Social Prescribing

When did we decide that the best cure for something is to force the application of it? – Isn’t that some sort of ye-oldie punishment that used to happen in the dark ages?

I think of that whenever I see advice for people suffering with mental health issues for example. – I know I talk a lot about mental health issues, but I really don’t care, this is my blog you are reading and its an important topic to me, so no apologies are made. I can also relate to issues contained within without needing to do a bunch of research first. I have my opinions and feelings from which I can bounce off of. Think about it, if you suffer from anxiety, one of the first things your GP will ask you is ‘have you been getting out lately?’ – What… really?

Taking things further, they may then offer to connect you with someone called a Social Prescriber.. which as it sounds, is somebody who’s… not a medical professional, whom medical professionals refer to when they are trying something different with patients. I am not saying different is bad. I’ve been to a so-called Social Prescriber, who’s first question to me was ‘How can I help you?’ – What… really? – You tell me buddy, I’ve just been passed along from a GP to you for assistance. According to the NHS England, Social Prescribing is a fairly new concept to be offered by the NHS (although not really in many more ways than one). Social Prescribing comes under Universal Personal Care which is part of the NHS Long Term Plan which says that by 2024;

  1. Personalised Care will benefit up to 2.5 million people giving them the same choice and control over their mental and physical health that they have come to expect in every other aspect of their life;
  2. Over 1,000 trained social prescribing link workers will be in place by 2020/21 rising further by 2023/24, with the aim that over 900,000 people are able to be referred to social prescribing schemes by then. Social prescribing link workers connect people to wider community support which that can help improve their health and well-being and to engage and deal with some of their underlying causes of ill health.
  3. 200K people will have a personal health budget so they can control their own care, improve their health experiences and experience better value for money services over a “one size fits all” approach;
  4. 750,000 people have a personalised care and support plan to manage their long term health conditions;
  5. Develop the skills and behaviours of 75,000 clinicians and professionals through practical support to use personalised care approaches in their day-to-day practice
  6. That we deliver universal implementation of the Comprehensive Model of Personalised Care across England, which fully embeds the six standard components – shared decision making; personalised care and support planning; enabling choice; social prescribing and community based support; supported self management; and personal health budgets and integrated personal budgets – across the NHS and the wider health and care system.

Source: NHS England

Some 59% of GP’s feel that Social Prescribing can lower their workload, and apparently my GP is among that percentile. – Which is understandable and I don’t think any less of him knowing this. The truth is, Social Prescribing could work, it just has a stupid name, and feels like a potentially dangerous option if it ever becomes the ONLY options available.

Anyway, the job of a Social Prescriber (from the limited interactions that I have had so far with one), – being one session to meet him and one phone call to follow up afterwards, seems to be that you sit with a person for an hour and talk about the current situation you are in – noting from earlier that this person is not a medical professional – and from that chat, they may make some notes, but they may not. From there they get on the PC with you watching and start to search for potential support charities, agencies and opportunities for you to interact with people in similar situations to that of your own self. Basically, they sit on the PC and find support groups for people with Mental Health issues. In my case, the issue he chose to focus on was Anxiety. The one that restricts my ability to go outside and meet with other people.

So searching through the internet for keywords of Anxiety and whatever interest I confessed interest within during our chat, and he finds two places that are ‘nearby’. The first of which is just down the road, and was a place I had found through my own research, because believe it or not, I do know how to search for myself. The second was one which I did not know about, which is located in a place that is ‘a bus ride away’. Some places are not accessible without referring from the GP. – So the basic process is, the GP is the gatekeeper of referral services, the GP refers to a 3rd party who does the searching with the service user (patient), and then the 3rd party talks with the GP and gets a referral made for the patient, the patient is referred and then is classed as being ‘off the caseload’ of the GP, as they would retain contact with the 3rd party social prescriber, who’s not a medical professional. – We will refrain from talking about how silly that sounds for the time being, but I would imagine these Social Prescribers work for agencies, who are ‘instructed’ by GP surgeries perhaps? (I really don’t know how the process works, how would I?). But somewhere, surely there is a payment that is made to the agency in question. So reducing the GP’s workload by reducing the time spent with patients, but increasing the cost through adding in a 3rd party (with no formal medical training)… Seems like a disaster waiting to happen to me. It also seems like the ‘know it all’ British way to be honest.

So lets talk about the topic we are talking about here… Referral to a charity which offers support groups for people who are suffering with anxiety. So their vision for supporting people is to support them through a social anxiety, by putting them in a position where they could find themselves socially anxious. That seems a little oxymoronic to me. I can’t and wont comment on it further at the moment. I haven’t yet been able to go to a session due to CoVID19, as the day after I signed up, all sessions were suspended indefinitely due to Lockdown. But on the face of it, providing a ‘solution’ to the problem of self-isolation and anxiety, by forcing social interactions seems, at least on the surface to be.. lacking in terms of getting to the bottom of deep routed anxiety issues. In fact I would go so far as to say it doesn’t help to treat the issue of anxiety at all, but instead force the service user to get used to being placed in such situations, and to basically force a change in behaviour. Yet another form of CBT. I am skeptical at best shall we say. I will probably write more on this topic as and when (if) the situation with CoVID19 changes and evolves, and as I find I need to.

There are many other instances in which the ‘treatment’ doesn’t seem to marry up with the condition, but most of them are within the area of ‘feelings and emotions’ rather than the physical issues such as breaking a bone. For example, if you had broken your leg, you wouldn’t be told to join a group and run a marathon. You would be told to rest then exercise through physiotherapy. Rehabilitation. It’s the step that’s missing in mental healthcare.