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Health Aff (Millwood). 2017 Dec;36(12):2195-2203. doi: 10.1377/hlthaff.2017.0759.

Medical-Legal Partnerships At Veterans Affairs Medical Centers Improved Housing And Psychosocial Outcomes For Vets.

Author information

1
Jack Tsai ( Jack.Tsai@yale.edu ) is a core investigator for the Veterans Affairs (VA) New England Mental Illness, Research, Education, and Clinical Center, in West Haven, and an associate professor of psychiatry at the Yale University School of Medicine, in New Haven, both in Connecticut.
2
Margaret Middleton is executive director of the Connecticut Veterans Legal Center, in West Haven.
3
Jennifer Villegas is a research assistant at the VA Connecticut Healthcare System, in West Haven.
4
Cindy Johnson is a staff attorney at the Connecticut Veterans Legal Center.
5
Randye Retkin is director of LegalHealth, a division of the New York Legal Assistance Group, in New York City.
6
Alison Seidman is a research assistant at the New York Legal Assistance Group.
7
Scott Sherman is a physician in the VA New York Harbor Healthcare System and an associate professor of medicine at the New York University Langone Medical Center, both in New York City.
8
Robert A. Rosenheck is a senior investigator for the VA New England Mental Illness, Research, Education, and Clinical Center and a professor of psychiatry at the Yale University School of Medicine.

Abstract

Medical-legal partnerships-collaborations between legal professionals and health care providers that help patients address civil legal problems that can affect health and well-being-have been implemented at several Veterans Affairs (VA) medical centers to serve homeless and low-income veterans with mental illness. We describe the outcomes of veterans who accessed legal services at four partnership sites in Connecticut and New York in the period 2014-16. The partnerships served 950 veterans, who collectively had 1,384 legal issues; on average, the issues took 5.4 hours' worth of legal services to resolve. The most common problems were related to VA benefits, housing, family issues, and consumer issues. Among a subsample of 148 veterans who were followed for one year, we observed significant improvements in housing, income, and mental health. Veterans who received more partnership services showed greater improvements in housing and mental health than those who received fewer services, and those who achieved their predefined legal goals showed greater improvements in housing status and community integration than those who did not. Medical-legal partnerships represent an opportunity to expand cross-sector, community-based partnerships in the VA health care system to address social determinants of mental health.

KEYWORDS:

Access To Care; Hospitals; Mental Health/Substance Abuse; Public Health

PMID:
29200329
DOI:
10.1377/hlthaff.2017.0759
[Indexed for MEDLINE]

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