Research Into Social Prescribing for Mental Health
If you ask most people about mental illness, they may describe images of people doped up on (medicinal) drugs. Indeed, medication is generally seen by clinicians as an important way to treat mental illness; particularly for serious mental illness.
However, taking medication may fail to address underlying causative factors in someone’s mental state. It may also fail to engage the patient in behaviours that may alleviate symptoms. The doctor may fail to treat to the “whole” person, in all their complexity and uniqueness.
One solution to this problem is for doctors to prescribe social activities outside of, or alongside, taking medication. For example, GPs could prescribe community peer-led intervention, active social support, joining a sports club or other social activity. This may bring a holistic advantage to achieving wellness . Indeed, there is evidence that social prescribing improves the wellbeing of patients with certain mental health conditions - “[s]ocial prescribing is viewed as a means of addressing mental, psychosocial, or socioeconomic issues, and enhancing community well-being and social inclusion” . A number of US researchers go so far as to say that:
“From psychological theories to recent research, there is significant evidence that social support and feeling connected can help people maintain a healthy body mass index, control blood sugars, improve cancer survival, decrease cardiovascular mortality, decrease depressive symptoms, mitigate posttraumatic stress disorder symptoms, and improve overall mental health.”
To further illustrate, a group of UK authors find that patients receiving social prescription in a secondary mental health service to engage in community mental health program found “positive mental health and quality of life so that patients are able to flourish emotionally, psychologically and socially”… “In terms of social well-being, social prescribing enabled social integration for previously isolated patients for whom ‘getting out of the house’ had previously been a challenge”.
The success of social prescription works on the basis that humans are fundamentally social creatures, who depend upon each other for practical, emotional, and personal support. We are all part of a web of relationships whose strength may impact upon our physical, emotional, and psychological wellbeing. Social determinants impact on mental health.
It is important to note that social prescribing may extend beyond connection to social groups, and encompass wider prescribing for such activities as exercise, art classes, meditation and so forth. Again, there is evidence that these forms of activity (or “intervention”) may positively impact the wellbeing of patients, particularly for mild anxiety, depression or eating disorders . Prescribed exercise has been positively correlated with benefits in reductions in anxiety, depression, and negative mood, with increases in self-esteem and cognitive functioning.
Finally, it would be remiss to discuss social prescribing without addressing the potential impact on severe or serious mental illness. Here the literature is far thinner ; perhaps we could refer to general suggestions that “getting out of the house” may help with people’s psychological balance for people living with schizophrenia or bipolar disorders? More research is needed. In any case, there are approaches to treatment of illnesses such as schizophrenia that engage a patient’s family and social circle; Open Dialogue therapy springs to mind. But that may be a topic of discussion for another day…
1https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4882-7
2https://www.emerald.com/insight/content/doi/10.1108/JPMH-10-2019-0088/full/html
https://www.tandfonline.com/doi/pdf/10.1080/17533015.2017.1334002?needAccess=true&
https://link.springer.com/article/10.1007/s10597-020-00631-6
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125010/
https://bjgp.org/content/bjgp/59/563/454.full.pdf
3https://www.tandfonline.com/doi/pdf/10.1080/17533015.2017.1334002?needAccess=true&
4https://link.springer.com/article/10.1007/s10597-020-00631-6
5https://www.emerald.com/insight/content/doi/10.1108/JPMH-10-2019-0088/full/pdf?title=social-prescribing-for-patients-of-secondary-mental-health-services-emotional-psychological-and-social-well-being-outcomes
6https://www.tandfonline.com/doi/pdf/10.1080/17533015.2017.1334002?needAccess=true&
7https://link.springer.com/article/10.1007/s10597-020-00631-6. See also a blog I wrote about schizophrenia and social interaction: https://www.onedoor.org.au/events-media/blog/schizophrenia-and-social-interaction
8https://d1wqtxts1xzle7.cloudfront.net/40103914/The_Open_Dialogue_Approach_to_Acute_Psyc20151117-20753-lrqofm-with-cover-page-v2.pdf?Expires=1651466036&Signature=OMiKRTrHEAbI5HfVvmrZ~UeGsrI65YYMo20htawjj16fhYdzgb93uhuBmW7VHWgZTiDQcAE7mW121HkRUAoC8rxQ8MLFKwJ0CExmz0ipHhQfyAny5qP41Pfm-VULbFeIPgmReN66jnNiKBKBHflnin1Mrvgk1UScYXcjyqEA2ey-TewCyFmQuayMOHvkAvXRXH397nZgr5hsWsPynKZlqU~0RWsdWTK4XbPzdCqMn3culj1SHlLQOtKV3y~hiRhlgZDUnhtLBUY3q2JrAQdfDv~hDRFC8gG542dqL5ktzwNQm33sPAsqi0z6irWvPR4vLB8ot-pu8-ATuz5N4B39lA__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA
http://jaakkoseikkula.com/wp-content/uploads/2016/05/ehssschizophreniaod2002-1.pdf
Dr. Richard Schweizer, Policy Officer at One Door Mental Health richard.schweizer@onedoor.org.au.
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Dr Richard Schweizer