Family physicians in Britain are increasingly prescribing art classes, gardening clubs and walking groups — as an alternative to pills — to patients with mental health challenges.
The practice, known as social prescribing, is covered by the U.K.’s National Health Service or NHS and is geared toward people with mental health challenges described as mild or moderate.
“What we’re looking at is non-medical solutions — where appropriate — for people that can often be more transformative than just giving them medication, which doesn’t always get to the root of the cause,” says Marie Polley, founder of the Social Prescribing Network, a group of health professionals involved with using the method.
“Within the NHS, we have general practitioners who are all recognizing that people are coming back to see them over and over and over again and what they’re prescribing isn’t working.”
The patient is typically involved in selecting activities, she adds.
“It could be creative groups where people are knitting or creating things because it’s a way of expressing when words don’t work,” Polley says.
“Or it could be something that looks at social welfare needs. It might be helping a person get their CV up to date and understand how to get back onto the computers and how to effectively apply for jobs so that they can get back into work and have something that brings purpose and meaning to them.”
What success looks like
Evidence on the effectiveness of the method is limited but anecdotally, Polley describes improvements to participants’ overall well-being.
They factor in what route a person is taking and how connected they are to people, she adds.
“We’re measuring well-being as an overall indicator of change.”
Part of what makes social prescribing work, according to Polley, is connecting the patient with a link worker — a person who is not clinically trained but is great with people and familiar with the volunteer and community sector in the local area.
“They can come alongside a person in the point of need. They can listen, they can establish trust and empathy. They can pragmatically help to break down some of the barriers to a person moving forward,” Polley tells The Current’s Anna Maria Tremonti.
An intuitive approach
Dr. Gary Bloch, a family physician with St. Michael’s Hospital, says the approach feels intuitive.
“It just makes sense that people will respond to being better connected socially as a core part of their health care.”
Based on his experience, he says targeting the social needs of patients first have the greatest impact. As such, they have income security specialists on staff.
If a patient is deemed to be living in poverty, Bloch refers them to the specialist.
“Our income security health promoters will go through a systematic process of helping them access benefits, helping them reduce their debts and helping them learn how to manage their finances.”
“Similarly on the justice front, we now work with a Legal Aid funded lawyer. If I see that someone has legal concerns of any sort — and these can be very broad from domestic violence issues to family issues to criminal issues — I can refer them straight over to that member of our team.”
Bloch is keen on seeing a similar framework adopted in Canada.
“I think the work in the U.K. has shown that there likely is a strong health payback through things like reductions in emergency visits and reductions in family physician visits.”
But he adds, “it’s going to take a bit a leap of faith for the government to fund this, to trial it and to see what happens.”