A Research and Evaluation Report for the Bendigo Health–Justice Partnership: A Partnership between Loddon Campaspe Community Legal Centre and Bendigo Community Health Services
214 Pages Posted: 28 Nov 2017
Date Written: October 31, 2016
The Bendigo HJP Research and Evaluation (HJPRAE) was undertaken over three years with an evaluative process embedded in the service from service start-up. At the time it was challenging research as it examines impact and grappled with the internationally renowned challenge of measuring the social determinants of health.
Qualitative and quantitative data have been collected using multiple tools and specific questions.
Findings: 1. The clients of the HJP are complex and more often than not have more than one legal problem and a multitude of other health and social welfare problems. They often feel judged and lack trust in services. They will seek help when they feel they are not judged, where they are respected and where there is service responsiveness. Appointments are problematic – time and place can be critical to engagement, especially for people who have experiences of trauma or negative previous experiences of the legal system. 2. During its life, the Bendigo HJP has provided a significant amount of legal service to clients on a range of matters, often where one client has a significant number of legal issues. The clients’ lives are complicated and building trust takes time. Given the project has only one lawyer co-located at the HJP, the number of clients and client problems tackled is significant in view of the limited staff, funding and resources. 3. The Bendigo HJP is reaching clients who would otherwise not have sought legal help. The role of their trusted health or allied health professional in facilitating that reach has been overwhelmingly critical – 90% of clients interviewed in the HJPRAE said that without the HJP they would not have sought legal help. 4. Clients who have multiple and complex problems reported they were anxious and frightened as they did not know their rights/position. They reported this impacted on their health and wellbeing. The effectiveness and quality of the HJP service and its impact as reported by health/allied health professionals delivered the following relevant responses: • confidence in engaging with services in clients to have increased by 90.9% • knowledge of rights and responsibilities in clients to have increased by 72.7% • knowledge of options and more skilled over time in clients to have increased by 90.9%. 5. The capacity of professionals, due to the HJP, to respond to legal issues with confidence has increased; that is, they have become ‘empowered’.
General Application to Other Replicable Models of HJP Clients turn to ‘trusted’ health/allied health professionals but may not turn to lawyers without the facilitation and transferral of trust. Some clients will not turn to a lawyer as they are not emotionally ready (e.g., due to trauma, fragility, fear) and so the health/allied health professional that they trust becomes an important intermediary for them to gain legal help and information at salient times. A service which is a HJP needs to be ‘opportunistic’ in taking advantage of clients’ health appointments to provide legal assistance – due to complexities of their lives and confusion, lack of confidence and being overwhelmed etc. The capacity of professionals, both lawyers and non-lawyers, as well as client service staff, is key/critical to being able to support clients in a timely way, when in crisis or ready for help. Legal Secondary Consultations (LSCs) ‘are pivotal’; ‘it would not work if we did not have LSCs’. A significant majority of research participants noted that the LSC enables quick, efficient and targeted building of knowledge which can ‘save time’ in the long run. The type of lawyer used has been critical to the success of the Bendigo HJP and should be considered when hiring and recruiting staff. Lawyers can’t ‘just sit in their office’ but need to interact, integrate, not be ‘too stuffy’ or ‘too hierarchical’, ‘avoid jargon’ and show ‘respect’. The type of person used in the role is key to the HJP’s success. Trust and relationships take time to demonstrate an impact and their effectiveness as they are predicated on relationships, human experience, confidence and positive interactions and cannot be driven by a ‘top down’ approach.
Keywords: Health Justice Partnerships, Impacts on Social Determinants of Health, Medical Legal Partnerships, Human Rights, Access to Justice
JEL Classification: K40
Suggested Citation: Suggested Citation