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Bridging the gap between health care and legal services for patients

Toronto, November 17, 2017

By Skaidra Puodziunas

Johanna Macdonald provides  legal counsel to  Sofia, a patient
Johanna Macdonald (right), the first lawyer with the Health Justice Initiative, provides legal counsel to Sofia, a patient at one of the hospital’s family health team sites who received a “prescription” from her doctor to see Macdonald for her health-affecting legal issues. (Photo by Yuri Markarov, Medical Media Centre)

It’s not just doctors and other health-care providers who see patients at St. Michael’s six family health team locations.

As part of a first-in-Canada Health Justice Initiative, patients also have access to an on-site lawyer and legal students who can help them with a wide range of health- affecting legal issues such as precarious employment or housing, family law and immigration matters.

The initiative has seen more than 600 patients.

“Most often clients I see can’t even begin to address their health concerns because they’re dealing with basic housing rights issues, for example,” said lawyer Johanna Macdonald, who saw patients from all the FHT sites. Macdonald recently left to become executive-director of Parkdale Community Legal Services; a search is underway for her replacement.

“By providing legal assistance in a hospital community clinic setting, communication channels between health-care providers and legal teams open up,” Macdonald said

The Health Justice Initiative is the first partnership in Canada between a hospital and a community legal clinic. Macdonald was employed by Neighbourhood Legal Services and Legal Aid Ontario funds the position. The other legal clinic partners are the ARCH Disability Law Centre, Aboriginal Legal Services of Toronto and HIV & AIDS Legal Clinic of Ontario.

The legal initiative is part of a larger strategy at St. Michael’s to address the social determinants of health—the circumstances in which people are born, grow up, live, work and age, all of which impact their health and overall well-being.

“The health justice partnership has helped us to recognize the impact legal issues have on a person’s health and well-being,” said Dr. Karen Weyman, chief of the Department of Family and Community Medicine. “By being able to address a patient’s legal issues, we often see their overall health improve.”

Macdonald said the Health Justice Initiative helps patients feel more comfortable opening up about legal issues in the clinic because it has a less intimidating environment than a formal law office. Most patients are referred to her by their primary health-care providers. However, patients can also contact the lawyer directly or attend a weekly drop-in clinic run by law students.

“We deal with highly sensitive and complex issues daily,” said Macdonald. “But the key is to listen and respond with compassion. It’s an honour and privilege to be a part of this project. I truly feel I’m making a difference for my clients.”

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 29 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.