Social Prescribing
I've never heard of it.
What is social prescribing?
Social prescribing links patients in primary care with non medical sources of support within the community.
Social prescribing is a mechanism for linking patients with non-medical sources of support within the community. These might include opportunities for arts and creativity, physical activity, learning new skills, volunteering, mutual aid, befriending and self-help, as well as support with, for example, employment, benefits, housing, debt, legal advice, or parenting problems.
Social prescribing is usually delivered via primary care, for example, through ‘exercise on prescription’ or ‘prescription for learning’, although there is a range of different models and referral options.
Social prescribing for mental health provides a framework for: - developing alternative responses to mental distress; - a wider recognition of the influence of social, economic and cultural factors on mental health outcomes across the whole spectrum of disorders; and improving access to mainstream services and opportunities for people with long-term mental health problems.
Social prescribing projects
The most common examples of social prescribing are primary care-based projects that refer at-risk or vulnerable patients to a specific programme: for
example, exercise on prescription, prescription for learning and arts on prescription. However, it also includes a very wide range of initiatives in which primary or secondary care staff provide a signposting or gateway service, linking patients with sources of information and support within the community and voluntary sector.
Social prescribing includes a range of perspectives on the causes and treatment of mental health problems and different definitions of both mental health and mental disorders. The broader, holistic framework evident in social prescribing, with an emphasis on personal experiences, relationships and social conditions, may be more compatible with lay understandings of mental wellbeing and mental distress than a medical model (Rogers and Pilgrim 1997), although there is also considerable support among GPs for more holistic approaches.
Expanding treatment options
Research by the Mental Health Foundation found that 78% of GPs had prescribed an antidepressant in the previous three years, despite believing that an alternative treatment might have been more appropriate. It also found that, of the whole sample, 66% had done so because a suitable alternative was not available, 62% because there was a waiting list for the suitable alternative, and 33% because the patient requested antidepressants.
Of the GPs surveyed, 60% said they would prescribe antidepressants less frequently if other options were available to them (Mental Health Foundation 2005).
While both medication and psychological therapies have a role, social prescribing provides a further opportunity to respond effectively, and at an early stage, to symptoms of mental distress, as well as to initiate a more proactive approach to mental health promotion.
Social prescribing provides a framework for developing alternative responses to psychosocial need and forms part of a wider recognition of the influence of social and cultural factors on health (Brown et al, 2004).
There is a growing consensus among health and social care professionals that psycho-social interventions should form a central component of treatment strategies for common mental health problems such as depression and anxiety (Swift & Parmentier, 2007).
This is especially relevant when one considers the rapid increase in the number of antidepressant prescriptions over recent years (Double, 2002).
There is now greater emphasis on a holistic approach, in which it is accepted that individual treatments and therapies may form only a small part of a much bigger strategy for promoting recovery (Mental Health Foundation, 1997)
References:
Brown. M, Friedli. L and Watson. S. (2004) Prescriptions for pleasure. Mental Health Today. June, 20-23
Double, D. (2002) The limits of psychiatry. British Medical Journal.
Mental Health Foundation. (1997) Knowing our own minds: A survey of how people in emotional distress take control of their lives. London, The Mental Health Foundation.
Swift, M. & Parmentier, H. (2007) Maximising treatment outcomes in the depressed patient. Update.