Moving from “What’s the matter with you?” to asking “What matters to you?

What is Social Prescribing?

Social Prescribing is a holistic approach to healthcare that brings together the social and medical models of health and wellness. It provides a formal pathway for health providers to address the diverse determinants of health, using the familiar and trusted process of writing a prescription.

Social prescribing bridges the gap between clinical and social care by referring patients to local, non-clinical services that are chosen according to the client’s interests, goals, and gifts. It allows doctors, nurse practitioners, and interprofessional health providers to formally refer patients through to community-based programs. It empowers clients to improve their health by developing new skills participating in meaningful activities, and becoming more connected to their communities. What does a social prescription look like? It could be participating in an exercise group, receiving a Good Food Box to support food security, taking an art or dance class, joining a bereavement network, getting one’s hands dirty in a community garden, exploring a local hiking trail with a group of peers, volunteering to visit older adults in the communities and much more.

Health equity is a cornerstone of effective social prescribing. It is not enough to simply refer a client to a recreational program or encourage them to visit an art gallery. Successfully implementing a social prescribing program means removing the barriers clients experience to doing these things. These barriers may be economic, geographical, interpersonal, or psychological. Social prescribing is about listening deeply, providing necessary supports, and empowering people to be co-creators in improving their own health and wellbeing.

For a quick overview, see our infographic that shows the deep impacts of social prescribing on health and wellbeing with results from our Rx:Community pilot project and internationally!

*NEW RESOURCE*

In collaboration with the Centre for Effective Practice (CEP) and the Canadian Institute for Social Prescribing, the Alliance supported the development of a new implementation resource for primary care clinicians and health care providers.

Access the full resource here >>.

 

Responding to the Social Determinants of Health and an Epidemic of Social Isolation

For the Alliance, transformative change in people- and community-centred care, health equity, and community vitality have always been guiding principles according to our Model of Health and Wellbeing (MHWB). Ensuring the best possible health and wellbeing of everyone in Ontario are key aspects of our foundational living document: the Health Equity Charter.

Beginning in the 1960s and 1970s, well before social prescribing, Alliance members championed these values through their strong focus on the social determinants of health in their community development initiatives and social programs. We have seen how these social factors affecting health – income, employment, self-confidence, housing, nutrition, education, the environment – all play strong roles in people’s overall wellbeing.

Increasingly, studies are recognizing social isolation and loneliness as significant risk factors that affect people’s physical and mental health. Public health measures during COVID-19, such as restrictions on gathering with friends and closures of community spaces, have been necessary to control the pandemic, but they have had unintended consequences. In two 2020 Angus Reid studies, a third of the population in Canada reported experiences of loneliness and social isolation, and half reported a decline in their mental health since the start of the COVID-19 pandemic.  This mental toll has continued into 2021, where recent research published by The Public Health Agency of Canada has shown that the number of Canadians with major depressive disorder has more than doubled. And more concerning, people reporting a weak sense of community belonging were 10 times more likely to screen positive for depression.

On the other hand, having strong social ties in your community and being actively engaged in community-based programs contributes to increased self-esteem. Developing expertise through cultivating new skills and hobbies also gives people the chance to feel steady improvement in their lives. By integrating social support and care across the health system, we can help people safely reconnect to their communities and reverse some of the health impacts of the pandemic.

How Does Social Prescribing Work?

Social prescribing is a specially structured way of referring people to a range of local, non-clinical services. It complements clinical treatments and seeks to address people’s social needs through community partnerships that align with clients’ interests and goals. As an asset-based approach, social prescribing recognizes people as not just patients with needs, but as community members with gifts to share. It supports participating clients as they engage with and give back to their communities. The goal of integrated healthcare and social prescribing is to go beyond treating illness to focus on advancing wellness.

Social prescribing may look differently depending on the community, their local needs and capacity. Five essential components have emerged as the foundation of an impactful model of social prescribing: the individual or client, the prescriber, the navigator, the social prescriptions, and the data pathway.

The 5 Key Components of Social Prescribing at a Glance

Social prescribing is centred on the client, an individual with social and medical needs, as well as interests, goals, and gifts (such as skills or their own resources).

The prescriber, a healthcare provider with trusted relationship with the client, is key to leveraging healthcare appointments as an opportunity to identify underlying non-medical issues and making a social prescribing referral.

The social prescribing navigator catches the referral and connects the client to appropriate resources based on self-identified interests and needs, and supports their journey to full wellbeing.

Social prescriptions can include a diverse range of non-clinical interventions, such as educational classes food subsidy, housing navigation, arts and culture engagement, peer-run social groups, and nature-based activities.  These prescriptions are most powerful when they include an invitation for clients to engage, co-create, and give back to their community.

Finally, a data tracking pathway follows the client’s journey throughout the social prescribing process. This enables the integration of meaningful data and lessons learned in real time to enhance quality of care delivery and monitor outcomes.

Watch this introductory video about Social Prescribing :

Social prescribing has gained widespread recognition in the UK with prominent figures in their healthcare system pioneering the change. Hear from the “godmother of social prescribing in the UK” – General Practitioner Dr. Marie Anne Essam in the video below about her experiences with social prescribing, and how she suggests healthcare providers can get involved:

 

Watch the full Summit Preview Keynote: What is Social Prescribing? webinar hereRx: Community: Research pilot on Social Prescribing

Rx: Community - Social Prescribing in Ontario

September 2018 marked the launch of an exciting chapter at Alliance as we initiated a first-of-its-kind pilot project in Ontario, called Rx: Community – Social Prescribing. As we learned about the core values of social prescribing, we realized that the Alliance shared the same values on which social prescribing operates from. Both our organization and this model of care apply a comprehensive approach to health and wellness, that is seeing health as grounded in community, and recognize the importance of empowering clients to act as partners in their care.

To help advance Rx: Community’s success, it was important that we form key partnerships with well-experienced professionals within the field of social prescription. We successfully partnered with mentors from the UK - Herts Valley Clinical Commissioning Group (link is external), experienced in social prescribing navigation, and Altogether Better (link is external), an organization with expertise in co-creation between primary care staff and clients. 

We began Rx: Community with an invitation to our member centers for an introductory session in order to learn how their work can align with the principles of social prescribing. From this session, 11 of our members, representing a diverse mix of urban, rural, Northern, and francophone communities, expressed interest in implementing social prescribing in their day-to-day practices. Some of the unique features our pilot program were the application of an equity-based lens in our approach to providing care. We ensured that material support was provided for our clients through food programs, housing, etc., as well as prescribing social prescribing champions – clients who co-designed and led programs for other clients to attend. From the lovely tunes of orchestra harmonies to delectable tastes of locally grown fresh produce, Rx: Community has offered a multitude of care treatments through social interventions and community referrals from our participating member centers. A key takeaway from this pilot project is recognizing that social prescribing may look different in different communities, depending on local needs and capacity.

    

Positive impacts on individuals, healthcare providers, and system integration

Rx: Community used a combination of different approaches to examine how social prescribing was implemented. Through client and provider surveys, focus groups, and health records, we tracked the impact of our work to understand how social prescription affected clients’ sense of wellbeing, health outcomes, and use of the health system. Additionally, we observed positive effects of social prescribing on the prescribers’ work and confidence as a result of their clients’ positive feedback. During the year-long pilot, over 1,100 clients across 11 CHCs were provided a total of nearly 3,300 social prescriptions. Seventy-one of the clients who received social prescriptions were supported to become volunteer Health Champions who co-created and delivered social activities and programs.

Finding #1: Clients reported overall improvements to their mental health and a greater capacity to self-manage their health, as well as decreased loneliness and an increased sense of connectedness and belonging. Finding #2: Healthcare providers find social prescribing useful for improving client wellbeing and decreasing repeat visits. They recognized the value of the navigator role, and, where it was not in place, they felt a need for more support. Finding #3: Social prescribing enabled deeper integration between clinical care, interprofessional teams, and social support; and it enhanced the capacity of the community through co-creation.

What’s next?

Social prescribing is gaining momentum in Canada among healthcare providers, community partners, researchers, funders, and policymakers. The wide interest and promising findings from Rx: Community shows that we ready to scale social prescribing broadly to support a more integrated health system and build more connected communities.

We recommend that:

Policymakers, funders, and Ontario Health Teams can create fertile ground for social prescribing by investing in primary health care and social supports. They can further advance social prescribing initiatives with direct financial, material, and/or policy support. Health care, cross-sectoral, and social support organizations can build and strengthen local partnerships, adapt social prescribing to the needs and assets of their communities, embrace culture change, and develop strategies for data collection and use. Researchers and academic institutions can contribute screening and evaluation tools, conduct data analysis, and provide research support to health care and social support organizations.

SP client outcome   Social prescribing decrease repeat visits

Watch this introductory video on social prescribing:

Read the final report:

Rx: Community - Social Prescribing in Ontario Final Report, March 2020 (link is external) (+ COVID-19 Letter (link is external)) Rx: Communauté - Rapport final sur la Prescription Sociale en Ontario, Mars 2020  (link is external)(+ COVID-19 lettre (link is external))

Ongoing Projects

Even though our research pilot has concluded, the work is continuing in several ongoing projects:

Black-Focused Social Prescribing Project

The Alliance is supporting a Black-Focused Social Prescribing Project with the Black Health Committee and Balsam Foundation to provide culturally competent programs for Black families and their communities. Across 4 Black-led community health centres in Toronto, this project is developing a social prescribing model grounded in Afrocentric values and principles to holistically improve Black health and wellbeing.

Links2Wellbeing project  

Partnering with the Older Adults Centres’ Association of Ontario, the Links2Wellbeing project offers social prescribing for older adults. Through the Social Prescribing Community Quilt website, we collected stories from health providers, staff, volunteers, and clients to gain insight into their experience of social prescribing and its impacts.  
https://www.socialprescribingquilt.com

Social Prescribing for Better Mental Health

Social Prescribing for Better Mental Health is an eighteen-month project funded by the Public Health Agency of Canada with the goal of delivering initiatives to support people whose mental health has been most affected by the COVID-19 pandemic.  

These initiatives aim to promote mental health, prevent mental illness, and build the capacity to address new and complex needs emerging from the pandemic.  

Through engagement, training, proactive identification, mental health navigation structures, and the expansion of local co-created programs, the Social Prescribing for Better Mental Health project is to enhance our capacity to provide improve mental health in communities, particularly for populations that face barriers.  

We hope that we will learn which interventions are most effective for post-pandemic recovery which will help to relieve the pressure on the whole health system.

Screening and intake tools

Use the links below to download templates that you can adapt (don't forget to add your own logo!) or incorporate into your own intake surveys.

Sociodemographic intake questions: These questions will help you collect information about your clients' background, identity, and socioeconomic situation. This data can support you in program planning for your community and tailoring the care you provide to each client. Screening questions on loneliness and social supports: These questions can help you measure the impact of social prescribing on clients' experiences of loneliness and sense of having social support. At intake, they can be used to assess clients' needs and assets. Along the way, they can measure changes in wellbeing.

Publications
In the Media

Dr. Nowak: Sometimes the most important prescription has nothing to do with medication, Healthing, February 17, 2022

Social prescribing: The next step for equitable healthcare (link is external), Healthy Debates, August 20, 2020

For people living alone, quarantines and physical distancing present unique challenges (link is external), The Globe and Mail, April 21, 2020

Social prescribing in the age of COVID-19 (link is external), Upstream, April 15, 2020

Prescriptions are for more than just drugs. Ontario Health Teams should use ‘social prescribing’ to improve our health and wellbeing (link is external), Healthy Debates, February 6, 2020

'It changed my life': New pilot project tests health benefits of social prescribing (link is external), CBC, December 24, 2019 (French (link is external))

The cost of loneliness: Canadians are facing a solitary future — and it's affecting their health (link is external), Ottawa Citizen, December 19, 2019

A doctor's prescription for social activities can have great personal and public health benefits (audio link) (link is external), CBC Metro Morning, November 19, 2019 Interview with John Paton, social prescribing participant at Belleville & Quinte-West CHC (audio link) (link is external), CBC Ontario Morning, November 20, 2019 Marginalized people need social connections, too (link is external), Toronto Star, November 11, 2019

Let’s Wage a War on Loneliness (link is external), The New York Times, November 9, 2019

Guelph doctors, health providers treat loneliness by prescribing yoga and crochet lessons (link is external), CBC News, August 14, 2019

Pilot project has health team prescribing hobbies, social activities to patients (link is external), Collingwood Today, July 18, 2019

Social prescriptions: Sense of belonging could be best medicine (video link) (link is external), Global News, June 19, 2019

Analysis: How to find friends in the age of loneliness (link is external), YorkRegion.com, April 9, 2019

New Social Prescribing Pilot Comes to Ontario (link is external), Health Quality Ontario Quorum, April 1, 2019

Better Health Care through Innovation (link is external), TVO - The Agenda, March 4, 2019

Loneliness: the silent killer (link is external), University Affairs, February 27, 2019

Feeling isolated? You can now be prescribed a trip to the museum (link is external), Toronto Star, January 28, 2019

A prescription for happiness (link is external), Belleville Intelligencer, January 3, 2019

'Social prescriptions' aim to ease patients' depression, loneliness (link is external), CBC and CTV News (alternate link (link is external)), January 1, 2019

Ontario health-care providers explore social prescriptions to help patients heal without drugs (link is external), The Globe and Mail, December 17, 2018

Doctor's orders: 'Social prescriptions' have been shown to improve health (link is external), CBC, December 9, 2018

Editorial: Forget the pills, play bingo (link is external), The Hamilton Spectator, December 9, 2018

Doctors can now issue prescriptions for free visits to the ROM (link is external), blogTO, December 6, 2018

Doctors can now prescribe a visit to the ROM through a new initiative to combat anxiety and loneliness (link is external), Toronto Star, December 6, 2018

Primary care providers exploring value of “social prescriptions” for patients (link is external), Canadian Medical Association Journal News, November 22, 2018

How social prescribing is changing healthcare in Ontario (link is external), Establish Media, November 1, 2018

Why doctors are prescribing bingo, not pills, to keep patients healthy (link is external), CBC, September 30, 2018

Social prescribing (audio link), CBC Ottawa Morning (link is external), September 26, 2018

Presentations and Webinars

          -- Follow-up webinar: Social Prescribing in Practice, June 17, 2020 - Slides(link is external) | Recording(link is external)

          -- Follow-up webinar: Social Prescribing in Research, June 25, 2020 - Slides(link is external) | Recording(link is external) Webinar: Arts on

    To learn more or join our Communities of Practice

    Join Our Communities of Practice

    Social prescribing is a practice dedicated to building up communities and fostering connections between like-minded people. In much the same way, the people who implement social prescribing initiatives, advocate for the social prescribing movement, or just want to deepen their understanding of social prescribing need a space to convene and learn from each other. With this need in mind, the Alliance is developing two communities of practice (CoPs) to bring people together on national and provincial levels.

    Canadian Social Prescribing Community of Practice

    The Canadian Social Prescribing CoP is a collaborative, interdisciplinary collective of people in discussion about how to raise national awareness and develop nation-wide strategies and approaches to implement and/or embed social prescribing in health and social systems. With cross-sectoral members from the arts, health care promotion, academia, and other sectors, this CoP is co-hosted by the Alliance for Healthier Communities, the Canadian Institute for Social Prescribing, United Way British Columbia, and the Older Adult Centres Association of Ontario.

    Members of the Canadian Social Prescribing CoP are paving the way forward to scale up initiatives, and have helped develop a national social prescribing referral pathway and the first current state report of social prescribing in Canada.

    Upcoming Meetings

    Quarterly meetings are recorded and held at 9:30 a.m. PST/12:30 p.m. EST on the second Tuesday of the month in January, April, July and October. Summary notes are provided after each meeting to all members of the CoP. 

    or to access previous recordings click here >>

    Resource and Contact Sharing

    Please share your contact information and other resources with the Canadian Social Prescribing CoP by filling out this short survey that will help inform other members of the CoP. You can also choose to opt out of sharing your contact information during this survey, or to provide feedback around what type of resources you are most interested in accessing.

    Ontario Social Prescribing Community of Practice

    At the provincial level, the Ontario Social Prescribing Community of Practice is facilitating interdisciplinary collaboration and connections between people who implement social prescribing across Ontario. Joining this community will help you get to know the social prescribing initiatives being put into motion in areas closer to you. Co-hosted by the Alliance for Healthier Communities and the Older Adult Centres Association of Ontario, the Ontario Social Prescribing CoP is a great opportunity to meet, share lessons learned and highlight promising practices from your projects while learning from others.

    Upcoming Meetings

    Members meet on a bi-monthly schedule, with meetings held from 1:00-2:30 p.m. EST, every third Thursday of the month. Meetings for this CoP are not recorded, and summary notes of each meeting are provided for all members.

    Resource and Contact Sharing

    For more resources and to facilitate contact between CoP members, the Ontario Social Prescribing CoP has a dedicated Google Drive resource hub and Google Group email listserv.

    If you would like to learn more, please contact: 

    Alliance for Healthier Communities
    communications@allianceon.org

    Key Resources 

    Social Prescribing Guidebook for Team-based Primary Care Providers in Ontario(link is external), September, 2020
    Poster: Social Prescribing as a tool for building climate resilience, OPHA Fall Forum, November 23, 2019
    Connected Communities: Healthier Together(link is external), Annual Report of the Chief Medical Officer of Health of Ontario, February 2019
    Fact Sheet: Spotlight on Reducing Social Isolation
    International: Social prescribing stimulus paper by the Royal Australian College of General Practitioners and Consumer Health Forum of Australia, November 2019
    Social Prescribing Infographic, May 17, 2022 ( English | French )
    A toolkit on how to implement Social Prescribing, World Health Organization, May 20, 2022
    Social Prescribing resource for health professionals, Centre for Effective Practice, November, 2022