How Medical-Legal Partnerships Help Address the Social Determinants of Mental Health

Abstract

Conditions related to where you are born, live, learn, work, and age—the social determinants of health—account for more than half of overall health and well-being. Problems in these areas include food insecurity, unsafe and unaffordable housing, family violence and instability, employment discrimination, inadequate education, and lack of access to health insurance and care. Such problems negatively affect physical and mental health and contribute to the health disparities that disproportionately impact low-income and marginalized communities of color. Housing instability and homelessness, for example, can increase the risk of chronic illness, infectious disease, and death, and also have a profound impact on mental health, creating or exacerbating psychological distress, anxiety, and depression. Research indicates that even years after an eviction, mothers are more likely to be depressed and report feeling increased material hardship and parental stress.

Many underlying social determinants of health implicate or raise legal issues that require advocacy to overcome. One patient might skip critical medical or psychiatric appointments because he is unaware of his legal rights in the workplace and is afraid of losing his job if he misses work. Another may suffer from severe depression even with significant counseling and medication management because of anxiety and stress associated with overwhelming debt or the threat of imminent family violence. Such “health-harming legal needs” create barriers to achieving good health and are major contributors to health disparities. Although nurses and other healthcare providers understand the significant impact social determinants have on health, they do not always draw connections between those determinants and the legal issues they raise. Nor do they generally think of law as a tool that can be prescribed to improve a patient's health and well-being.

Medical Legal Partnership (MLP) is an innovative healthcare model that fills that gap by bringing doctors, nurses, and other health professionals together with lawyers to address unmet legal needs that negatively impact health and well-being.

Keywords: health law, health policy, medical-legal partnerships, mental health