@article {Liawjabfm.2022.220349R1, author = {Winston Liaw and Thomas F. Northrup and Angela L. Stotts and Christine Bakos-Block and Robert Suchting and Alvin Chen and Abigail Hernandez and Lisandra Finzetto and Charles Green and Thomas Murphy}, title = {Medical-Legal Partnership Effects on Mental Health, Health Care Use, and Quality of Life in Primary Care: A Randomized Clinical Trial}, elocation-id = {jabfm.2022.220349R1}, year = {2023}, doi = {10.3122/jabfm.2022.220349R1}, publisher = {The Journal of the American Board of Family Medicine}, 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.}, issn = {1557-2625}, URL = {https://www.jabfm.org/content/early/2023/04/06/jabfm.2022.220349R1}, eprint = {https://www.jabfm.org/content/early/2023/04/06/jabfm.2022.220349R1.full.pdf}, journal = {The Journal of the American Board of Family Medicine} }