Lawyers and health professionals are working together to create change

Across Australia, a quiet revolution is taking place that’s changing the way some of the most vulnerable in our communities access legal help.

In a practitioner-led movement, community lawyers are leaving their offices and setting up shop inside hospitals and community health services as a way to better meet the needs of people with complex and intersecting health and legal problems.

Known as health justice partnerships, these collaborations embed legal help into health care services and teams to help to address the underlying drivers of poor health, such as mould in public housing causing respiratory problems, or credit and debt exacerbating stress and diverting people from meeting their health care costs.

Health justice partnerships have formed in response to a growing body of evidence that shows there are groups of people who are vulnerable to intersecting legal and health problems who are unlikely to seek the specialised help that could provide solutions.

In 2012, a landmark Australian study into legal need established that over one-fifth of people in Australia experience three or more legal problems in a given year, many of which cause illness. People often do not seek advice for these problems; and if they do, they are more likely to ask a non-legal advisor, such as a health professional, than a lawyer. In light of this, the idea of including a lawyer in a health care team just makes sense.

In regional, rural and remote communities, where access to services can be limited, it is not surprising that health justice partnerships are thriving. Approximately 25 per cent of health justice partnerships are located outside major urban areas, with some of the most advanced examples operating in rural communities.

One such example is in Bendigo where, since 2014, a lawyer from Loddon Campaspe Community Legal Centre has been based at Bendigo Community Health Service. The lawyer provides legal help for patients experiencing a range of problems, including family law child contact matters, infringements, criminal law, family violence, child protection and consumer issues. They also provide training to staff in the health service about the kinds of problems that need legal help and the systems that patients might be involved with, such as child protection and protection orders for family violence. This health justice partnership recognises that many legal conflicts manifest as health issues and that by working together, health and legal service providers stand a better chance of helping clients address their health, social and legal issues.

With increasing interest in how health justice partnerships can fill gaps in health and human services comes an increased need to know more about how these services are currently operating: who is collaborating and where, how they are working together, who they serve, and the assistance they provide.

In 2017, Health Justice Australia, the national centre for health justice partnerships, surveyed services working in this way to build a foundational picture of the health justice landscape in Australia.

We found that from a fledgling movement in 2012 with only a handful of services, there are now 48 services that identify themselves as health justice partnerships. They are located in almost all states and territories in a range of settings, including hospitals, community health settings and Aboriginal community controlled health organisations. They target a variety of populations, including women facing family violence, Aboriginal and Torres Strait Islander people, older people at risk of elder abuse, and people living with mental health issues, among others.

Health justice partnerships also play an important role in systems change, through small-scale reforms at the local level that can have a significant impact for immediate patient communities; and systemic change, bridging the gaps between service silos through which people who are vulnerable to complex or compounded need routinely fall.

Mapping a new path: the health justice landscape in Australia, 2017 is based on the data collected in this survey. It provides an insight into how practitioners are leading the way in reorienting services around the needs of the people who use them. It provides a baseline picture that will support planning, evaluation and the development of a best practice health justice partnership model.

If you’re interested in this way of working, you’re already doing it (or something similar), or simply want to know more, contact Health Justice Australia ([email protected]). We will be sharing more from this work at the National Rural Health  Conference in 2019. We hope to see you there!