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Social welfare legal problems and mental health
Social welfare law governs the rights of citizens in relation to issues such as welfare benefits, debt, housing, employment and community care. The conditions referred to as “social determinants of health” often have their roots in social welfare legal issues; for example, poverty, homelessness, adverse living and working conditions. A wealth of literature documents the impacts of these social determinants on health and inequalities (Marmot et al., 2010; Marmot et al., 2020); however, their legal underpinnings are rarely recognised in the public mental health discourse.
Unmet legal needs have a particularly strong relationship to mental health and well-being. Stress-related illnesses or other adverse consequences for mental health are reported by a fifth of adults experiencing a legal problem (Franklyn et al., 2017). These health consequences can lead people to require and use health-care services (Pleasence et al., 2008). The relationship between legal problems and health is bi-directional, with illness being one of the major factors leading to the development of social welfare legal problems such as issues with employment and eligibility for income support (Nosowska, 2004; Zevon et al., 2007). People with mental health issues tend to have more complex and urgent needs for legal advice (Mette and Williams, 2017) and more commonly report discrimination in relation to welfare benefits (Hamilton et al., 2016).
Legal assistance is an intervention that can be used to tackle mental health-harming social conditions and help prevent adverse social impacts of deterioration in mental health (Genn, 2019). Partnerships between health care and legal services have emerged across the world in response to these interconnected health and welfare needs (Lawton, 2014; Forell, 2018). In this paper, we describe an example of a health-justice partnership; discuss the rationale and evidence for this approach in relation to mental health; and reflect on implementation challenges and future directions in the UK. We draw on both health and legal literature to frame the discussion.
The health-justice partnership approach
In England and Wales, the most common health-justice partnership service model is primary-care–based welfare rights advice, where the advice service is co-located and/or receiving referrals from healthcare professionals (Beardon and Genn, 2018). One example of this type of partnership operated across two London boroughs...