Medical-Legal Partnerships to Serve Veterans with Mental Illness

Background:  This presentation offers results of a one-year observational study of Medical-Legal Partnerships for homeless and low-income veterans with mental illness in the Veterans Affairs healthcare system. First-of-its kind evaluation conducted across four sites in two Northeastern states. In MLPs, legal providers work with healthcare teams to help patients address legal problems that impact their mental and physical health. Civil legal problems, stemming from negative social determinants include: evictions, child support issues, consumer debt, and difficulty obtaining disability benefits – all of which are addressed by MLPs.

Methods:  A convenience sample of 200+ veterans referred by their VA clinicians for MLP services at one of four sites in two Northeastern states. Eligibility criteria for MLP services: low-income and currently receiving VA mental health services.  The association between MLP services and improvements in mental health and quality of life outcomes will be evaluated using repeated-measures design. Data from workshops to educate  VA clinicians about MLPS will be analyzed for pre-post change using paired t-tests.

Findings:   The sociodemographic and clinical characteristics of veterans served by MLPs will be described along with their legal problems and the legal services received. The effect of providing legal services on housing, mental health, and quality of life outcomes in the first 6  months will be presented.

Conclusions: MLPs are a relatively new approach that hold great potential in addressing social determinants of mental health. Mental health clinicians are receptive and willing to working with legal providers to help clients improve their lives. Veterans with mental illness seeking services through MLPs have complex needs and often more than one legal issue. These legal issues often take longer than 3 months to resolve, but VA clinicians are receptive to working in MLPs.