Skip to main content

Main menu

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • Other Publications
    • abfm

User menu

Search

  • Advanced search
American Board of Family Medicine
  • Other Publications
    • abfm
American Board of Family Medicine

American Board of Family Medicine

Advanced Search

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • JABFM on Bluesky
  • JABFM On Facebook
  • JABFM On Twitter
  • JABFM On YouTube
Research ArticleOriginal Research

Medical-Legal Partnership Effects on Mental Health, Health Care Use, and Quality of Life in Primary Care: A Randomized Clinical Trial

Winston Liaw, Thomas F. Northrup, Angela L. Stotts, Christine Bakos-Block, Robert Suchting, Alvin Chen, Abigail Hernandez, Lisandra Finzetto, Charles Green and Thomas Murphy
The Journal of the American Board of Family Medicine May 2023, 36 (3) 414-424; DOI: https://doi.org/10.3122/jabfm.2022.220349R1
Winston Liaw
From the Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Texas (WL); Department of Family & Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School (TFN, ALS, TM); School of Biomedical Informatics, University of Texas Health Science Center at Houston (CBB); Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston (RS); University of Texas Health Science Center at Houston, McGovern Medical School, (AC); Department of Medicine, University of Texas Health Science Center at Houston (AH); Department of Counseling, Wake Forest University, Winston-Salem, North Carolina (LF); Department of Pediatrics, University of Texas Health Science Center at Houston (CG).
MD, MPH
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Thomas F. Northrup
From the Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Texas (WL); Department of Family & Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School (TFN, ALS, TM); School of Biomedical Informatics, University of Texas Health Science Center at Houston (CBB); Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston (RS); University of Texas Health Science Center at Houston, McGovern Medical School, (AC); Department of Medicine, University of Texas Health Science Center at Houston (AH); Department of Counseling, Wake Forest University, Winston-Salem, North Carolina (LF); Department of Pediatrics, University of Texas Health Science Center at Houston (CG).
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Angela L. Stotts
From the Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Texas (WL); Department of Family & Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School (TFN, ALS, TM); School of Biomedical Informatics, University of Texas Health Science Center at Houston (CBB); Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston (RS); University of Texas Health Science Center at Houston, McGovern Medical School, (AC); Department of Medicine, University of Texas Health Science Center at Houston (AH); Department of Counseling, Wake Forest University, Winston-Salem, North Carolina (LF); Department of Pediatrics, University of Texas Health Science Center at Houston (CG).
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Christine Bakos-Block
From the Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Texas (WL); Department of Family & Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School (TFN, ALS, TM); School of Biomedical Informatics, University of Texas Health Science Center at Houston (CBB); Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston (RS); University of Texas Health Science Center at Houston, McGovern Medical School, (AC); Department of Medicine, University of Texas Health Science Center at Houston (AH); Department of Counseling, Wake Forest University, Winston-Salem, North Carolina (LF); Department of Pediatrics, University of Texas Health Science Center at Houston (CG).
PhD, LCSW
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Robert Suchting
From the Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Texas (WL); Department of Family & Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School (TFN, ALS, TM); School of Biomedical Informatics, University of Texas Health Science Center at Houston (CBB); Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston (RS); University of Texas Health Science Center at Houston, McGovern Medical School, (AC); Department of Medicine, University of Texas Health Science Center at Houston (AH); Department of Counseling, Wake Forest University, Winston-Salem, North Carolina (LF); Department of Pediatrics, University of Texas Health Science Center at Houston (CG).
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Alvin Chen
From the Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Texas (WL); Department of Family & Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School (TFN, ALS, TM); School of Biomedical Informatics, University of Texas Health Science Center at Houston (CBB); Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston (RS); University of Texas Health Science Center at Houston, McGovern Medical School, (AC); Department of Medicine, University of Texas Health Science Center at Houston (AH); Department of Counseling, Wake Forest University, Winston-Salem, North Carolina (LF); Department of Pediatrics, University of Texas Health Science Center at Houston (CG).
BS
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Abigail Hernandez
From the Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Texas (WL); Department of Family & Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School (TFN, ALS, TM); School of Biomedical Informatics, University of Texas Health Science Center at Houston (CBB); Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston (RS); University of Texas Health Science Center at Houston, McGovern Medical School, (AC); Department of Medicine, University of Texas Health Science Center at Houston (AH); Department of Counseling, Wake Forest University, Winston-Salem, North Carolina (LF); Department of Pediatrics, University of Texas Health Science Center at Houston (CG).
BS
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lisandra Finzetto
From the Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Texas (WL); Department of Family & Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School (TFN, ALS, TM); School of Biomedical Informatics, University of Texas Health Science Center at Houston (CBB); Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston (RS); University of Texas Health Science Center at Houston, McGovern Medical School, (AC); Department of Medicine, University of Texas Health Science Center at Houston (AH); Department of Counseling, Wake Forest University, Winston-Salem, North Carolina (LF); Department of Pediatrics, University of Texas Health Science Center at Houston (CG).
BA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Charles Green
From the Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Texas (WL); Department of Family & Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School (TFN, ALS, TM); School of Biomedical Informatics, University of Texas Health Science Center at Houston (CBB); Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston (RS); University of Texas Health Science Center at Houston, McGovern Medical School, (AC); Department of Medicine, University of Texas Health Science Center at Houston (AH); Department of Counseling, Wake Forest University, Winston-Salem, North Carolina (LF); Department of Pediatrics, University of Texas Health Science Center at Houston (CG).
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Thomas Murphy
From the Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Texas (WL); Department of Family & Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School (TFN, ALS, TM); School of Biomedical Informatics, University of Texas Health Science Center at Houston (CBB); Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston (RS); University of Texas Health Science Center at Houston, McGovern Medical School, (AC); Department of Medicine, University of Texas Health Science Center at Houston (AH); Department of Counseling, Wake Forest University, Winston-Salem, North Carolina (LF); Department of Pediatrics, University of Texas Health Science Center at Houston (CG).
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • References
  • Info & Metrics
  • PDF
Loading

Abstract

Purpose: To determine whether an immediate referral to a medical-legal partnership (MLP), compared with a 6-month waitlist control, improved mental health, health care use, and quality of life.

Methods: This trial randomly assigned individuals to an immediate referral or a wait-list control. The MLP involved a collaboration between the primary care clinic and a legal services organization. The primary outcome was stress (6 months) as measured by the Perceived Stress Scale (PSS). Secondary measures included the Center for Epidemiologic Studies Depression Scale; Generalized Anxiety Disorder scale (GAD-7); Patient-Reported Outcomes Measurement Information System (PROMIS); and emergency department (ED), urgent care, and hospital visits. Assessments were at baseline and 3-, 6-, and 9-month follow-ups. Bayesian statistical inference and a 75% posterior probability threshold were used to identify noteworthy differences.

Results: Immediate referral was associated with lower PSS scores and higher GAD-7 scores. PROMIS scores were higher for the immediate referral group with respect to several subdomains. At 6 months, the immediate referral group demonstrated 21% fewer ED visits and 75.6% more hospital visits.

Conclusion: Immediate referral to the MLP was associated with lower stress and a lower rate of ED visits but higher anxiety and a higher rate of hospital visits.

Trial Registration: ClinicalTrials.gov Identifier: NCT03805126.

  • Clinical Trials
  • Family Medicine
  • Health-Harming Legal Needs
  • Mental Health
  • Primary Health Care
  • Quality of Life
  • Referral and Consultation
  • Social Determinants of Health
View Full Text
PreviousNext
Back to top

In this issue

The Journal of the American Board of Family     Medicine: 36 (3)
The Journal of the American Board of Family Medicine
Vol. 36, Issue 3
May-June 2023
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author
  • Back Matter (PDF)
  • Front Matter (PDF)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Board of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Medical-Legal Partnership Effects on Mental Health, Health Care Use, and Quality of Life in Primary Care: A Randomized Clinical Trial
(Your Name) has sent you a message from American Board of Family Medicine
(Your Name) thought you would like to see the American Board of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
14 + 4 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Medical-Legal Partnership Effects on Mental Health, Health Care Use, and Quality of Life in Primary Care: A Randomized Clinical Trial
Winston Liaw, Thomas F. Northrup, Angela L. Stotts, Christine Bakos-Block, Robert Suchting, Alvin Chen, Abigail Hernandez, Lisandra Finzetto, Charles Green, Thomas Murphy
The Journal of the American Board of Family Medicine May 2023, 36 (3) 414-424; DOI: 10.3122/jabfm.2022.220349R1

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Medical-Legal Partnership Effects on Mental Health, Health Care Use, and Quality of Life in Primary Care: A Randomized Clinical Trial
Winston Liaw, Thomas F. Northrup, Angela L. Stotts, Christine Bakos-Block, Robert Suchting, Alvin Chen, Abigail Hernandez, Lisandra Finzetto, Charles Green, Thomas Murphy
The Journal of the American Board of Family Medicine May 2023, 36 (3) 414-424; DOI: 10.3122/jabfm.2022.220349R1
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Introduction
    • Methods
    • Results
    • Discussion
    • Conclusions
    • Acknowledgments
    • Appendix.Study Screening Instrument–CONSORT Checklist
    • Notes
    • References
  • Figures & Data
  • References
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • A Qualitative Analysis of a Primary Care Medical-Legal Partnership: Impact, Barriers, and Facilitators
  • Google Scholar

More in this TOC Section

  • Evaluating Pragmatism of Lung Cancer Screening Randomized Trials with the PRECIS-2 Tool
  • Perceptions and Preferences for Defining Biosimilar Products in Prescription Drug Promotion
  • Successful Implementation of Integrated Behavioral Health
Show more Original Research

Similar Articles

Keywords

  • Clinical Trials
  • Family Medicine
  • Health-Harming Legal Needs
  • Mental Health
  • Primary Health Care
  • Quality of Life
  • Referral and Consultation
  • Social Determinants of Health

Navigate

  • Home
  • Current Issue
  • Past Issues

Authors & Reviewers

  • Info For Authors
  • Info For Reviewers
  • Submit A Manuscript/Review

Other Services

  • Get Email Alerts
  • Classifieds
  • Reprints and Permissions

Other Resources

  • Forms
  • Contact Us
  • ABFM News

© 2025 American Board of Family Medicine

Powered by HighWire