Social Prescribing: A Collaborative Approach to Health and Wellbeing

Loss is a key theme that presents time and time again, whether it’s loss of a loved one, a job, health, housing, independence or how they expected life to be. If people are not supported to process this grief, along with the accompanying emotional upset, shock and low mood, they can find themselves with reduced confidence, self-esteem and motivation.

‘Loneliness is the most unrecognised health crisis of this generation … [It’s] as fatal as smoking 15 cigarettes a day, making it more dangerous than obesity,’[1] according to Senator Keith Swanick, GP and Chairperson of the Loneliness Taskforce in Ireland, citing a recent U.S. study.[2]

As a Social Prescribing Coordinator, I have seen first-hand how isolation impacts both the individual and our health services. I will focus here on this impact and provide an overview of Social Prescribing, a service that helps connect people to activities and supports in their local area.

Isolation doesn’t discriminate; it can affect people across all age groups and backgrounds, and can have a profound effect on health and wellbeing.[3] Those experiencing it can suffer disproportionately with mental health issues, cognitive decline and hypertension, and are more likely to be admitted for residential or nursing care.[4]

The causes of loneliness and isolation can be multifaceted such as family breakdown, bereavement, leaving education early, unemployment, lone parenting, addiction, ill health, caring responsibilities or migration.

People experiencing this isolation often don’t know where to go for support and so attend their GP to look for a medical solution to a social issue. GPs are then expected to source the correct supports for an individual’s myriad social needs. The cost to the Irish health service is as yet unknown but in the UK 20% of patients attend their GP for social rather than medical reasons, costing the NHS £395m per year.[5]

In a growing number of locations around Ireland, health professionals now have access to Social Prescribing, a referral service that aims to reduce loneliness and social isolation by linking people with non-medical sources of support within their local community.

Social Prescribing Coordinators support individuals to access interventions such as exercise classes, social groups, creative activities, volunteering opportunities, employment services and educational courses. We work in conjunction with health services, relieving pressure on primary care teams whilst increasing the uptake of local supports and services. In Waterford City, Social Prescribing services are available free of charge to people over 18 regardless of their income or employment status.

I have worked in Social Prescribing for three years, initially as a Coordinator in Hackney, East London. In January 2018, supported by a dedicated inter-agency steering group, I set up the Waterford service, which is funded by Healthy Ireland. When reflecting on the diverse community I worked with in Hackney and now the people I meet with in Waterford, I am struck by the similarities rather than the differences in what people speak to me about and look for support with.

Loss is a key theme that presents time and time again, whether it’s loss of a loved one, a job, health, housing, independence or how they expected life to be. If people are not supported to process this grief, along with the accompanying emotional upset, shock and low mood, they can find themselves with reduced confidence, self-esteem and motivation. All of these factors can cause them to feel isolated. My role is to work with them and support them to access the right services for their needs.

In order to do this, I stay up to date with the supports and services that are available locally and link people with these as smoothly as possible. In Waterford, there are a diverse range of organisations and activities available to the public including many arts opportunities that take place in specific creative spaces, community hubs, local libraries and community health settings such as Shine Waterford Discovery Hub and Solas Cancer Support Centre. It is important that I can offer people suggested activities in a range of locations and with a variety of costs from free community sessions to paid-for evening classes. Of the participants I have worked with, they have taken up drama, art, dance, crafts and photography. Participants have told me that these creative sessions have allowed them to reconnect with their younger selves, giving them renewed confidence and showing them new ways of coping with life’s challenges.

Social Prescribing operates differently in each location around Ireland depending on the profile of the local area. We are fortunate in Waterford to have access to so many resources that I can encourage and support people to attend. In more rural parts of the country, where there are fewer activity options, Social Prescribing Coordinators are listening to the needs of participants and responding by organising and facilitating new groups in the local areas themselves.

The Waterford Social Prescribing Service has secured funding for an evaluation of its programme in 2019 and so for now we look to studies carried out in Donegal and the UK for the potential impact of the service. The Donegal evaluation showed there was ‘a highly significant positive impact on wellbeing, anxiety and depression levels and there was a 20% reduction in GP attendance for participants.’[6]

In Hackney, there was ‘an 81% improvement in social networks, 76% developed coping strategies, 57% took up physical exercise and 75% improved their levels of self-esteem.’[7]

Further research is needed as many studies are small scale and focus on progress rather than outcomes. Researchers have also discussed the challenges of measuring the results of the services’ complex interventions. However, the UK Department of Health is so encouraged by the impact Social Prescribing is having on individuals and the health service, they have pledged to have the service available to every GP practice across England within the next 5 years.[8]

In conclusion, loneliness and isolation are having a major impact on individuals’ lives and putting extra strain on an already overstretched health system. Social Prescribing provides the opportunity for people to heal from their loss, to look to the community around them and to discover the range of services available in their local area.

Cecily Maher is a graduate of Social Care from Waterford Institute of Technology. She has worked with marginalised communities in both Ireland and the U.K. for the last sixteen years. In the past she worked locally, regionally and nationally with the LGBT+ community in Ireland and was a founding member of the London Irish LGBT Network. She managed the volunteer and outreach services of a charity that supports the health and wellbeing of Irish people in London, training in brief intervention, motivational interviewing and goal setting. She is delighted to be able to transfer her experience of working as a Social Prescribing Coordinator in Hackney to her home city of Waterford.

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[1] https://www.thejournal.ie/readme/keith-swanick-loneliness-4369249-Dec2018/

[2] https://www.webmd.com/balance/news/20180504/loneliness-rivals-obesity-smoking-as-health-risk

[3] https://www.campaigntoendloneliness.org/wp-content/uploads/Loneliness-Is-An-Epidemic.pdf

[4] https://lonelinesstaskforce.files.wordpress.com/2018/06/loneliness-taskforce-a-connected-island-an-ireland-free-from-loneliness.pdf

[5] https://www.citizensadvice.org.uk/Global/CitizensAdvice/Public%20services%20publications/CitizensAdvice_AVeryGeneralPractice_May2015.pdf

[6] https://www.hse.ie/eng/services/list/4/mental-health-services/nosp/research/reports/donegal-social-prescribing-evaluation.pdf

[7] https://www.family-action.org.uk/content/uploads/2014/03/Family-Action-Impact-Report-2015-Social-Prescribing.pdf

[8] https://www.gponline.com/dh-pledges-roll-gp-social-prescribing-across-england-2023/article/1496121