PM2072: Addressing Unmet Social Needs and Social Risks—mlps as a Vehicle to Access Justice

Background: Despite high legal needs, access to justice to resolve needs is poor, particularly among communities of color. Reasons for lower engagement include prior negative interactions with the criminal justice system that subsequently impact views about the civil justice system, negative past experiences with public institutions, and decreased willingness to engage in any legal proceeding or to seek legal help as it counters personal narratives of self-sufficiency. Medical legal partnerships (MLPs) address individual and structural barriers to attaining optimal health. Little is known about how interactions with MLPs reflect broader concepts of access to justice.

Methods: We conducted a qualitative cross-sectional study of a medical legal pilot program at a tertiary children’s hospital to describe how access to an MLP relates to concepts/perceptions of access to justice. Parents of children who were referred to an MLP were invited to participate in a semi-structured interview about their experience with the MLP. Interviews were transcribed verbatim and coded by two raters, with discrepancies resolved by consensus. The study was approved by the Institution’s IRB.

Results: Parents noted multiple barriers to accessing legal services (Table 1) to resolve unmet social needs and, despite having problems lasting months (Participant 14) to more than a year (Participant 15), hadn’t sought legal services, “before the introduction to services in the clinic.” (Participant 15). Many were not aware that their problem could be framed as a legal issue (Participant 20) or that they would qualify for legal assistance (Participant 18). Without the MLP some noted even if they were aware of the legal nature of their problem, they would not have been able to secure legal assistance (Participant 13). Individuals were motivated to pursue legal assistance for multiple reasons (Table 1), including failed prior attempts at resolution (Participant 13), inadequacy of alternative options (Participant 18), and the difficulty in navigating programs, particularly in the disability setting (Participant 2). Involvement in the MLP invoked perceptions of access to justice (Table 1). Some reflected on equity issues that could benefit from legal recourse (Participant 2). Others noted that access to justice is a fight, fought with legal assistance. (Participant 20). Finally, some noted that MLP involvement empowered them for the future. (Participant 10).

Conclusion: Lack of awareness of unmet social needs as legal problems may impede timely seeking of legal services. Screening for unmet needs may better identify problems to allow appropriate referral to legal services, particularly for those who lack capacity to secure legal services without such programs. Participation in MLPs may assist respondents in conceptualizing their issues as being related to accessing justice. Experiences with MLPs can also better prepare individuals to manage problems in the future, with or without legal assistance, expanding their access to justice.