Tessa Boyd-Caine writes:
COVID-19 is an unprecedented public health emergency warranting the extreme measures we are now seeing implemented. And as states and territories begin to lock down non-essential services, many of us are preparing to remain at home and out of harm’s way.
While few of us will escape the impacts of COVID-19, not all of us will experience them in the same way.
There are many people already whose existing problems may be exacerbated by the crisis. At the same time, the capacity of the services they rely on to support them will be severely strained. In some cases, those services may have to cease entirely.
Social distancing disastrous for some
And what if staying at home is the worst thing possible for your health?
While ‘social distancing’ is intended to protect against transmission of the virus, it can be disastrous for some. What about the people whose reliance on the private rental market or public housing leaves them with no choice but to live in accommodation that directly undermines their wellbeing; whether through the presence of mould impacting their respiratory health or overcrowding that spreads infection?
A global catastrophe of this proportion is stressful for us all, but some people living with mental health problems will to experience heightened symptoms. People living with disability, who rely on personal support services, may also be disproportionately affected.
‘Social distancing’ isn’t helpful here. Now, more than ever, people need contact with others they trust. We need to observe the rules of physical distancing, while staying as socially connected as possible with those who need it.
And what of the women and children at risk of or experiencing family violence, or seniors who are vulnerable to elder abuse, for whom the home is anything but safe?
The Morrison Government’s weekend funding announcement regarding mental health and family violence services is welcome recognition that support is needed right now.
However, there are those whose existing social and legal challenges will worsen during this pandemic; people for whom phone lines and counselling won’t protect them from the worst of the social impacts of COVID-19.
These are the communities who need more than a health response to the current crisis; they need a health response that recognises that quality and security of housing is critical for social distancing and self-isolation to be effective. People living in accommodation that is unhealthy or unsafe must be offered alternatives as a matter of urgency.
Community and social services are being scaled back, because of funding uncertainty and/or to maintain workforce and community health. Now is the time for these services to be ramped up, while supporting the health and safety of those frontline community service workers.
Health inequality already plays a role in who is likely to access hospital emergency departments most often; it also determines who will be hit worst and longest by the social consequences of this crisis. While our primary and acute health services will be responding to the direct impacts of COVID-19, social and community services will be needed to mitigate the inequalities of indirect impacts.
We need a frontline workforce for the indirect impacts of COVID-19
Some of the people most at risk from the indirect impacts of COVID-19 will be unable to access phone services. This might be because it is unsafe, for instance in the context of family violence or elder abuse, where people are trapped at home with their abusers. Or because phone advice is itself a barrier to access; for example some people with poor mental health, or people with language or other barriers, where direct access to a person or trusted relationship can make a difference.
For those who will need in-person access, it is the services and the people they serve that are best placed to identify what this looks like. This might mean allowing some legal help to continue on-site. Other services and settings must determine how they can best provide this contact to their most vulnerable clients. Government and other funders must recognise that some of this work will need to be done in person, and offer frameworks to enable this; both in terms of identifying this as essential work and providing the protective equipment to ensure workers and community members remain safe.
We need emergency measures to support legal and other assistance on this frontline
Uncertainty of funding is a major barrier to the preparedness of legal assistance services to meet existing, let alone anticipated increases in, demand for their help. Finalising the National Legal Assistance Partnership is critical to that end.
However, thousands more Australians will now be eligible for publicly funded legal assistance than ever before. The impact of COVID-19 adds to existing critical issues, such as credit and debt, housing, employment, criminal and family law. We must create the capacity for services to scale up to meet our expanding legal needs.
Governments need to work with legal assistance service representatives to determine the level of funding needed to provide legal assistance for issues arising due to the COVID-19 crisis, for those now eligible for it.
The national COVID19 coordination commission
There will inevitably be problems arising from mistaken or confusing advice that needs to be rectified, or decision-making that needs to be reversed. For example, mistakes are inevitable as thousands of additional people access social security for the first time and are reliant on a new and possibly inexperienced workforce at Centrelink. Such problems will likely drive a spike in demand to legal assistance services.
The National COVID-19 Coordination Commission provides an opportunity to identify and resolve problems early and effectively. We need to see a coordinated, cross-agency process that brings together decision-makers in critical services such as social security (for example Centrelink or Services Australia) and frontline services (for example, the peak bodies for legal assistance and social service organisations). These will function as the ‘canary in the coalmine’ when things go wrong.
It is uncommon for advice and support services to have a direct line to decision-makers within the systems they are providing advice about. But this model will ensure people continue to access the support they need; and would also prevent a surge of legal and other challenges when systems fail to work the way they’re intended during this crisis.
Health Justice Australia will continue to receive and share feedback from our partnerships on the very real challenges they are facing, now and as the crisis unfolds. A broad-spectrum approach must be taken as seriously as the economic impacts we are already witnessing. Because there is no economy without society.
And it’s the already existing inequalities in some people’s lives – the social context in which we all live and work – which means the indirect impacts of this health pandemic could be as dire as the virus itself.
Tessa Boyd-Caine is CEO of Health Justice Australia