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When making ends meet feels overwhelming, should your GP prescribe antidepressants – or a lawyer? At the Centre for Access to Justice, UCL students are helping to ensure vulnerable communities have access to both.

Words Anastasia Hancock Photographs Alun Callender


It’s a scene typical of a doctor’s waiting room. A small boy waits for his mum’s appointment to finish, delving into a box of crayons almost as big as he is, while surrounded by leaflets offering advice on how to stay physically and mentally healthy. It’s not the first time the pair have been to this particular medical centre, but rather than seeing the doctor downstairs for medical advice, they’ve come upstairs, because this time, it’s legal advice his mum is getting.

This mum-and-son family are part of a pioneering new initiative that addresses the fact that physical and mental ill-health are often a manifestation of more fundamental social issues – and aims to treat them at source. The last time this boy’s mum came to the medical centre, the doctor she saw spotted that the stress and sickness she was experiencing was likely to have been caused by the battle she was having with her employers. Rather than sending her on her way with a prescription to treat the symptoms, the doctor was able to refer her to a service just up the stairs, the UCL integrated Legal Advice Clinic (UCL iLAC).

This mum is just one of many users of the service who have been left with nowhere else to turn in the face of troubling legal issues that have contributed to serious health complaints. “Doctors know that often the health issues people bring to GPs are caused by social welfare problems,” says Professor Dame Hazel Genn, Director of the UCL Centre for Access to Justice (UCL CAJ). “They may be stressed due to a precarious job situation, or their child has asthma caused by damp in unsuitable housing conditions. Our Health Justice Partnership is a move towards social prescribing – it is addressing the source of problems on the spot.”

Dame Hazel has spent much of her career looking at public use of the justice system, and says that concerns about citizens’ access to justice have been around at least “since Dickens’s time”. Studying the range of everyday legal problems that people face, she realised that many people don’t know where to go for help, and often end up going to the wrong place for advice or giving up altogether.

What struck her most forcefully was that a single legal problem left unresolved can lead to a cascade of others. A simple debt issue can lead to desperate consequences such as the break-up of a family or the loss of a home, which can lead to serious stress-related health concerns. UCL iLAC is thus the culmination of decades of research, focusing on early advice and intervention by co-locating with a GP surgery, a place people typically go to seek help.

The service, unique among universities, is led by the UCL CAJ’s team of qualified lawyers and advisers, with UCL Laws students working under their supervision. People such as Klara Holdstock, a human rights law graduate, who coordinates iLAC operations.

Inevitably, clients who come here for the first time are highly stressed and often feel very alone. So when Ms K, a young person with a history of self-harm and substance misuse, walks through the door, Holdstock is immediately on hand to make her feel welcome and comfortable.

“It’s important to stay calm, and to let people know we’re here to help,” she explains. For people like Ms K, whose mental state has worsened since becoming homeless and who is struggling to navigate the steps required to obtain housing, receiving the advice and support that the UCL iLAC team offers reminds her that she isn’t forgotten. It’s an invaluable part of the recovery process.

Ms K’s case is worryingly prevalent, and the number of people who find themselves with unresolved legal issues and no access to the right advice is growing. It was this that prompted Dame Hazel to establish the UCL Centre for Access to Justice, combining legal teaching with pro bono legal advice for vulnerable communities.

Patients like Mr D, a pensioner in his early 70s, who suffers from severe depression. He was referred to iLAC by his GP after he went to the surgery with concerns over his worsening mental health, caused by his precarious housing situation. Mr D was living in temporary accommodation in a small room in a basement flat while his homelessness application was being considered by the council. After finding they had no duty to house him, they served him with an eviction notice two days before Christmas.

Paul Heron, a housing solicitor at iLAC, is passionate in his defence of people like Mr D. “I don’t get angry with the local councils,” he explains, “but I do get angry with the system that is designed to treat people claiming benefits or with housing issues as if they’re guilty of something.”

Heron fights tooth and nail for his clients, as evidenced by a phone call he receives between appointments from a worried lady being threatened with eviction. He is at once reassuring and tenacious, leaping up from his seat to grab files and calling down the corridor to colleagues. He is truly invested in his clients’ lives. “The poorest in society are being picked on,” he says.


Doctors know that the health issues people bring to GPs are often caused by social welfare problems

Professor Dame Hazel Genn, Director


The clients we see need advice and literally can’t get it anywhere else because so many advice services have been cut

Rachel Knowles, Head of Legal Practice

“People are really struggling to get help when they need it,” says Rachel Knowles, UCL CAJ’s Head of Legal Practice, a solicitor and teaching fellow who supervises and mentors students undertaking community care work. “The clients we see need advice and literally can’t get it anywhere else because so many advice services have been cut. It can be disheartening at times, particularly where vulnerable children are concerned.

“Sometimes the level of austerity feels hopeless and organisations like local councils just don’t have the funding to help them. But when we have small wins for clients, that feels hugely positive.”

They may be small wins for the team at UCL iLAC, but for the individuals they advise, the effect is life-changing. For Mr D, the homeless pensioner, the service managed to prevent his earlier eviction and several other subsequent attempts. Today he is promised a place in sheltered accommodation for pensioners. For Ms K, the young woman with a history of self-harm, the lawyers helped her fill out the forms for benefits appropriate to her health conditions, even as her health deteriorated and she was hospitalised. They persisted in contacting the Department for Work and Pensions (DWP) to ensure that she was not released from hospital with no money, and are working on securing her permanent accommodation.

The benefits of the service, however, extend not just to the client but also to the UCL students dedicating a part of their academic experience to working at iLAC. For many, this is the first time they have directly experienced the kinds of problems that the most vulnerable in society can face and, as Dame Hazel points out, it can be a transformative experience. “It makes them understand the importance and the power of law to protect,” she says.

Shiva Riahi, Head of Projects at the CAJ, agrees. “From an educational perspective we are trying to place the theoretical in a practical context by exposing students to the barriers people face in accessing justice,” she says. “Until you spend hours on the phone with the DWP trying to get to the right person, or send letter after letter only to be continually ignored, you may not truly appreciate how easy it is to be shut out from effectively accessing the legal system, which is ultimately there to protect and promote individuals’ rights.”

For some, the help the service has provided to overcome these hurdles has meant the difference between life and death. For Heron, one case stands out. A former soldier who served in Iraq had found himself in significant rent arrears, was facing homelessness and suffering with PTSD. After some “perseverance and doggedness”, social services provided the ex-soldier with proper budgeting advice and a rental deposit, and he is now living successfully in private rented accommodation.

The project is still in its early days, and the team is seeking to demonstrate the measurable impact the service is having by undertaking research into the health and wellbeing of clients, as well as the outcomes of the legal cases. The research aims to gather evidence on how integrating health and legal advice services can support both individuals and the health system.

“Sometimes people will become upset when recounting their stories, as often they’re under significant emotional strain,” explains Sarah Beardon, the team’s Health Researcher. “But they understand the value of the research and they want to be part of finding a solution for their community. Taking part in the study can even be quite therapeutic, as people rarely have the opportunity to be really listened to. But most importantly, the clinic is changing people’s lives in a very tangible way, and we hope the research will support the development of similar services in future.”


Shiva Riahi (left) and (right) Klara Holdstock

Until you spend hours on the phone with the DWP or send letter after letter, you may not appreciate how easy it is to be shut out from the legal system

Shiva Riahi, Head of Projects


People want to be part of finding a solution for their community. Taking part in the study can even be quite therapeutic – it’s an opportunity to be really listened to

Sarah Beardon, Health Researcher

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Portico Issue 4. 2017/18