real issue."
Clare Perry, the Ministry of Health's acting deputy director-general for health system improvement and innovation, said as General Practices were mostly private businesses, the Ministry is unable to enforce who they accept as patients.
"We know that accessing services and income support can be challenging for homeless people and specialist housing services and a range of social and healthcare services are available to provide assistance with this."
Perry said there were outreach services set up to provide mental health and addiction support to homeless people and one example was the Oydessy House's Haven café in Auckland's Karangahape Rd.
"Ensuring those that do live on the street live longer is something we all need to play a part in – at the community level, local authorities, and a number of government agencies working together to provide wrap-around support for our homeless populations.
"The Ministry of Health was committed to ensuring there is access to healthcare to people regardless of their living situations," Perry said,
In the report, researchers said abuse and trauma were recognised as being major pathways to homelessness, which was snowballed by emotional distress of living on the streets.
"We found that nearly 70 per cent of cases had evidence of stressful and traumatic life events that [echoed] the rate of suicide ideation we uncovered."
Fabre said accessing suicide ideation should be part of routine screening provided by health providers in contact with homeless patients.
Munroe, who has been feeding the homeless for the past eight years, said there needed to be more places in the communities where homeless people could walk in, get a cup of tea or a coffee, have a chat without being judged and get free medical care if they needed.
"We need to start looking after our people."
The researchers stressed the findings did point to those who were most deprived of access to healthcare and did not include those living in transitional housing, motels or private dwellings.
They also added that some relevant coroners' reports may have been missed.
A life lost
The study comes after a Coroner's report this week revealed a 41-year-old man living on the streets died because he had consumed synthetic cannabis.
He collapsed on the footpath of Auckland's Queen St on August 4, 2018.
A member of the public had been walking along Queen St when he noticed Oliver Manukau collapsed on the ground," Coroner Erin Woolley said.
"The member of the public put Mr Manukau into the recovery position.
"Other members of the public also helped by calling emergency services, monitoring Mr Manukau's pulse and breathing and commencing CPR when they could no longer detect a pulse."
He went into cardiac arrest and ambulance staff performed CPR but it was too late. He could not be revived, and he was pronounced dead at the scene at 2pm.
Where to get help:
• Lifeline: 0800 543 354 (available 24/7)
• Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
• Youth services: (06) 3555 906
• Youthline: 0800 376 633
• Kidsline: 0800 543 754 (available 24/7)
• Whatsup: 0800 942 8787 (1pm to 11pm)
• Depression helpline: 0800 111 757 (available 24/7)
• Rainbow Youth: (09) 376 4155
• Helpline: 1737
If it is an emergency and you feel like you or someone else is at risk, call 111.
