Re-thinking What is Needed to Win Support for a Social Prescription Program in HRM

 

By Kendall Worth!

As my regular readers know – and a quick look at the directory of my BLOG will show – over the past couple of years, a central thread in my advocacy and journalism has been making the case for a Social Prescription Program or Organization.

These blogs have discussed what a Social Prescription Organization (SPO) or Program is: briefly, - an initiative that addresses social isolation in our community, through various activities, services and events. It is framed by an approach to health care and well-being that addresses not only physical health and economic well-being, but also highlights social factors that impact well-being.

Some of my BLOGS have explored how such a program or organization may come to light here in HRM, how it might be sponsored, managed and funded. But a lesson I have learned from my efforts to promote the social prescription approach is the extent to which this approach is not valued and is often actively contested by many of those in the “financially better-off” section of our society. These people clearly do not believe that social isolation is a serious issue that needs intervention.

In the face of this negative feedback, I decided a few months back to take a break from talking to such contacts. I felt that I needed to take some time to re-think my pitch for the SPO proposal. This does not mean that I am giving up on my advocacy efforts. It just means that I will take the time to think through a new approach.

By way of background …

Over the many years I have been writing and advocating for Nova Scotians living in poverty and dealing with mental health issues, I have often felt compelled to point out that many of our better-off friends, family and neighbours have little knowledge or understanding as to how our province’s Income Assistance (IA) system works. I believe that it is this ignorance that is the source of much of the social stigma that IA recipients are subjected to in different places and spaces.

For many years, I addressed issues on social isolation and mental health in articles written for both the Nova Scotia Advocate and the Halifax Media COOP.  But it was not until I had the opportunity in 2024 to attend a conference on social prescription in Toronto that I started to appreciate the research and analysis that inform the social prescription approach, and I learned the related vocabulary and implications for public policy, as I wrote about here.

Despite the reluctance of so many to endorse and adopt the Social Prescription approach, I do not believe that we can give up on the idea. Further educational, promotional and advocacy work NEEDS to be done so that we can at pilot test this approach in HRM.

Looking forward ….

Given our inability to make much progress on this issue over the past year, I recognize that it may be necessary to start looking at different ways of pitching this idea to the community at large. Some creativity and innovation will likely be needed.

 ·        First of all, I think we have to make a more compelling case to both the general public and to policy-makers that social isolation is indeed a chronic and debilitating problem for people living on Income Assistance. It is not just a question of “feeling lonely”, - it is a much more complicated risk factor in the lives of many people.

·        Secondly, we also have to make clear the connection between chronic social isolation and many of the mental health issues faced by IA recipients. Whether these issues take the form of anxiety, depression or more complex and debilitating conditions, we need to make the case that addressing social isolation is one important pathway to addressing these conditions.

·        Thirdly, we need to make the case that social prescription is one of the best ways to address social isolation. The community needs to recognize that the fact that local soup kitchens and food banks have drop-in centres available for clients to linger and chat is simply not an adequate response. We need a program (preferably even a dedicated organization) that will build on lessons learned in other cities as to how best to help IA recipients to build healthy social relations, friendships and networks.

I have no illusions about how easy this educational / advocacy strategy will be to design and implement. Many of these issues are quite complicated. I am reminded of an experience from a few years back, when we were starting up the All Together Link Project. As I wrote in a BLOG at the time, we had secured some short-term funding to pilot test some social prescription style approaches in HRM, and had circulated a survey to potential clients and participants, asking what sorts of activities might appeal to them most.

When we tabulated the results of the survey, I was disappointed to see that NO ONE – not a single person - had expressed any interest in walking and hiking out in nature. I had thought this would be a great activity, - no cost, good for your health, an opportunity to chat and build social relations, get to know your city – and nature, etc., etc.  When I expressed my disappointment, one of our team members, - the Executive Director of a local organization, noted that some of her clients already walk 20 km in the course of their daily life, trudging from home to a soup-kitchen, on to a health clinic, then another agency, etc. etc. We should not be surprised, she told, us, if few poor people want to spend their “free time” doing even more walking!

One of the advantages of the social prescription approach is that the activities prescribed to individual clients are treated as part of a broader assessment of physical and mental health, - and come from health care professionals. Perhaps some doctors and health care professionals do pro-actively address issues of social isolation in their one-on-one meetings with clients from my community. I just do not know, as what happens behind those closed doors tends to stay behind those doors.

A Social Prescription Organization would bring to those conversations a pro-active approach to building social networks, building and maintaining friendships, etc. And to those who claim that they are “introverts” and simply prefer to stay home “chilling”, perhaps we need a more assertive approach to ensure that people are not simply hiding behind their anxieties instead of addressing them.

So, - in Conclusion!

There is much work yet to be done to if we want to build the community support necessary for securing both government and private investment in the Social Prescribing approach. This will need to be creatively done as there is a fair amount of criticism and skepticism related to this approach, as critics dismiss it simply as a “social club” that should not be publicly funded.  Suggestions from my readers as to possible strategies are always welcome!

Kendall Worth is an award-winning anti-poverty activist who lives with disabilities and tries to make ends meet on income assistance.