Loneliness, social isolation, low income, unemployment, disability, chronic pain – these things have a huge impact on overall health, and medical professionals in Ontario are now being equipped to address the patient as a whole, instead of just the high blood pressure.

“Rx: Community” is an 18-month pilot project connecting UK experts in social prescribing with 11 Community Health Centres across Ontario. The West Elgin Community Health Centre (WECHC) is one of the centres participating in the pilot, headed by Health Promoter/Systems Navigator Stephanie Skelding (RN BScN).

Photo courtesy of WECHC

What is social prescribing?

Social prescribing is a means of referring people to a range of local, non-clinical services, seeking to address people’s needs in a holistic way and supporting individuals in taking greater control of their own health. Examples of social prescribing include referring patients to participate in a nature club, walking group, community band, drama society, or woodworking group.

Social prescribing is a concept that has been gaining traction internationally in the medical community, especially in the UK. There, researchers have been able to demonstrate its benefits. Cornwall Live reported that patients living with chronic pain who attended holistic singing lessons at the recommendation of their GP experienced significant positive results. Of the 150 patients enrolled, 94% reported increased wellbeing, and 62% even say they lost weight.

Photo courtesy of WECHC

According to West Elgin’s Stephanie Skelding, the power isn’t necessarily in the activity itself, but the feeling of community that comes from participating in a group like this. Though the patients may have illnesses that can’t be cured medically, “They come together as a group of people and they share stories, successes, and struggles – and they don’t feel so alone.”

The social prescribing model in West Elgin

Social prescribing formally came to Elgin County through the Alliance for Healthier Communities, which is a network of community-governed primary health care organizations. The Alliance received a grant from the Ministry of Health and Long-Term Care to implement a social prescribing pilot across the province. On September 26th, WECHC hosted a training session with the organization’s staff and two experts from the UK (SNJ Associates provides the full story here).

The pilot will continue until December 2019, by which time WECHC and other participating community health centres aim to have developed sustainable and clear processes for social prescribing and be able to measure its impact in the community. It is hoped that lessons learned from the pilot will inform other interested healthcare providers and help scale and expand this initiative in Ontario.

Tim Anfilogoff (Head of Community Resilience, National Health Service, Herts Valley, UK) speaking at WECHC. | Photo by J.A. Conrad.

Social prescribing is not a totally new concept to the area, however, but rather a new spin on an old idea, according to the Alliance for Healthier Communities. It is the idea that people are healthier when they are connected with social resources and supports in their communities. Skelding says that WECHC already had a holistic approach to healthcare before the project began, but now they have a name for it anda more structured way of approaching it, including a wayof collecting rich data to prove the benefits of the social prescribing approach.

1.7% of the population in the UK  200,000 people  have not had a conversation with friends or family for a month.

The social prescribing project has proven to be a huge undertaking in West Elgin, which includes the rural communities of Rodney, Dutton, and West Lorne, and all the farmland in between. Skelding’s role as Systems Navigator includes searching out all the programs and groups that run in the area and adding them to the asset map that she is building.

“It’s going to be massive when I’m done with it. Just the calls I made yesterday, I had three more people to call as a result, and I’m sure those people again will know of things that I hadn’t heard of yet.” Researching these programs and calling their organizers has led to a social prescribing network in West Elgin that could benefit any age group, from prenatal to 100 and over.

Battling loneliness with social prescribing

One of the factors that the CHCs are addressing is social isolation – a very real and dangerous issue for many people, especially among the elderly. The United Kingdom, which has recently appointed the world’s first Minister for Loneliness, has looked into the issue of social isolation extensively. Researchers found that 1.7% of the population (200,000 people age 65 and over) have not had a conversation with friends or family for a month. Some 360,000, or 3.1%, have not had such a conversation in over a week.

Studies put the harm from social isolation on par with smoking and obesity, and it also increases the risk of depression and dementia. The UK has responded to it with an official Loneliness Strategy, which promises to enable all GPs to refer clients through social prescribing by 2023.

Photo courtesy of WECHC

WECHC has had many clients who were identified as socially isolated. However, Skelding says they’ve found that once these individuals get connected in the community, their visits to their GP office were greatly reduced. For some, the need may have been the human contact more than the actual ailment.

Conclusion

Skelding’s vision for the project is for every staff member at WECHC to be thinking around the lines of social prescribing and not just the medical model. Though this approach takes time and the building of a relationship with the client rather than a quick prescription for more pills, the result is far more effective because it takes into account the whole person.

“We want people to look beyond their diagnosis to who they are as a person.” –Stephanie Skelding

“So long in healthcare we’ve said, ‘you’re a diabetic,’ or, ‘you’re a this or that,’ and we don’t want people to be defined by their illness…. We know that when people feel like they belong, they have a place to be, they have a purpose in their life and they’re not illness or diagnoses focused – their health actually gets better.”

Keep up with WECHC’s work on their website: https://wechc.on.ca/