Justice in Health? Studying the Role of Legal Support in a Culturally Responsive Mental Health Service in Australia.

Abstract

Health Justice Partnerships (HJPs) are collaborations across law, health, and social care seeking more equitable health outcomes. This article aims to explore an HJP embedded within a culturally responsive mental health service in Australia for people who are culturally and racially marginalized (CARM). We draw on data produced for an evaluation of this service between August and November 2022 to conduct a reflexive thematic analysis. Thinking conceptually with the social determinants of health and intersectionality operationalized as structural, political, and representational, we present findings from individual and group interviews with 16 service users and 37 service providers. First, we describe the variety of legal issues service providers and service users encounter and how they affect opportunities for good health. Second, we provide insights into how care coordination across practitioners from different sectors and professions takes place to support service users. Third, we identify service principles and values that inform practices of integrated and culturally responsive care. We tie these insights together to demonstrate how multiple social categories flow together in the experiences of people from CARM communities in Western, White normative, and/or settler colonial societies. People confront built-in legal issues, for example, related to immigration legal status, welfare, housing, employment, or family, that affect mental health. Health, legal, and social systems have the dual capacity to capture people from CARM backgrounds in relations of care as well as oppression. We offer methodological reflections on studying these dynamics through culturally responsive qualitative research and discuss implications for culturally responsive HJP practice.