Bendigo Health-Justice Partnership breaks down silos to improve patient health and well-being

Our Health-Justice Partnership Lawyer Jessica McCartney loves her job. In a recent video she enthused about her collaboration with doctors and allied health professionals who work together to address the unmet legal needs of Bendigo Community Health Service clients.

Jess has been our Health-Justice Partnership Lawyer since 2015. Prior to Jess, this role was held by Nickie King.

The Partnership is an innovative initiative funded by the Clayton Utz Foundation. It provides free and confidential legal advice to clients who are referred to Jess by BCHS professionals. Jess provides legal advice and advocates on behalf of clients with legal issues ranging from family law to family violence, child protection, consumer law, infringements, criminal matters and credit and debt issues. She also provides secondary consultations to BCHS staff and delivers community legal education.

Since late 2013 the project has helped more than 300 BCHS clients. It has assisted in more than 130 cases and provided advice to a further 175 clients. 41% of the Partnership’s clients have a disability. 44% of these clients have had a psychiatric disability. In 19% of cases, family violence was a factor in the client’s circumstances.

Health Justice Partnerships embed legal services within health services or vice versa. They help vulnerable and disadvantaged clients to address unmet legal needs which may be affecting their health or well-being. HJPs deliver free legal advice, casework and assistance to health service clients, develop the capacity of health service providers to identify and respond to legal issues, and identify legal and policy issues that impede client well-being.

Since 2013 the Partnership has contributed to three policy initiatives: a review of the Conciliation conference process operated by Child Protection; a review into the support needs of children with autism and their families; and a report by the Office of the Public Advocate, Rebuilding the Village: Supporting Families where a Parent has a Disability. Nickie King’s work with the Partnership inspired Loddon Campaspe CLC’s to develop a dedicated Child Protection Legal Assistance program (which she now leads), funded by Victoria Legal Aid.

HJPs sprang from research which indicated that only a small proportion of people with legal issues seek legal assistance, with many preferring to seek guidance from health or social service providers. When combined with the fact that people with a health issue or a disability tend to experience higher rates of legal issues than the general population, the concept of such a partnership became a no-brainer. In short, Health-Justice Partnerships acknowledge that health, social and legal issues are often intertwined. Rather than dealing with the issues as if they were siloed from each other, professionals work holistically to tackle a cluster of problems that if unresolved will escalate and exacerbate ill health.

Jessica is based at the Bendigo Community Health Service’s Kangaroo Flat site three days a week.  As she says ‘It is so satisfying being responsive to our client’s legal issues and easing their stress. Being on site is essential to the success of this project. Because I am on site, I am just down the hall from health workers and clients, so I am easy to access. The project delivers a multidisciplinary service for BCHS clients.’

‘My work is so varied and interesting. There are so many legal issues that I assist with and provide representation at court for. I help clients who have outstanding warrants for unpaid infringements. I have held companies accountable for unfair tactics on vulnerable clients and I have provided representation and assistance to victims of family violence.’

Staff at Bendigo Community Health Service also acknowledge the benefits that flow from the Partnership. Andie West, the Senior Manager, Children, Youth & Families notes how the partnership has increased the capacity of BCHS to deliver services to clients and how it has changed their practice. ‘All of our staff now routinely ask clients questions that could lead to a disclosure about a legal issue. We can ask these questions because we know that we have a trusted, direct referral to the Health-Justice Partnership.’

Our generalist Lawyer Dr Rob Southgate and Dr Liz Curran from the Australian National University are currently evaluating the Partnership. They have interviewed staff, clients and external stakeholders. And their preliminary findings are positive. Their research has found that:

  • Almost all the clients interviewed say they would not have accessed legal help if it had not been for the referral from a BCHS professional.
  • All the clients interviewed experienced positive health and other outcomes following the HJP intervention, including reduced stress and anxiety.
  • The BCHS professionals interviewed said that the Partnership had increased their legal knowledge and their capacity and confidence to identify legal problems for their clients. The relationships with Nickie and Jess led to BCHS professionals referring their clients for assistance and their seeking secondary legal consultations.
  • Service effectiveness has been greatly improved by having an accessible lawyer on site. The ‘approachability’, non-judgmental and respectful attitude of the lawyers were critical factors to successful client and professional engagement.
  • The HJP has significantly increased the engagement, capacity, and empowerment of clients and professionals, counter-acting siloed service provision and improving integrated service collaboration.
  • The three-year pilot funding period enabled enough time to build trust and engagement and achieve service effectiveness.

A key theme arising from the research has been trust. It seems that by ‘borrowing’ the trust already developed between BCHS professionals and their clients, our HJP lawyers have been able to engage with vulnerable and disadvantaged clients who might otherwise be reticent to seek legal assistance.

Several BCHS staff noted the benefit that flows from having a lawyer on site who can provide advice when a client’s life is in crisis. As one BCHS clients put it: ‘When I’m looking for help, I need help when I need it. Not two weeks later. Otherwise it turns to shit.”

The flexibility, opportunity and co-localised nature of the Health-Justice Partnership feeds into and promotes trust, symbiotic professional development and increased professional capacity, ensuring a more holistic service for BCHS clients.

The Health-Justice Partnership’s funding ends in October 2016. Loddon Campaspe Community Legal Centre and Bendigo Community Health Services are keen to ensure the ongoing viability of the service.

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