What is social prescribing?

It’s Mental Health Awareness Week and while the theme for this year is loneliness, it’s still important to think about all areas of mental health. 

Not only did the pandemic make some people feel more isolated than ever, and heighten things like health anxiety, but there are now global events (like the invasion of Ukraine and the rising cost of living) that mean we’re feeling more worried, anxious and stressed than ever before. 

In fact, we’re currently in the middle of a mental health crisis with 38% of GP consultations now having a mental health element, compared with 25% pre-Covid. 

But the increased demand is causing a strain on resources and means people are struggling to get the help they need.

However, this is where social prescribing can come into play.

What is social prescribing?

If you’re not clued-up on what that it is, social prescribing refers to when professionals refer patients to a range of local, non-clinical services to support their health and wellbeing.

So social prescribing seeks to address people’s needs in a holistic way – rather than turning to medications.

‘It works primarily by encouraging people to engage in activities that are meaningful and enjoyable to them, and connecting to other people,’ explains Dr John Read, a professor of clinical psychology at the University of East London.

‘Social prescribing is the use – particularly in primary care (GPs) – of social activities instead of (or in addition to) medication, often for mental health problems such as depression.’

This can include exercise, sports, joining community groups and NGOs, art, drama, volunteering and more.

What are the benefits?

John says: ‘It is now recognised that our primary and mental health services have become grossly over-reliant on a medical model approach to emotional distress.

‘This has led, for example, to one in six people being prescribed antidepressants every year with even higher rates for women, older people and poorer people.’

John explains that while antidepressants and drugs can benefit some people, they can also cause adverse side effects and risks and can sometimes lead to dependency – so other alternative options need to be considered, too.

As a result, social prescribing is gradually being used as an alternative to starting people on antidepressants or other medications.

John says: ‘It avoids implying that there is something irreversibly dysfunctional about people’s brains (e.g. the unproven “chemical imbalance” myth generated by the drug industry).

‘And it encourages us to use our own resources and the resources of the community around us.’

It’s also a more cost-effective as an initial option, and John points out that it saves the NHS money.

What’s the science behind it?

There’s a growing body of evidence that social prescribing can lead to a range of positive health and wellbeing outcomes. 

In fact, studies have already pointed to improvements in quality of life and emotional wellbeing, mental and general wellbeing, and levels of depression and anxiety.

One evaluation of a social prescribing project in Bristol, from the early 2010s, highlighted improvements in anxiety levels and in feelings about general health and quality of life.

And, in 2019, the NHS long-term plan announced an inclusion of social prescribing into its comprehensive model of personalised care. 

This new model aims to enable people – particularly those with more complex needs – to take greater control of their health and care. It also plans for at least 900,000 people to be referred for social prescribing by 2023/24.

So it’s no doubt something we’ll be seeing more and more of over the coming months and years.

Social prescribing can work for a wide range of people, including those…

• with one or more long-term conditions.
• who need support with their mental health.
• who are lonely or isolated.
• who have complex social needs which affect their wellbeing.

Are there disadvantages to social prescribing?

However, it’s worth pointing out that for those who suffer with social anxiety, social prescribing may work in a similar way to exposure therapy – as the patient could feel forced into community activity.

So some patients may find themselves in uncomfortable situations, which may actually heighten feelings of anxiety.

Kimberley Brownlee, a professor of philosophy at the University of Warwick, has also points out another concern.

She says: ‘It might seem to trivialise the pain and complexity of loneliness as something easily solved with some chat.

‘If a GP gives someone a social prescription, he might leave her office feeling more disheartened and incompetent than when he walked in.’

However, it does seem that overall the benefits of social prescribing tend to outweigh the disadvantages.

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