Maia - IMCL client
Maia was pregnant with her fourth child when she linked in with the Women’s Drug and Alcohol Service (WADS) at the Royal Women’s Hospital. There she met Meg, a social worker.
WADS is the only state-wide multidisciplinary drug and alcohol service providing specialist clinical services to pregnant women with complex substance use dependence.
“Maia was a devoted mother,” recalls Meg.
She also faced a number of challenges, including insecure housing, financial difficulties and limited social supports. She disclosed to Meg that she had been a victim of family violence from her ex-partner and she was separated from their children, who remained in his primary care.
During Maia’s pregnancy, she was diagnosed with a serious illness and her condition rapidly deteriorated after she gave birth. With uncertainties around who would care for the child if she was unable to, the Department of Health and Human Services (DHHS) intervened seeking a protection order.
Maia wanted to maintain control over who her child would live with and ensure the baby was in a caring and loving home. Confined to the hospital, her ability to access legal help to deal with DHHS's intervention was limited.
It's not uncommon for patients to have legal problems, explains Meg. “Most of the women we see at WADS, a huge percentage, have issues that they could talk to a lawyer about.”
But, if it wasn’t for IMCL’s onsite legal service, Meg says, it’s unlikely patients like Maia would be able to get the legal help they need.
During Meg’s three years at the Service she has worked closely alongside Jess. As part of IMCL’s Health Justice Partnership at the Hospital, Jess delivers a legal advice outreach clinic at WADS once a fortnight.
“I think the benefit of having Jess is we’re a ‘one stop shop’. The way that the clinic runs is very multidisciplinary and when the patients come in for their pregnancy care they actually get to see a range of different professionals while they’re here. We offer much more in our clinics than many other maternity clinics would."
IMCL Lawyer Jess de Vries (left), social worker Meg Hardiman (middle) and midwife Katrina Flora (right) from WADS worked side-by-side to support Maia.
“WADS is a gateway to women receiving a number of vital services during their pregnancy. It’s a critical juncture to engage pregnant women with complex needs,” explains Jess.
In Meg’s view establishing an environment of trust is key to the success of the partnership between IMCL and WADS.
“Jess is coming to a space where the patients feel comfortable and safe and trust us and our service. To send a woman down to see a lawyer in an offsite setting, even if it is a community legal service which is warm and welcoming and relatively informal, it’s still scary. It is much easier to refer the women when Jess is in. I can personally take them into the room and it is much more personable.”
Having easy and flexible access to a lawyer meant that Maia was able to remain at the centre of the process and able to drive its pace.
“Even when she was unwell Jess was able to speak to her and resolve issues and make progress despite Maia being unwell. She understood that she had to modify the way that she was working with Maia because of her illness. She was just very responsive,” says Meg.
“We know that a person’s legal problems don’t stop when they are in hospital and it is a huge burden when they are already experiencing considerable stress and anxiety about their prognosis. Being closely connected with the hospital allowed me to continue to manage her legal matters and preserve her interests," explains Jess.
Jess worked intensively alongside Maia for nearly a year. This involved multiple visits to the hospital and appearing in court on Maia’s behalf when she was too sick to attend in person. In addition to the child protection case, she helped Maia to formalise decision making about her treatment through a medical power of attorney and connected her with pro bono lawyers to prepare a Will.
"It was incredibly important for her to know that her wishes were made clear and safeguarded by people she trusted, if her treatment was unsuccessful. We also resolved some minor oustanding driving charges,” says Jess.
“There was definitely a sense of relief for Maia when she connected with Jess for legal support – I remember her commenting on the ease of access, given Jess was co-located and feeling as though she didn’t have to keep repeating her story, knowing that we were all connected and working together to support her,” says Meg.
"I think being community-based and being co-located means that Jess’ finger is much more on the pulse. It’s a partnership where we work together and we’re on the same page.”
Meg explains that being on the same page means having a mutual understanding of the impact that legal and other psycho-social issues can have on health and the benefit of holistic care.
“Because we’ve been able to support our female patients in those other areas of their life – like tidying up legal issues, accessing safe housing, getting an intervention order and accessing material aid so they can start preparing for the baby – everything else clicks into place. Substance use often will decrease without us directly addressing it and attendances at clinic appointments increase."
This also has a positive impact on the mothers’ relationship with their babies, explains Meg.
"The more we’ve got them coming in to see us for the practical things that Jess and I can provide, they start to think ‘well actually oh I’m here well I’ll go for that ultrasound’ and then they start to really bond and connect with their baby.”
“I wish every maternity patient had the opportunity to receive the same wrap-around care that staff at the RWH provide, as it is often crucial to mother’s maintaining care of their children,” says a hopeful Jess.
After many months of negotiating and advocating on Maia’s behalf with DHHS, the department eventually withdrew their protection application, giving Maia valuable time to spend with her children and putting an end to all her legal matters.
“In helping to resolve her legal matters she was able to focus on her treatment and concentrate on what was most precious to her which was spending time with her children and knowing that they would be well cared for,” says Jess.
In Meg’s view the proof of the success of the partnership is cases like Maia’s and she recalls her fondly. “With the support of our team, including Jess from IMCL, Maia worked hard to address her issues during the pregnancy and made good progress in various areas of her life. Despite her situation, she was bright, resilient, optimistic and witty. It was rare to see her without a smile on her face.”
IMCL Lawyer Jess de Vries (right) and social worker Meg Hardiman (left) work closely together through IMCL’s Health Justice Partnership.