People who are culturally and racially marginalized (CARM) in Western, White normative and/or settler colonial societies confront a variety of built-in legal issues, for example related to immigration legal status, welfare, housing, employment, or family, that affect their mental health. Facing culturally unresponsive and complex health, legal and social care systems can delay or prevent accessing psychosocial supports to address such social drivers of poor mental health. This working paper draws on the evaluation of a culturally responsive mental health service with an embedded Health Justice Partnership (HJP) undertaken between August 2022 and November 2022 in Australia to reflect on the potential benefits and pitfalls of legal support in culturally responsive care.
Legal issues encountered by participants in our sample stemmed from financial difficulties (including debts), welfare access, family breakdown (including domestic and family violence), housing (including access and condition), and employment, migration and settlement troubles. While these legal problems often affect the lives of all people experiencing social disadvantage, people who are culturally and racially marginalized face additional complexities. Legal, welfare and health systems that are culturally unresponsive or fail to recognize the intersecting pathways to social exclusion present formidable challenges to addressing the social drivers of mental ill-health in this population.
Health and social care integration is a perennial challenge for care practitioners siloed by funding streams and time-limited-service delivery. HJPs as a practice-led movement bringing together different sectors, disciplines and worldviews has the potential to create opportunities to address social determinants of ill-health. In the case of legal support for people who are culturally and racially marginalized, this movement needs to be guided by a combination of interdisciplinary frameworks including trauma-informed, strength-based, and person-centered approaches enabling culturally responsive care in which legal, peer and clinical staff need to be accommodated. Where such diverse practitioners collaborate as partners working towards a greater health equity through individual, meso-level and macro-level advocacy, HJPs represent an antidote to some effects of systemic exclusion.