Alex Barwick ABC Alice Springs Drive presenter: Dr Tessa Boyd-Caine is the CEO of Health Justice Australia. She’s with me this afternoon. Great to have you in the studio So what exactly is the connection between health and how people fare in the justice system?
Tessa Boyd-Caine: Hi, Alex. Yeah, not many people think that seeing a lawyer can be good for your health, but really that’s what we’re talking about because for lots of problems that lead people to go and see a health service and to try and get help with their health, often there are underlying drivers where the solution sits beyond the health system. And in the case of health justice, it might well sit in the legal system. So people often think justice is about courts and prisons and policing. But actually we’re talking about everyday problems that have legal solutions. A really good example of that is the impact of mould in someone’s public or rental housing. So you might go and see your doctor because you’ve got respiratory problems or you can’t shake your kids cough. But actually the thing that’s making you sick is the mould in your housing. And until we get that housing fixed, we’re not going to be able to deal with that respiratory problem. So the idea behind health justice is the idea that we help doctors and other health workers collaborate with lawyers so that in addition to getting the cough fixed, we’re actually getting the legally worded letter off to the landlords that says you’ve got to provide a healthy environment for your tenants.
AB: Is there much of a connection and is there much communication going on between those that work in the medical field and the legal system in a place like Central Australia and the Barkly?
TBC: Increasingly, yes. So we support this idea of Health Justice partnerships, which is a collaboration between health and legal services. So here in Alice Springs, you’ve got Women’s Legal Services, you’ve got Legal Aid, you’ve got a range of publicly funded available legal services who are understanding that the kinds of problems that have legal solutions are often being named, are often being talked about in non legal services. So those legal organisations are building partnerships with your base hospital, with your community controlled health organisations to support Aboriginal and Indigenous clients working with other mental health and other health organisations. Because the idea is that you start where people are accessing help and then you bring a range of other services into that setting and that can be really hard because a lot of people are living in remote communities where really immediate access, well, it’s just not there.
AB: So what is available for people like that and what are some of the challenges that need to be overcome?
TBC: Yeah, I mean, the tyranny of distance, I don’t need to tell you or your listeners about that. But again, partnership between services is about doing more with what we’ve got. So yes, these services need to be funded and yes, they need to be delivered where people have need, but also they Carnarvon be more effective if they’re working better with a range of other services. And so that ability, for instance, if you’ve got someone travelling into a remote community, the ability for that person to identify a range of problems in the lives of that community, potentially make referrals, potentially build partnerships with other services so that they can respond better to that range of needs. That’s really the opportunity in partnership and it is a real way of bringing services to the communities that they’re here to help.
AB: So is part of this about, say, remote nurses or visiting doctors making those referrals?
TBC: Sometimes it’s through referrals, sometimes it’s through those nurses or other health practitioners learning more about how legal problems might be shaping the health of the people that they’re here to help. So we’re building capability in our workforce. We’re building capability in the people who work in our services so that when they’re sitting in front of someone thinking, Oh, I think there’s a really serious housing issue. And what they’re hearing from that person is a credit or a debt issue. They can make the connections there in the moment that might be a referral. It might be by providing information, it might be by a range of other ways, including potentially taking information back to other services.
AB: I guess I think, oh gosh, everyone’s under the pump, whether it’s, you know, a Legal Aid or CAWLS here in Central Australia or it’s those remote nurses and doctors. It sounds like an extra layer to put on people who are already stretched, but you think the outcomes will actually end up being beneficial?
TBC: It’s such a great question, Alex, and actually I had that when I first started looking at this approach. But what we’re seeing is that practitioners in these services, service providers, are often seeing a range of problems that they don’t have the skills or the tools to respond to. So in fact, if we’re building capability, if we’re building the knowledge about how to respond to those problems or the relationships with other services that can, we’re actually making the life of those service providers easier and we’re making their services more effective for the communities that they’re here to help.
AB: Is a good example of this the residents of the remote community of Santa Teresa, Ltyentye Apurte are taking legal action against the Territory Government for the condition of their houses?
TBC: I think that’s a really good example of communities using the law to address not just their housing needs but their health and their justice needs. Often we think about the law as what happens when you get into trouble. It’s the acute end. It’s when things have gone wrong. And this idea about health justice partnership is actually trying to help people use the law to prevent those crises in the first place.
AB: What about just for an individual, let’s just say for an example, for a woman who’s being abused by her partner, how does health and access to the justice system come into play there?
TBC: Yeah, family violence is something we do a lot of work on. So we know that no matter how much we improve pathways to help through the justice system, most women and children are going to be accessing help from their health care services. So if we’re not helping health services identify and respond to the needs of people who are not safe at home, then we’re missing a huge opportunity to tackle these problems much earlier. So we see a lot of work helping health professionals understand that a justice response to family violence doesn’t mean we’re sending around the cops and we’re getting dad taken off. It might mean we’re putting in place an intervention order. It might mean we’re helping mum think about what are her financial resources. There’s a range of legal responses we can provide people in a context of family violence or family breakdown, and health pathways can be a really key doorway to that help.
AB: Speaking of things in context, I know you’ve been meeting with lots of local organisations and talking with lots of local residents about what’s going on in Central Australia and the Barkly. There are serious issues around people’s health, housing, interaction with the justice system. We’ve been talking over the last day about the really high incarceration rates here in the Northern Territory. When you talk to locals, what are you hearing in terms of what’s already happening and what could be done better or what could there be more of
TBC: Yeah, look, I really understand people want to feel safe. They’re often concerned they might be angry about what they see as crime rates in their local area. But actually, the Barkly’s a beautiful example of where community is taking action in really important and innovative ways. I mean, the evidence tells us no matter how much we want to lock people up, that doesn’t actually make a difference to crime rates. It often makes them worse. But in the Barkly, we’ve seen both thinking about these sorts of partnerships between services and ideas like justice reinvestment that are saying, okay, what’s the underlying problem? How can we as a community respond to that? And I guess part of my interest is in making sure that services are really connected into that work so that services are supporting those justice outcomes that benefit everyone. So practically on the ground, Health Justice Partnership has a real strength in that it’s not a single way of working. It’s about understanding what communities need and helping services respond to that need. So in Alice Springs, you might be able to access a lawyer when you go to the emergency department. We know lots of the factors that drive people into emergency are not actually health issues. So it might be that you’re on site or you’ve brought someone in and you’re able to get legal help there and then. But there are other services who might say, actually, we don’t want a lawyer on site. That’s not what our community need. We need our staff to build relationships with the legal service so that they can make a trusted referral for the people who are coming here for help. And that’s allowing innovation in the service response, but it’s also making sure that community is at the heart of how our services work together.
AB: Tessa, thanks so much for. Tessa. Thanks so much for your time this afternoon. Thanks, Alex. Doctor Tessa Boyd-Caine. She’s the CEO of Health Justice Australia. She’s giving the keynote address tomorrow at this two day conference being run by NTCOSS in Alice Springs.