By Kendall Worth!
This BLOG is a follow-up to my BLOG of August 25th. In that BLOG I shared my working definition of Social Prescription: 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.
This reflects my understanding of poverty that is often not appreciated by those from outside of my community. This understanding is rooted in the simple reality that being poor means MORE than not having money. It includes dimensions of our lives and well-being that are not directly economic in nature, but impact different elements such as one’s mental and physical health. And it can have a huge impact upon our social contacts and networks.
Many of these aspects are inter-woven with life on Income Assistance in Nova Scotia, both in terms of trying to survive on its meagre financial benefits. As well as the unending complications of life once caught up in the bureaucratic nets of the IA system.
At the time, I was unaware of the extent – if any – that the Gov’t re-thinking of the ESIA program actually incorporated principles and practices of Social Prescribing. Hopefully, as community service professionals these policy-makers would have been aware of the principles of social prescribing, and how it is widely seen as an effective approach to addressing issues of social isolation that are both a cause and an effect of poverty and mental health issues.
At the time, I wrote an open letter to then Finance Minster Karen Casey about the importance of social inclusion in the lives of people, and how the Gov’t should try to implant social inclusion measures in the work of Community Services. I never got a response to this letter, so have no idea whether this was actually considered.
At a minimum, I have argued in my writing that as part of the ESIA Transformation process, the government should increase Income Assistance rates to a liveable amount, which I estimated in 2018 to be $2,500 a month. That might enable people to live a life of simple dignity, with modest opportunities for social engagement and interaction.
Either way, it became a mute point as the Liberal Gov’t made only limited progress on the ESIA Transformation process before it was defeated by the Houston Conservatives in 2021 and the entire “transformation” initiative was quickly scrapped. Since then, the Houston Govt has only engaged with the ESIA program in the form of providing occasional - needed but modest - increases to benefits in response to rapidly increasing rates of inflation.
With no Gov’t adoption of the social prescription approach, the main social outlet for many IA recipients is engaging with people they meet at places like Souls Harbour or Hope Cottage, or perhaps while they stand in line at their local food bank. As I have written about in an earlier BLOG, this limited social exposure often means that people retreat into a comfort zone of self-isolation. This is not in the best interests of their mental health.
And as I have explained in earlier blogs here and here, the benefit system is structured so as to actively discourage if not totally block IA recipients from sharing households and co-habiting, be that for simple economic reasons, never mind social ones.
A Social Prescription Lens would help people see the world differently.
My on-going challenge in this campaign is to help people see that Social Prescribing is a lot more than simply helping people to socialize together. Too many people, both in my own community as well as those who are financially better off, see social prescribing basically as a social club. When it is actually about recognizing the fundamental need of ALL people to build community and form and maintain friendships.
In this framework, measures of an individual’s social isolation should be just as important a measure of their health and well being as other more conventional health indicators like your blood pressure or pulse. And professionals should use these indicators to then prescribe appropriate responses and interventions to improve that person’s well-being.
(Of course, there is already plenty of MEDICAL evidence that social isolation does indeed have a significant negative impact on people’s physical and mental health. It can have measurable impacts on measures of stress like cardio-vascular disease, as well as measures of depression and anxiety.)
Surely we can all agree that opportunities for social engagements, building community and maintaining friendships are not the same for all people in our society, - the rich and the poor, the healthy and the infirmed, those who are employed and those who are not, those with families and networks and those who are starting from a point of isolation. It is often said that the best way to find a new friend is through an old friend. But that is not so simple for those who start from a place of isolation.
So, how best to ensure access to such opportunities to the people in our community who NEED them the most, but are probably LEAST able to afford the associated membership and entrance fees?? Clearly there is need for some interventions in this area: in a recent blog I discussed how this could apply to people who like to work on crafts. Surely it should be possible to build safe spaces, networks and communities for people with these sorts of shared interests and hobbies.
In my advocacy and writing, I have tried to address the full range of measures of well-being that underly the social prescription approach. As we see in the definition I provided above, these include:
Physical health and well-being: I addressed this first in a 2018 article, making the case for people in our community to get better access to health and recreation facilities, and encouraging people to take advantage of these opportunities when they can. But I have also noted how barriers to physical activity can be both financial and psychological in nature, such as those associated with running and the Bluenose Marathon, as discussed here.
Economic health and well-being: I have addressed the poverty dimensions of social isolation in many previous BLOGs so do not need to repeat that here. This is particularly true for Nova Scotians living with a disability, as elaborated here.
Addressing loneliness and isolation: this is the central pillar of the Social Prescription approach, and here in HRM, we piloted this approach through a short-term project called the Mitigating Social Isolation Project, - later the All Together Link - which I have written about here.
The need for personal growth: While there are many paths to personal growth, this is the aspect of social prescription that would be most directly addressed through the review and revision of the Career Seek Program that I have long been advocating for.
Creativity
and community connection: Sometimes the easiest way
to make first connections with community is as an observer or audience member. This is why I
regularly promote through this BLOG free community events such as summer
festivals. Just getting outside and into a friendly, festive crowd can itself
be a BIG step for many people feeling socially isolated.
The bottom line is simply that applying a Social Prescription lens to those living socially isolated lives can take us in many different directions. Each of these can be one small piece of the puzzle necessary to help people in my community to break through the barriers that isolate and constrain them.
To that end, I
fully intend to keep up my advocacy work on this campaign. It is only
through our continued efforts that we can secure a better tomorrow for
EVERYONE!
Kendall
Worth is an award-winning anti-poverty activist who lives with disabilities and
tries to make ends meet on income assistance.
Such a helpful article, Kendall. I really am so glad to see every one.
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