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February 18, 2020

Social Prescribing for Health

Reuel S. Amdur

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The United Kingdom has a Minister of Loneliness. That is something that Natasha Beaudin noted in her talk to Ottawa's SWAG (Social Workers in Aging and Gerontology) on January 23. She is a health promoter at Ottawa’s Centretown Community Health Centre. She spoke on social prescribing, referral of patients to non-medical activities, be they arts, leisure activities, or the like.

She mentioned the United Kingdom because the practice of social prescribing is much more advanced there.  The practice addresses the reality that perhaps a quarter, more or less, of people is lonely or isolated.  Social prescribing in Britain is part of the country’s long-term health strategy and has been well researched.  Studies have shown that, after a successful referral, demand on doctor services dropped an average of 28%, with hospital emergency admissions down 24%.

While the British practice involves an active engagement of physicians, her experience is that here it is more of a challenge to interest physicians and nurses.  Social workers and other health workers also make such connections, but social prescribing refers specifically to what doctors and nurses do. In Ontario, community health centres have taken the lead in promoting the practice.

D.C. Williams, Ontario’s Chief Medical Officer, said that “people with a weak sense of community belonging are more likely to  be in the top five per cent of users of health care services; this five per cent accounts for more than 50 per cent of total health care spending. . . , costs that could be reduced if these individuals were part of connected communities.”

Staff may be assigned to enable such referrals, link workers.  The enabling work may be as simple as putting up posters describing activities or events or as intensive as sitting down with the patient to identify and follow through on specific undertakings.  Centretown has obtained passes to museums and musical venues to facilitate such referrals.

One interesting wrinkle in this process is use of people in the role of health champions.  These are volunteers to help create solutions for people needing links to community resources.  Often the champions are themselves people who have needed to move beyond loneliness and isolation. 

The Alliance for Healthier Communities, involving community health centres, is conducting a pilot study on the effectiveness of social prescribing.  Preliminary findings are promising.  Patients are found to have greater sense of belonging, shown in a variety of ways.  They develop better social support networks, become able to support others, are less isolated, interact more effectively with health care providers, are more aware of available social supports, and develop more of a sense of accountability.

Patients also exhibit decrease in anxiety and depression and improved mood, self-esteem, and self-confidence.  They have more of a sense of purpose and are more motivated.  They feel greater sense of accomplishment.

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