GMAHN Social Prescribing Guide - Social Prescribing by dfsiopmhy6


									                            Social Prescribing
                               December 2005

Stress, anxiety and depression are the most common reasons for consulting a
doctor, and the largest group of prescriptions are for anti-depressants or

PCTs of the future will work on the wider determinants of health rather than
just focus on the medical approach. One GP, who has been involved in a pilot
scheme of learning on prescription, feels that health centres should be one-
stop shops where a variety of patient support is provided.

It is now quite common for patients to be prescribed exercise by their GPs but
other forms of ‘social prescribing’ are also emerging to improve physical and
mental health.

A basic model of social prescribing, signposting seeks to link patients up with
the non-medical facilities and services available in the wider community that
they can access to address the factors that influence their wellbeing.

Arts on Prescription
Creative activity has been shown to increase self esteem, provide a sense of
purpose, give structure to an otherwise shapeless day, help people engage in
social relationships and friendships. Enhance social skills and community
integration and improve an individual’s quality of life.

“Stockport Arts on Prescription has been unique in the country in providing a
ten year social prescribing intervention for people suffering from mental health

The continuing success of Stockport Arts on Prescription has largely stemmed
from it's securing mainstream PCT funding, retaining its highly skilled and
committed artists and the support of Health Care and Arts & Health

In many ways, the Stockport Arts on Prescription has been ahead of it's time:
• the scheme both promotes mental wellbeing and prevents mental ill
   health. This fits with the current move to rescope the concept of mental
   health to encompass wellbeing as well as illness.

•   there is a gathering momentum to provide social prescribing services in
    response to the need for mental health/wellbeing services (arts, books,
    exercise, learning and information on prescription)

This movement is a response to a recognition that :
•   a person's mental wellbeing needs extend beyond solely medical

•   Primary Care, where most of the mental health work goes on, needs to
    provide and link up to services which support people's holistic wellbeing
    needs whether that is artistic, physical, social or developmental.

•  the prevalence of mental health problems (one in four) calls for the
   expansion of self help and self care services."
Elysabeth Williams-Senior Health Promotion Advisor-lead for Mental Health
Stockport PCT

"Arts on Prescription is a course of art sessions that introduces participants to
basic drawing and painting techniques. The course is structured yet flexible
and aims to provide a supportive environment to people who are vulnerable
due to an experience of mental or emotional distress. The people who are
referred often have anxiety or depression and the project hopes to help
people regain their confidence, learn about art and meet others whilst
involved in a positive activity.
A Mental Health worker organises referrals, supports the group and provides
advice and relevant information along the way. Professional artists run the art
classes. This is NOT art therapy, the work produced is not analysed.
The introduction course lasts 16 weeks, after that participants can opt to
continue into the next class, with more advanced painting techniques, and
beyond that is the opportunity to join Artistic Moves, a participant managed
project which meets weekly."
Alison Kershaw Lead Artist
Stockport Arts on Prescription

The evaluation method used is completion of a questionnaire before and after
the sessions. As well as obtaining information about the person’s age and
ethnic origin, questions are also asked on
Contact with the GP in the last 3 months
Contact with other health professionals in the last 3 months
General Health Questionnaire (assesses anxiety, depression, somatic
complaints and social functioning)
Social relationships
Activities, interests and hobbies

People who remain in the project report a better self-concept, their mental
health does not deteriorate and for many, it improves. They appear to be
using fewer resources and participating in more social and leisure activities.

Bibliotherapy-Books on Prescription
The implementation of a bibliotherapy service means that GPs will have
access to an alternative method of treatment for those suffering with mental
health problems. The GP may give a patient a paper based “prescription” of
recommended self help books.
These books can then be borrowed from the local library free of charge. The
topics covered will be depression, anxiety, social phobia, panic, anger, stress,
low self-esteem, eating disorders, obsessional compulsive problems,
compulsive gambling, the aftermath of sexual abuse and bereavement.
Most of the books present a structured Cognitive Behavioural Therapy
approach, offering complete step-by-step treatment programmes.
A recent Department of Health commissioned review concluded that self help
methods have a high potential in mental health treatment.

Trafford are working on a pilot project, no one else in GM is looking at this yet.
They are working closely with the arts officer, libraries, a local GP and Bluesci
(A&H organisation working in community mental health). They are working on
the premise that the GP will help to suggest the list of books required and

Learning on Prescription
GPs, practice nurses, health visitors, counsellors and mental health nurses
refer patients, usually with symptoms such as anxiety, agoraphobia, low self
esteem or chronic pain to a learning advisor.
The advisor works with the patient to identify activities that could help alleviate
symptoms such as assertiveness class, yoga, painting or computer training.
The patient is then supported through the enrolment process.
One GP said “Prescriptions for learning have helped lots of our patients live
fuller lives. People report less pain, more energy, greater amounts of fun, and
they consult less often.”

Research by NIACE (National Institute of Adult Continuing Education) in 2001
revealed that 87% of people felt physically better as a result of learning while
89% reported positive emotional or mental health benefits.

Laughter on Prescription
Just by laughing, we release chemicals into our bodies that reduce stress,
boost our immune system and make us feel great! So it can be like a therapy
but we help ourselves without having to engage brain and just by playing and
having fun.

Laughter on prescription could be developed by
• creating a performance piece based on happiness
• creating photocollages of laughing faces
• running laughter sessions through performance theatre or comedy

Social Prescribing
In Choosing Health, the aim is to build on the public’s desire for a healthier
future by ensuring that the self care support is in place for people, particularly
those in disadvantaged groups and areas, to make healthier choices about
diet, physical activity and lifestyle.

Social prescribing builds on those aims to include a local process to access
self help tools and groups, creative and physical activities and ensure a more
holistic approach to health, increase social inclusion and social capital.

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