Jack Tsai (
Margaret Middleton is executive director of the Connecticut Veterans Legal Center, in West Haven.
Health Aff (Millwood). 2017 Dec;36(12):2195-2203. doi: 10.1377/hlthaff.2017.0759.
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.
医疗法律伙伴关系是法律专业人员和医疗保健提供者之间的合作，旨在帮助患者解决可能影响健康和福祉的民事法律问题，已经在几个退伍军人事务部（VA）医疗中心实施，为患有精神疾病的无家可归和低收入退伍军人提供服务。我们描述了在 2014 年至 2016 年期间，康涅狄格州和纽约州四个合作点的退伍军人使用法律服务的结果。这些伙伴关系服务了 950 名退伍军人，他们总共遇到了 1384 个法律问题；平均而言，解决这些问题需要 5.4 小时的法律服务。最常见的问题与 VA 福利、住房、家庭问题和消费者问题有关。在对 148 名退伍军人进行为期一年的随访的亚样本中，我们观察到他们在住房、收入和心理健康方面有显著改善。与接受较少服务的退伍军人相比，接受更多伙伴关系服务的退伍军人在住房和心理健康方面的改善更大，而那些实现了预先设定的法律目标的退伍军人在住房状况和社区融入方面的改善比那些没有实现的退伍军人更大。医疗法律伙伴关系代表了在 VA 医疗保健系统中扩大跨部门、基于社区的伙伴关系的机会，以解决心理健康的社会决定因素。
