The Importance of Social Prescribing

Social prescribing involves personalising treatments to our patients – finding alternatives to the standard medicine we prescribe. It often uses the local voluntary services in the community to provide social and emotional support.

It is often done in primary care and not thought of as something immediately relevant to psychiatry, as a secondary mental health service. However, we hosted a social prescribing conference jointly with NHS England on the 12^th of June which was a huge success. Our patron, Prince Charles, provided a video for the day and is very much in support of our work in this area. 

The aim of the day was to begin a network across the country of social prescribing leads within mental health organisations to support the development of social prescribing services, not only in primary care but in secondary mental health too.

Some members might be questioning why we, as psychiatrists, are supporting social prescribing. There are in fact many reasons:

1. First, we all use the biopsychosocial model to varying degrees in our practise, and social prescribing services would support the ‘social’ aspect of this approach.
2. Second, there is good evidence that people with more social identities have improved mental and physical health outcome (Jetton. J et al, 2012). 
3. Third, it could help reduce the load on GPs and CMHTs through better engagement with local charitable and volunteer organisations.
4. Fourth, it will provide a legitimate option for those without a mental illness but with psychosocial stressors, thus avoiding potential over-pathologising and inappropriate manage of these issues within a medical model.
5. Fifth, and perhaps most topically, is that social prescribing has the potential to significantly improve the sustainability of mental health care. 

Extinction Rebellion, however you might feel about their methods, brought the issue of climate change to the front pages of all the newspapers and highlighted how it will affect human societies and importantly, our health. Many doctors were involved in the actions because they see the threat of climate change as a direct threat to human health – including mental health. We have a part to play in the national response to this issue because we have a social role, as doctors, to advocate for health issues. 

Being part of the health community, we have a strong and trusted voice with the lay public, institutions and government which should be used. Further, our patients are particularly at risk from the health impacts of climate change and the NHS has an enormous potential to reduce the UK’s carbon emissions. The carbon footprint of the NHS is around 20 million tonnes per year. Most of this is clinically related such as medication, clinically related travel and medical equipment. On average, we as doctors contribute ten times the emissions in our work life than we do in our personal life. We need to respond by acting responsibly in our day to day work.

The College Sustainability Committee have developed a top ten list of things psychiatrists can do to improve the sustainability of their practice – take a look (PDF).

Hopefully, after reading this, you can see the importance of social prescribing within mental health trusts and the relevance to our patients. So many of our patients need psychological and social support, just as much as they do our clinical support. By educating ourselves around the topic of social prescribing, encouraging its use in our local area, and encouraging patients to use those services available, we could make a huge impact both to our patients and the NHS.

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