what does the evidence tell us? professor pascoe pleasence faculty of laws, university college...
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What Does the Evidence Tell Us?
Professor Pascoe PleasenceFaculty of Laws, University College London
“We live in a law-thick world” Gillian Hadfield
Links between legal problems and morbidity
A Medical-Legal Vicious Cycle (adapted from Tobin Tyler et al 2011, p.236)
Homelessness Health problems
Inability to work / disruption of work
Eviction Loss of income / welfare needs
Non-payment of rent
• Over the past two decades, at least 33 large-scale national surveys of citizens’ ‘legal needs’ in upwards of16 separate jurisdictions.
• Around 100 publications associated with the surveys
• A substantial evidence base, providing a remarkably consistent picture
National citizen surveys Sub-national citizen surveys
Health impact of legal problems
CSJPS 2010 and 2012
51.3% reported to have one or more adverse consequence
24.7% reported to have led to stress-related illness
4.0% reported to have led to another mental health problem
8.8% reported to have led to physical ill-health/injury
More than 15 million legal problems each year
CSJPS 2010 and 2012
Health impact of legal problems
The health impact of legal problems
Impacts reported by those experiencing legal problems
(Gramatikov & Verdonschot 2010)
Legal problems and morbidity: a strong association
Problem prevalence by age and illness/disability status
(English and Welsh Civil and Social Justice Survey – Pleasence and Balmer 2009)
Legal problems and morbidity: a strong association
Problem prevalence by age and illness/disability status
15-24 25-34 35-44 45-54 55-64 65+0
25
50
75
100
No illness/disability Physical only Mental only Physical and mental
Age
Prob
lem
pre
vale
nce
(%)
(Australian LAW Survey – Coumarelos and Pleasence 2013)
Drilling down
A closer look at young people
Legal Problems, Age and Disadvantage as Determinants of Mental Health
No problem Problem0%
10%
20%
30%
40%
50%
16-24 NEET Isolated 16-24 NEET Not Isolated 16-24 EET Isolated 16-24 EET Not Isolated 25-59
Group
% w
ith m
enta
l hea
lth p
robl
em (M
CS <
45)
A closer look at young people
And comparing users of YIAC services
Patient centredClient centredCitizen centred
Health and legal problems: and public services
Increasing co-ordination of health and legal services
292 Medical-Legal Partnerships in hospitals in 36 U.S. states.
Inspired the Health-Justice Partnership between Bendigo Community Health Services and Loddon Campaspe CLC.
Building on other initiatives in Australia, such as West Heidelberg CLS’s long-term integration with Banyule Community Health, the NSW Cancer Council Legal Referral Service, Baker & McKenzie Cancer Patients’ Legal Clinic at Peter MacCallum Cancer Institute.
Similar initiatives in England, such as Macmillan Welfare Benefits Service.
Around 40% of CABx outreach is in health settings.
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