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Research Report: Outreach legal services and complex needs: what works? Justice issues paper 12
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Outreach legal services and complex needs: what works? Justice issues paper 12  ( 2009 )  Cite this report



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The synthesized findings from the eleven studies included in the review are organised around our two research questions:
  • The effectiveness of outreach legal services
  • The features of effective outreach legal services.

Under these two sections, the key synthesised findings (themes) are indicated by bolded headings (italicised and otherwise). Examples are drawn from individual studies to illustrate the points.

The effectiveness of outreach advice services

Outreach services can reach target clients

The review identified that quality outreach legal services can reach clients with complex needs and who had not sought assistance before from mainstream legal service providers, or who otherwise would not have received legal assistance. However, to achieve these outcomes, outreach services need to be appropriately located and connected with target groups and their support agencies. The additional features of outreach services that did successfully reach and assist clients with complex needs are detailed below under features of effective outreach services.

    Analysis of the monitoring data and closed case client records show that the projects were very successful in reaching clients who were both financially excluded and who had not previously sought advice. (Smith & Patel, 2008, p. 4)

Outreach legal services can provide positive outcomes for clients

The review indicated that effective outreach legal services can improve the circumstances of clients with complex needs. This could happen in a number of ways.

    The advice services provided led to a whole range of positive outcomes for clients, including payment plans, and averting the loss of a home or utilities disconnection. In terms of measurable financial outcomes, the pilot projects gained £1.875 million as income for their clients in the one year reference period. (Smith & Patel, 2008, p. 8)

First there was substantial evidence in the studies reviewed indicating that legal assistance through outreach services to people with complex needs can provide positive legal outcomes and improve clients' circumstances, in those areas of law provided by the services. These included housing and tenancy, the management and reduction of debt, management of fine related debt and driving restrictions, access to children and other family matters, access to welfare payment and Centrelink matters. However, many clients also had legal issues which were beyond the scope and/or expertise of the outreach service (e.g. crime, family law). In these cases services tended to provide legal information or would have to refer the matter elsewhere.

The results also suggest that advice through outreach may prevent legal issues from escalating in seriousness which occurs when problems remain unaddressed. However, there is a need for further research in Australia to actually quantify the benefits (e.g. in terms of reduced debt, additional income and saved homes) of providing legal assistance to disadvantaged clients, who otherwise would not have accessed legal help.

Even when legal assistance did not result in desired outcomes, some studies found that the assistance provided to marginalised clients raised clients' self confidence, self esteem and their capacity to take responsibility for their matters. Clients spoke of the assistance provided acting as a 'circuit breaker', enabling them to 'get on with' other areas of their lives. Examples were given of clients being more able and prepared to seek further assistance for subsequent legal issues following the assistance of the outreach service.

    The HLC had settled the mind, calmed them down, reduced stress, broken impasses and provided a new start in many cases... Others stated that the assistance provided had motivated them to help themselves more and given them a starting point. (Kilner, 2007, p. 9)

A number of studies noted the impact of the advice on clients' stress levels and overall health. These studies indicated that debt advice in particular could reduce clients' anxiety. This was chiefly so in cases where action could be taken to manage situations which were 'out of control' (e.g. threatening calls from creditors, immediate threat of eviction) and in cases where clients have long term health problems, which had been exacerbated by the stress. One study surveyed doctors with and without welfare rights advice outreach services on their premises and found that doctors with welfare services were significantly more likely to agree that "welfare rights provision improves the health and well being of their patients" (Sherr, 2002 p.68). Smith and Patel (2008) postulate that better health results for clients receiving debt advice saves money spent on the public health system.
    The research also showed that people getting advice experienced benefits in terms of lower anxiety, better general health, relationships and housing stability. Therefore, beyond the immediate impact of the money advice, the outreach projects can be expected to have generated a range of important additional benefits for clients, and, in turn, saved associated public expenditure, for example, the demands on the health service caused by physical or stress-related ill health. (Smith & Patel, 2008, p. 47)

Impact on the target group through advocacy and law reform

Some of the outreach legal services included in our review used a model which combined case work, systemic advocacy and law reform to address the needs of very marginalised clients. The rationale for including advocacy and law reform in the work of the service was that, on the basis of what is learned through the outreach service, strategic action can be taken to improve the ways laws affect all people in the target group — including those who are so marginalised that they don't even reach outreach legal assistance. The models reviewed indicate that, if appropriately resourced to do this work, outreach legal services could bring the experiences of their constituents to advocacy and law reform.

Impact on host agency

Our review indicates the placement of outreach legal services at host agencies could be mutually beneficial for each service. Host agencies were happy to accommodate outreach legal services, finding that their own service delivery to these 'hard-to-reach' clients was streamlined and the effectiveness of referrals increased. The externally funded outreach legal services assisted the caseworkers to progress their clients' matters without being a drain on the host agencies resources.

    The clinic relieves the burden on the agency, rather than being a burden. (Goldie, 2003, p. 67)

The co-location of the outreach service, and the relationships built between the services provided opportunities to increase the knowledge, skills and networks of the host agency workers, and lawyers alike.

Features of effective outreach services

Pre-planning and needs analyses

A feature of effective outreach legal services is that they reach clients who otherwise would not have received legal assistance. However, the review found that it is important for services to have undertaken appropriate legal needs and service gap analyses prior to the outreach service being established. This involved engaging with other organisations and services from the planning stage to ensure that the outreach legal services were not duplicating existing legal services in the area. Early engagement with other organisations had the additional benefit of streamlining referral processes both to and from the outreach legal service. This was identified as important in the studies, as clients with complex needs may need support from a range of agencies (e.g. housing, welfare, other or specialist legal services) in order to address the range of issues that may be affecting them.

Linking with clients

An overarching theme — and three key findings of this review — concerned how outreach legal services actually connect with 'hard-to-reach clients'. Outreach services need to consider how clients will find out about their service and be encouraged to use it, bearing in mind that this client group is unlikely to actively seek assistance, particularly from a service it is unfamiliar with. In the studies reviewed, three main strategies were successfully used to 'reach' clients: appropriate location, effective referral to the service, and direct marketing to the client group.

Location

Our review indicates that a defining feature of effective outreach legal services is that they are located in places that can be easily reached (e.g. by public transport) and are regularly used by target client groups. Outreach legal services included in our review were located in welfare agencies and homelessness services, community centres, doctors' surgeries, Aboriginal Legal Services,6 mental health services, community credit unions, child and family centres and prisons. The appropriateness of different sites varied with the type of clients the service was aiming to reach and the type of service which was being delivered. Overall, however, our review indicates that successful outreach locations are places:

    Co-location with Aboriginal medical services is an option that should be considered in the development of new outreach services. However it is too simplistic to expect that by merely co-locating outreach legal services with health services, that this will of itself provide effective legal services for disadvantaged Aboriginal people. (Dimos, 2008, p. 64)

  • where there is currently a gap in legal service delivery to the target group
  • which the target group are familiar with and trust, such as places they already access
  • where (to ensure potential client numbers) there is a flow of target-group clients through the service. For instance, more clients access a community centre or welfare agency on a given day than a hostel which has a small number of residents staying for several months
  • that are physically accessible to target clients, including clients with disabilities and clients living in remote or regional areas
  • that have private spaces in which clients and advisers can meet and discuss confidential issues.

However, as will be illustrated below, while placing the outreach service in an appropriate location is important, this alone will not guarantee that clients will access the service.

Effective referral pathways

Building relationships with key 'problem noticers', often in the host agency where the service was located, was a key strategy used to link potential clients with the outreach service. 'Problem noticers' was a term applied in some studies to those host agency staff, staff from other agencies and community members who may notice a client has a legal problem and refer them to the outreach legal service. It was clear from the studies reviewed that simply locating a service on-site at a host agency was usually not enough to generate sufficient and appropriate referrals to the service.

To most effectively use the host agency or community members as a source of referral, our review indicates that:

  • initial and ongoing relationships need to be forged between the host agency (and/or other referring agencies) and the outreach legal service
  • 'problem noticers' benefit from training by the outreach service in how to identify whether clients have relevant legal issues and what the outreach service can do for their clients
  • One pilot project reported that it had provided training to family support workers around how to identify clients in financial difficulty and make referrals. Earlier research into the delivery of advice in health care settings highlighted the importance of delivering formal training for staff in the role of problem noticers. (Day, Collard & Davies, 2008, p.31)

  • the best sources of referrals are sources who are already trusted by the client group, such as case workers, community members or friends.

Marketing the service

The review also identified the importance of marketing the service directly to target clients and communities, and the agencies and individuals who support them. This strategy was particularly useful when host agency referrals were not sufficient to generate clients. The studies indicated that it is not only important to market the existence of a service, but also to outline what the service can do for clients and how they can contact the service.

As 'hard-to-reach' clients tend not to approach services they are unfamiliar with or do not trust, communication and marketing through existing trusted services or people appeared most effective. Indeed, services commonly reported reaching new clients through word-of-mouth referrals from existing clients, once the service became established. The review suggests that some ongoing marketing through host agencies and other local services may also be necessary, and that promotional strategies need to be appropriate to the target audience, for example, culturally appropriate and in plain language. This may involve, for example, explaining or using examples to describe more abstract concepts such as 'civil law'.

Collaboration with the host agency

Another key finding of the review concerned the importance of using both formal and informal mechanisms to sustain an ongoing relationship between the host agency and outreach legal service. Ideally, the relationship between the outreach service and host begins at the planning stage and involves strategic and operational issues. Communication is vital to support ongoing relationship-building, to maintain the flow of appropriate referrals and to address any issues that arise.

Successful strategies identified to maintain communication included shared planning days, regular staff meetings, informal communication between host agency and outreach staff (e.g. in a common tea room) and training for the host agency by the outreach staff and vice versa. Formal resolution processes for disputes between the host agency and outreach service were also put in place in some services.

    ... pilot projects agreed that ongoing work was needed to maintain good working relationships and adequate numbers of referrals from partner organisations. In practice, this meant keeping the project high profile among partner organisations, for example by advisers attending staff or team meetings on a regular basis, making presentations to partner organisations to remind them about the project and its potential benefits for their clients, or informal networking with staff. (Day, Collard & Davies, 2008, p. 31)

Host agencies were an important source of referrals for the outreach legal services (see linking with clients, above). However, in some cases, host agency staff also played an active role in the provision of legal assistance to their clients. For instance, some caseworkers sat in on client interviews, assisted clients to gather necessary documentation and ensured clients met appointment times or court dates.

Service delivery to people with complex needs

As well as actually reaching 'hard-to-reach' clients, several findings of the review identified the importance of providing legal assistance in a way which is appropriate for clients with complex needs. Clients with complex needs may have multiple intersecting legal and non-legal issues. While they may only come to an advisor or lawyer about one issue, this issue may well be bound up with other issues in their lives. In addition, due to the nature of their disadvantage, these clients tend to have difficulties in working with lawyers and dealing with their legal issues. They may have cognitive impairment or literacy issues which affect their interactions with lawyers and others. They may feel intimidated and lack trust in the prospect of dealing with lawyers and may feel embarrassed about seeking assistance (particularly for debt related problems). They may not always attend appointments, may not have necessary documentation and may be difficult to locate for follow up assistance.

Familiarity and trust, providing flexibility, timely services, consistency, confidentiality, and communicating effectively with clients were all identified as key features of effective outreach service delivery to clients with complex needs. Each of these findings is discussed below. Some studies also suggested that clients with complex needs benefited most from concrete assistance, not just advice. Assistance may include writing letters, making phone calls, preparing documentation and in some cases, providing representation in courts or tribunals.

Familiarity and trust

The studies reviewed also stressed the importance of building trust, in order to encourage clients to access the outreach legal service. Clients were more likely to engage with services and individual advisors with whom they were familiar and they trusted. This could take time to develop. As discussed above, locating services in host agencies that were already known and trusted by clients helped to facilitate relationships between clients and the outreach legal service. A number of studies also observed the benefits of high quality legal assistance not only to clients and their outcomes, but in terms of building a good reputation among clients and other services.

    Aboriginal people need to be able to trust someone before they are accepted. When referring people, the Aboriginal Legal Service needs to be satisfied that they are being referred to someone they can trust. (Dimos. 2008, p.43)

Flexibility

All the outreach legal services included in this review focused on particular areas of law — commonly debt and money advice, or 'civil law' more broadly. However, clients who came to these services often also had legal problems which were beyond the scope of the service (e.g. criminal or family law issues). Given the barriers that people with complex needs face in accessing any service, several studies stressed the need for services to be flexible in the range of legal issues they address. Where particular issues could not be addressed by the outreach lawyers, effective referral to other specialist support was considered vital.

Appointment times or drop-in services?

The outreach services reviewed also needed to cater for the chaotic and transient nature of the lives of many of their clients. Studies found that if clients could not 'drop in' on the spot or make an appointment as soon as possible, some simply did not come back. Some services used appointments and others ran a drop-in service. Both types of service provision had mixed results. Drop-in services were reported to be less efficient for service providers. However, drop-in services were often effective in dealing with clients at the time they were ready for action to be taken. A number of services that used an appointment system had difficulties with clients not attending as scheduled.

Strategies employed by services to reduce non-attendance by clients included telephoning or sending text messages to clients on the day of their appointment, having field officers locate and provide transport for people for appointments (a strategy used in small Indigenous communities), and timing legal appointments with clients' visits to the host agency for other services.

Staying in contact with transient clients

One example of the need for and application of flexible practices concerned the strategies identified to assist transient clients. Many studies identified prompt access to assistance as a key strategy to keep in contact with transient clients. However, other strategies employed to stay in contact with clients included:

  • providing the client with clear information about how to get back in contact with the service (e.g. a business card with the name of the lawyer)
  • taking several different contact numbers, addresses or the details of contact people from clients at the first meeting.

Free service

Only one study specifically reported findings concerning the impact of paying (or not) for the outreach legal service provided. In that case, the fact that the legal service was free was seen to increase its accessibility. This finding was reported across a number of outreach sites reviewed in that study.7

Timeliness of advice and action

The studies reviewed reported that clients with complex needs were often slow to seek help and may well be at crisis point by the time they get to an outreach legal service. For these reasons, services ideally need the capacity to provide assistance as soon as possible. One study found that the timeliness and relevance of advice was more important to clients than their familiarity with the service, particularly when issues were at crisis point.

    Fast action is often required due to pressing circumstances and also because the client cannot be relied upon to take follow up action or pursue referrals. (Kilner, 2007, p. 19)

Confidentiality

As outreach legal services may be provided in places where clients are known to others, confidentiality and the importance of having a private space in which to meet an advisor were identified as key issues. In the studies we reviewed, clients seeking debt related advice were particularly concerned about confidentiality.

Consistency/continuity of service

Consistency and continuity in service provision were also highly valued by clients across the studies, with clients preferring to see the same lawyer (a familiar face) each time. Consistency is easier in services with regular paid staff, compared to clinics which operate with a roster of volunteers. However, even some outreach services with paid staff had difficulties with staff turnover. Where continuity of staff is not possible, particularly if matters continue over several months, continuity of service delivery, consistency of advice and handover strategies were considered vital. The location and management of files was an important aspect of maintaining continuity (see 'record keeping' below). The use of precedents and procedure manuals assisted some services with maintaining continuity.

Effective communication between legal advisers and clients

The review indicates that clients with complex needs benefited from and appreciated friendly, approachable and respectful legal advisers, who took time to explain things to the clients in plain language.

Clients also highly valued lawyers who had the ability to listen to them. Not only does the communication between legal advisers and clients take skill, but consideration must also be given to the time that advice sessions may take (see resourcing below), particularly when there are complex issues to unravel.

    The lawyers are always friendly and easy to understand. They simplify things. It was hard to speak to [the lawyer] at first but he made things easy. He explained things to me in an easy way. He was quite thorough. They don't make you feel like an idiot. (Goldie, 2003, p. 32)

This type of effective communication between lawyers and clients was noted to increase client confidence in the process and outcomes (even when these may not have been the outcomes they had hoped for) and their capacity to understand and address their legal issues. Effective communication was also a cornerstone of building the level of trust required to sustain both the client in dealing with their particular matter(s), and the service more broadly.

Staffing, skills and training

The review has highlighted that effective legal outreach involves more than the work of legal advisers alone. Here we discuss the range of roles involved in effective, sustainable outreach legal services and the skills/training required for these roles.

Legal advisers

The review identified skills needed by legal advisers to work in outreach with clients with complex needs. Ideally, outreach lawyers:

  • have sufficient expertise in the relevant areas of law, recognising that the issues facing clients may be complex/at crisis point
  • have some level of knowledge across a number of different areas of law, as clients may come to them with a range of intersecting legal problems
  • are aware of where and how to refer clients who have issues beyond their expertise or role, including understanding the role and capacity of the host agency
  • are skilled in communicating and working with the target group, including clients with chaotic lives, mental health issues and cognitive impairment.

The studies reviewed indicate that it can be difficult to recruit legal advisers who have all of these skills and knowledge.
    ... I sometimes do also have concern about the advice and areas of law that arise although I do think that I keep my head above water. (Lawyer quoted in Goldie, 2003, p. 82)

For this reason, it is likely that training will be required in one or more areas. In addition, cultural awareness training may be required for legal advisers working with Indigenous Australians and other culturally diverse communities.

The review also indicates that all lawyers or advice staff benefit from training in:

  • the operation of that particular outreach service including administrative and record keeping requirements, particularly as they pertain to managing the files of transient clients
  • appropriate referral, including information about the legal and social services available to their clients and the role and work of the host agency
  • safety issues.

The review found that it may be useful to incorporate an ongoing program of training, given issues of staff turnover in a number of the outreach programs reviewed. Notably, some studies observed how the experience of working in legal outreach itself enhanced the skills of the legal staff.

Consideration must also be given to the appropriate supervision of legal work undertaken (particularly if junior lawyers are involved) and the availability of specialist advice to the lawyers.

Para-legal staff

The review identified that clients with complex needs may not always require high level 'legal' skills to address their legal needs. Some clients required para-legal help, for instance, in filling in forms or making phone calls. One suggestion to address this issue was to include either voluntary or paid para-legal staff within the service.

Coordinator

It was clear from the review that appropriately resourced coordination and administration are also intrinsic to the success of outreach legal services to people with complex needs. The tasks undertaken by coordinators included:

  • developing and sustaining relationships with host agencies and other problem noticers
  • developing relationships with other service providers assisting the target client group, for onward referrals
  • accessing specialist support for legal staff, including (pro-bono) assistance from barristers
  • managing funding, funding reporting requirements and program administration
  • coordinating recruitment and training for outreach staff and training for host agency staff.

Where there is no coordinator, these tasks may need to be factored into the advisor's time.

Costs and resourcing

The findings on the costs of outreach services are not straight forward.

A feature of outreach legal services reviewed here, is that they served disadvantaged clients with complex needs. A number of studies found that it can take more time, more resources and more skills to effectively reach and assist these clients -particularly when clients have multiple legal problems and/or other complex needs. Through statistical modelling, Smith & Patel (2008) found that advice time did vary between different client groups.8 However, when the number and type of debt problems were factored into the model, the characteristics of the debt (number and type) were found to be stronger drivers of advice time than the degree of financial exclusion of the client.9 Advice time also varied depending upon the organisation at which the client received the advice.

Smith & Patel (2008) also observed that, in terms of total project funding, outreach cases cost more than mainstream advice services. However, if costs are based on a cost per hour of advice, they found that debt advice provided to disadvantaged clients through outreach can take less time per client, and therefore cost less, compared to providing debt advice to these clients through mainstream legal services. Smith & Patel (2008) conclude that the additional cost of outreach relates more to the overhead or 'fixed' costs of outreach, than the advice sessions themselves. Synthesising the results from all the studies, the fixed costs associated with effective outreach include:

  • coordination and administration
  • supervision and training for advice staff
  • ongoing collaboration with and training for host agency staff and problem noticers
  • marketing costs for the outreach service
  • technology and infrastructure (telephones, internet access, intranet access where appropriate)
  • in some cases, case management of clients who require ongoing or more active support.

Notably it is these very features and their associated costs which our review has identified as the elements that make outreach services more effective.

That said, resourcing requirements will also vary with the host site. For example, outreach to prisons presents particular issues in terms of access, the availability of inmate clients due to lockdown and limited access to technology by advisers (e.g. no mobile phones or internet access) when visiting prisons (see also Grunseit et al, 2008). Other issues such as non-attendance at appointments can also increase overhead costs.

Technology and infrastructure

The review identified that access to appropriate technology at outreach sites facilitated quicker and more effective service delivery. For instance, access to internet (or intranet where appropriate) enabled legal advisers to undertake research, access precedents and produce letters and documents on the spot. Access to client files from outreach sites (in hard copy or electronically) allowed for immediate assistance to transient clients, who may appear for assistance unannounced. Online file management could also assist in monitoring the quality of services provided.

Record keeping and review

Effective record keeping was identified as an important feature of successful outreach legal services. It enabled appropriate supervision of files and staff, allowed the project to be monitored and reviewed, and was used to mount a case for ongoing project funding. As discussed earlier, effective record keeping also helped the service stay in touch with and assist transient clients when they did appear.

All of the programs reviewed had received funding from external funding streams (e.g. Government grants). Appropriate monitoring and review processes were generally a condition of the funding. A key issue in the studies reviewed concerned the capacity of services to meet reporting requirements. Some studies reported lawyers not completing reporting/administration requirements as they were 'too onerous' or because they felt uncomfortable asking clients questions about issues such as disability.

Another issue raised in the review was the need to set realistic and appropriate targets when working with 'hard-to-reach' clients through outreach. As discussed earlier, outreach has a range of necessary but fixed costs associated with its set up and ongoing support. In addition, target clients may be more challenging to assist. This may translate into longer timeframes, fewer clients and higher costs.



These were civil law advice clinics delivered in a host agency which predominately provides criminal law services.
A principal researcher in the set of UK studies reviewed here, noted that most of the people who received outreach advice from the services they reviewed couldn`t afford to pay for advice. She raised the question of whether cost was not explored in many evaluation studies as it may be perceived to be too obvious a question to ask (personal communication, Aug 2009).
For example, they found that advice time was significantly shorter for clients from ethnically diverse backgrounds, compared to `white` clients, and significantly longer for lone parents and couples with children compared to people without children.
In this study `financial exclusion` is measured against 5 criteria, including, no bank account, no savings held, use of high interest credit, priority debts owed and annual income less than 14,500 pounds.

 These were civil law advice clinics delivered in a host agency which predominately provides criminal law services.
 A principal researcher in the set of UK studies reviewed here, noted that most of the people who received outreach advice from the services they reviewed couldn`t afford to pay for advice. She raised the question of whether cost was not explored in many evaluation studies as it may be perceived to be too obvious a question to ask (personal communication, Aug 2009).
 For example, they found that advice time was significantly shorter for clients from ethnically diverse backgrounds, compared to `white` clients, and significantly longer for lone parents and couples with children compared to people without children.
 In this study `financial exclusion` is measured against 5 criteria, including, no bank account, no savings held, use of high interest credit, priority debts owed and annual income less than 14,500 pounds.


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Forell, S & Gray, A 2009, Outreach legal services to people with complex needs: what works? Justice issues paper 12, Law and Justice Foundation of NSW, Sydney