By Kendall Worth!
As regular readers of my BLOG know all too well, I am a big advocate for the creation of a Social Prescription Program or Organization here in Halifax.
This is rooted in my experience and observation of social isolation as a HUGE barrier for low-income households and Income Assistance recipients. As explained in earlier BLOGS, social prescription is “an approach to health care and well-being that addresses not only physical health and economic well-being, but social factors that impact well-being, such as loneliness and isolation, and the need for personal growth, creativity and community connection”.
Making the Case for an SPO:
Social prescribing programs and organizations help to bridge the gap between what is needed in a community and what is available to address these social factors. As I continue to promote this idea in my community and beyond, I am asked many questions. In this current BLOG post I will share some of these questions, - and my efforts to answer them.
This is a follow-up to my December BLOG where I spoke to the initial feedback I had received. Much of this feedback was from people from outside my community, - and was framed by the misunderstanding that a Social Prescribing Program is simply one BIG Social CLUB. This is a complete misrepresentation of the social prescription approach, as I have already explained here.
Indeed, I have elaborated what I consider to be the four key elements of a Social Prescribing Program, namely:
#1 – it will address the need of our community for a broad expansion of support activities and services;
#2 - it will cultivate PEER support activities;
#3 – it will bring people together to work on a set of goal-oriented projects around a shared objective; and
#4 – it will provide a safe space in which people in our community can socialise “after hours”.
In other words, Social Prescribing is much more than a social club. It is a systematic approach to addressing social isolation through a mix of activities and interventions that reduce loneliness and enhance well-being of individuals and the community by fostering growth through connections.
More Questions:
In a more recent round of conversations with members of my community, three new questions have emerged that I think important to share. They all address the challenges of making and keeping friends that many in my community face. This lack of friendship relations is a deep, underlying cause of social isolation and related anxiety and depression.
Question #1: On Friendships and Boundaries: One person I recently spoke with focused her question on the challenges people face in defining, understanding and respecting personal boundaries in their friendships. I have addressed this issue in earlier BLOGS as it is often the first reason that people give for ending friendships: “The other person did not respect my boundaries”.
The question I was asked was twofold: “Do people actually understand why they have been ghosted by others? Do they learn from this experience, - can they do better in the future?”
My answer is simply that “It is complicated”. It is often awkward to have these difficult conversations about boundaries and behaviours amongst friends. It is even more complicated to have these conversations between “former” friends, after the break up.
That is why it can be helpful to have professional staff trained in social prescription to help facilitate these conversations, either one-on-one or by bringing the concerned parties together. This may not save the friendship, but it can hopefully help the concerned individuals to understand what happened and give them the skills and motivation to do better in the future. Hopefully, it can also help to address any mental health issues such as depression or anxiety that may emerge after the end of a relationship.
This conversation then prompted a discussion on the negative impact that alcohol can have on many friendships. It is very difficult for some people to respect boundaries around alcohol consumption, particularly if there are issues of dependency involved. In such cases, the Social Prescription Program would have to recognize its own limitations and refer the concerned individual to AA.
Question #2: On Reaching Back to the Past: Many of us can remember a less complicated, less stressful time in our lives, - perhaps when we were younger, were in better health, more stable relationships, and maybe had a decent job. It was probably a time before we went on Income Assistance, and perhaps before mental health struggles began to redefine our lives.
This sense of a better time can prompt people to want to reconnect with our past, - our families, old friends, and home communities with whom we are no longer in touch. To what extent can we re-connect with the comfort zone of our earlier lives?
To be blunt, this can be a very big challenge. For some of us, this nostalgic image of the past is imagined. In reality, those old times were often not “happy days”. And even for those whose memories of a happier life are accurate, returning to those times and relations can be a problem. There is a saying that one can never step back into the same stream - because with the passage of time, both you and the stream have changed.
For many of us, there is also the social stigma we now face as old friends and even family members look down upon us for being a recipient of Income Assistance, or for struggling with mental health issues. As I have discussed here and here, we cannot really move ahead in our lives by looking in the rear-view mirror.
Question #3: On Costs: Another set of questions inevitably arises around money issues. Many social activities have costs associated with them (for membership, equipment or whatever) which make it impossible for Income Assistance recipients to participate. So, people ask, - are there cost-free alternatives already available in the community? Would there be cost-free options in a Social Prescribing Organization?
For my own part, I often promote in this BLOG different low-cost or no-cost events and programs in our community. There is no need for people to focus their social activities on expensive options like eating out at a restaurant or drinking at a bar.
There are many different options available, some of which have a cost-free or pay-what-you-can option. This includes arts and cultural events, festivals, and educational programs such as seminars, courses and night classes. A Social Prescribing Program would likely support participation in such activities, but this would not be its primary focus.
In Conclusion:
The general principal underlying a Social Prescription Program or Social Prescribing Organization is the need to create “comfort zones” for Income Assistance recipients.
I discussed this notion in a recent BLOG post where I underline the importance of creating stigma-free environments in which people can socialize with each other. One idea that is often mentioned in this context is that of a “sober bar”, a place where people can socialize after hours but without alcohol present. I have discussed this idea before, and just want to underline that as a government funded program, the sale or consumption of alcohol will not be feasible.
The intent is not that the SPO becomes an all encompassing social club, - but that it serves as a hub and safe space where clients and participants can build community connections and grow individually. Hopefully, these latest questions and answers can help to clear up any remaining confusion about the social prescribing approach and will help move this proposal closer to reality in Halifax.
Kendall Worth is an award-winning anti-poverty activist who lives with disabilities and tries to make ends meet on income assistance.
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