The year 2020 will go down in history as one of the toughest. In Australia, it began under a cloud of smoke from a horrendous bushfire season, during which 34 lives were lost, more than 3500 homes destroyed and 18 million hectares burned. Then, as the nation began surveying the aftermath of this destruction, Covid19 swept the globe.
Both were crises that affected people’s health, financial security and wellbeing. But for some, these effects were exacerbated by existing, underlying need. People who were already disadvantaged by insecure or overcrowded housing, by precarious employment, by exposure to stigma and discrimination, or who were unsafe in their own homes were hit hard by the health as well as the social and economic impacts of the pandemic.
2020 highlighted the deep, structural inequities that drive complex need and shape people’s experience of and resilience to crisis. It also shone a spotlight on the failings of service systems that operate from a single vantage point, such as the health or legal systems, when the reality for many people is that they experience multiple, intersecting problems concurrently.
More than ever before, the crises of this period demonstrated the importance of health, legal and other human services working together to collaborate around the needs of the people and communities they serve.
Health justice partnership demonstrates how services did exactly that.
When the pandemic hit, health settings, which are a common port of call for help in relation to family violence, began to close or reduce accessibility. Added to the barriers facing clients reaching out, alarm grew at the reduction of help-seeking by women and children at risk of or experiencing family violence. In response, service-led innovation became essential in meeting these needs in a rapidly changing environment. Born of necessity, much of this innovation drew on technological solutions, including webchat and mobile phone numbers for helplines. But it also relied upon the tenacity of practitioners to identify new and safe ways of responding to high-level need among the communities they serve.
Another group of people experiencing complex need during the pandemic were people vulnerable to chronic or mental illness. Evidence began to point to the possibility that people were delaying seeking medical attention due to the pandemic. From their experience of responding to complex health and legal need, health justice partnership practitioners expressed concern about people living with chronic illness or mental illhealth who might be isolating themselves from key services to avoid Covid19 infection, cutting themselves off from important supports for their health and welfare in doing so.
A number of health justice partnerships reported outreach and follow-up by one or other of the service partners to these shared clients, providing important avenues to monitor those most at risk of loneliness, isolation and underlying health conditions.
Working through partnership in this way demonstrated an efficient and effective approach to monitoring the welfare of priority patients or clients, while services were themselves adapting to the conditions of the pandemic. However there was also a downside for these partnerships: where there was a drop-off in numbers of people accessing health services, that had a flow on effect in terms of reduced access to legal help too.
The lessons learned from health and legal assistance services through these successive crises reveal much about what worked, what did not, and how we can build back better to improve service and systemic responses to complex need.
- Despite serious impacts on health and legal practitioner wellbeing, health justice partnership has helped health and legal assistance services to identify and respond to rapidly changing needs among the communities they serve through the successive crises of bushfire and pandemic.
- The capability of services to respond rapidly to changing need in the community was not always matched by government, even when government’s ability to work at scale was critical.
- To improve government responsiveness and community resilience during crisis, we need effective processes that identify and share lessons about what problems are emerging within communities and how best to respond to them by health, legal assistance and other service systems.