How health justice partnerships transform responses to family, domestic, and sexual violence
Many women who experience family violence, many reach out to a healthcare professional. In today’s analysis, Dr Joyce Chia (@JoyceKWChia), Policy & Advocacy Lead at Health Justice Australia (@HealthJusticeAu), asks how we can better equip the health system to respond to violence against women and children. Health Justice Australia is a national not-for-profit centre of excellence that supports the expansion and effectiveness of health justice partnerships.
Building upon the health system
When women experience family, domestic and sexual violence, about a third reach out for advice and support from their doctor or another health professional. So how can we better equip the health system to respond to violence against women and children?
As stakeholders pointed out in the consultations leading up to the development of the next National Plan to End Violence against Women and Children, one way to do that is to ‘invest heavily in health-justice partnerships.' This would build upon the Australian Government’s previous investment in health justice partnerships under the previous National Plan. According to the Consultation Report:
Health-justice partnerships were held up by stakeholders as a demonstration of ‘what it looks like to really transform service system responses’.
Health justice partnerships transform responses
So what are health justice partnerships? Health justice partnerships (HJPs) embed legal help in healthcare settings and teams, to address unmet legal need for those who are vulnerable to intersecting legal and health problems, but who are unlikely to turn to legal services for solutions. For example, when a woman goes to a hospital or community health centre, a health practitioner who has concerns about her safety can work with a lawyer as part of a multidisciplinary team to make sure the woman’s safety is protected as part of her care.
It's a collaborative, person-centred service model that 'allows for a wraparound response to the diverse needs of different communities'. It helps people navigate a complex service system, reducing the trauma of retelling their story and improving their access to the support they need.
It's a model that works especially well where people have complex and intersecting needs that undermine their health and wellbeing, such as in family, domestic and sexual violence. Of the 109 health justice services across Australia, almost half of them targeted such violence, and almost all of them reported responding to issues relating to family, domestic and sexual violence.
As stakeholders in the Consultation Report on the National Plan highlighted, these partnerships work. They help to provide early legal advice in the places people trust:
Essentially we know that women are more likely to talk to their health professionals and seek quasi-legal advice than they will talk to lawyers, because they don’t have access to lawyers in the way that they have access to health professionals ... If they can then be linked in with lawyers, legal advice, legal assistance, it can be a really safe way of obtaining that advice and assistance.
They also expand access to services by leveraging the:
opportunity to use a system as vast as the healthcare system, so many trusted points of entry in lots of different contexts, whether it’s community-controlled health services, whether it’s child and maternal health nurse centres ... using that trusted point of access to get help to a whole range of other problems that are appearing in peoples’ lives.
Importantly, the model means that health providers don't need to become experts in legal need. Rather, by 'connecting services better together ', health justice partnerships can build the 'legal awareness and capability of health workers'.
Health justice partnerships as a response for First Nations communities
The Consultation Report identified the opportunity for health justice partnerships in Aboriginal and Torres Strait Islander communities to offer community-led, strengths-based responses to family, domestic and sexual violence. This is a model that already exists. Of the 109 health justice services, 20 involve Aboriginal community-controlled services.
As someone explained in that report:
Health-justice partnerships are so key because our ACCHOs are a trusted source, … it’s a place where we identify, it’s where we self-determine … Community-controlled model is the model that we protect fiercely, and that model has come out of not being visible in this country and being powerless in this country. And so, health justice partnerships, particularly when you are partnering with an [ACCHO] to deliver comprehensive primary healthcare for Aboriginal and Torres Strait Islander people, is a key, key partner, because that network is ingrained and woven through community.
Health justice partnerships work to protect children
The Consultation Report also highlights the potential role health justice partnerships could play in providing early support to parents at risk of involvement with child protection systems. As one practitioner explained:
I work a lot in the child protection space at the moment and early legal advice is not something that happens in that area at all. It’s sort of crisis response at obviously a critical time of removal of children and we want to see much earlier advice so our health justice partner, should be providing early legal advice to women who are pregnant with the aim of actually keeping the baby in their care when they’re discharged.
In a Health Justice Australia survey, 31% of health justice partnerships reported child protection work as one of their most common issues, especially in the context of family, domestic and sexual violence. Partnerships have already demonstrated success in keeping families together, or reuniting them. By providing legal help earlier for families at risk experiencing violence, and at risk of interaction with child protection systems, health justice partnerships have the potential to support a shift in the service response from one of risk and removal, to a focus on the wellbeing of the child and their family.
Sustaining effective health justice partnerships
As stakeholders pointed out in the Consultation Report, these partnerships need to be 'embedded into funding agreements and the budget process', with more funding over a longer timeframe. As one stakeholder explained:
We need to make sure … that everybody has to have competency in identifying and responding and referring, and so that we’re actually picking things up earlier … But we have to resource the services, because they’re not going to be able to prioritise that early intervention if we don’t fund them.
Existing, effective partnerships need to be sustained with ongoing funding, and further investment is required to enable this collaborative service response in more settings, including regional and remote areas. Health Justice Australia has already put before the Australian Government a budget proposal that sets out what it would take to build and scale up investment in health justice partnerships under the next National Plan, and the National Aboriginal Community Controlled Health Organisation (NACCHO) has also put forward a proposal to invest in more health justice partnership pilots involving ACCHOs.
Health justice partnerships centre wellbeing
Health justice partnership is an example of a community-led, person-centred service model that responds to shared government policy objectives – to protect and promote the safety, health and wellbeing of women and children. By centring the wellbeing of women and children as the outcome, different policy frameworks, including the new National Plan to End Violence Against Women and Children, and Safe and Supported: the Framework for Protecting Australia’s Children, can drive investment across the government in a system that supports collaboration and partnership between and across existing service sectors. Sure, this will need more investment, but it is also about ensuring existing services are funded in a way that enables them to be more holistic. By enabling these collaborations, the government can transform how services respond to improve the safety and wellbeing of women and children.
This post is part of the Women's Policy Action Tank initiative to analyse government policy using a gendered lens. View our other policy analysis pieces here.
Posted by @PNagorcka-Smith