By Kendall Worth
My long-standing promotion in this BLOG of the social prescription approach to addressing mental health issues inevitably prompts many questions, from both within and outside my community.
The most frequent question of course is “What exactly IS social prescribing?” Basically, I try to explain it as follows: social prescribing recognizes the negative impact of social isolation on marginalised and vulnerable people and actively integrates responses to this isolation in the treatment of mental health and other issues.
This question is soon followed with “So you want to replace current clinical treatment with a new approach?” To which my firm answer is NO! Doctors, psychiatrists, counsellors, social workers and other trained professionals have important roles in providing clinical treatment, counselling, assessments and other professional supports. Someone experiencing a mental-health condition may well need these professional services. Social Prescribing is NOT a substitute for receiving appropriate professional care, but it can be complementary.
“So what does social prescribing actually involve?” In a nutshell, social prescribing helps connect people with community activities, peer supports, social groups, opportunities to meet people and other non-clinical forms of support. This is why I advocate to establish a Social Prescribing Organization in Nova Scotia which would create structured opportunities for people who are socially isolated to participate in their communities and develop healthy human connections.
Of course, the next question almost always is “But does this approach actually work?” This can be answered in different ways, as I have shown in an earlier BLOG here.
Today’s Question:
Today I want to address another question which goes back to root causes. And seems to represent an obstacle to promoting the social prescription approach.
“But Kendal, why exactly do so many people in your community struggle with social isolation? Why do they seem to have so few if any friends and why do they struggle to build and maintain social relations?
From my experience, there are two common assumptions behind this question. Firstly, there is skepticism that people’s lack of social relations is tied to their poverty. Which leads to the second assumption that there is something “wrong” with people who cannot maintain basic social relations with family, friends and neighbours.
I should point out that more often than not, these views are expressed by “better off” people who have limited experience with the daily realities of a life lived in poverty. I am not talking about care professionals here, - who engage regularly with Income Assistance recipients and usually have a deeper understanding of the social determinants of health.
But sadly, many other members of the public do hold these beliefs and as a result, they seem to consider social prescription to not be a “serious” approach to mental health issues, but simply a social club for poor people, that will be funded by taxpayers.
I had heard basic ideas about the social prescription approach years ago, but my learning was greatly enhanced by attending a National Social Prescribing Conference in Toronto. I wrote about that event and experience here and shared what I learned about the track record of social prescribing in other jurisdictions and health systems. There is also a local initiative to research and test the approach in Nova Scotia (see here) but not much has happened yet to move beyond small scale research projects. This lack of commitment and action has prompted me to write directly to government Ministers.
Putting a Focus on First Voices
This is why I remain committed to promoting First Voices through my BLOG as these voices never seem to be heard at government or academic tables.
This has included my articles on how social isolation is now being normalized as people simply being “introverts” – and how ever since the pandemic lockdowns this has become a popular “self-diagnosis” amongst First Voices themselves. When there is nothing in their personal backgrounds to suggest that they were ever “introverts”. I strongly believe that in many cases, people are simply self-identifying as introverts because of their diminished social and economical circumstances.
This conversation relates closely with many others I have had with both First Voices about the challenges of social anxiety and social stigma that directly impact every day upon people living on Income Assistance here in Halifax. Addressing these two issues are part and parcel of what a social prescription organization should be doing. This is often done through peer support programs – a topic which I will explore in depth in a future BLOG.
Let me close
this BLOG with one piece of good news. I have recently had some encouraging
feedback and interest from Susan Leblanc, the MLA for Dartmouth North who I
interviewed recently (see here) and with whom I will follow-up once the current sitting of
the Provincial Legislature finishes.
Hopefully we
can make some important progress in advancing the Social Prescription approach.
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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