Can Social Prescribing Tackle Loneliness?

KateJopling

I’m Kate and I work as a consultant with organisations in the voluntary sector on a range of issues including ageing, health and care. In recent years I’ve done a lot of work on loneliness like working as Director of the Campaign to End Loneliness, writing the final report of the Jo Cox Commission on Loneliness and recently assessing progress on the Government’s Loneliness Strategy on behalf of the Loneliness Action Group.

Loneliness and Social Prescribing

One of the flagship announcements in the Government’s Loneliness Strategy last October was the roll out of social prescribing services across England – with funding from NHS England by 2021 every Primary Care Network (PCN) will have a Link Worker to help people to access support and activities in the community.

This is good news. There is limited evidence around what works in tackling loneliness overall, but what there is suggests that offering individuals who are experiencing or at risk of chronic loneliness one-to-one support is a good way of reducing loneliness. With chronic loneliness being defined as feeling lonely often, it is this support that allows them to reconnect with people in their communities

So why am I worried about the roll out of social prescribing?

Making sure Social Prescribing works for Loneliness

Firstly, ‘social prescribing’ is a very stretchy term and, while diversity of provision is good, we need to ensure that the models that roll out are the ones that work. In good social prescribing services, Link Workers spend time getting to know individuals, giving them time and space to talk about the issues. They recognise that usually there is a complex web of practical and emotional barriers that is getting in the way of social connections – not just a lack of information. They also understand loneliness deeply.

Knowing that loneliness can be surrounded by stigma means you appreciate that asking people if they are lonely won’t always elicit a true response. You also want a Link Worker to understand that people who have been lonely for a long-time struggle more in social situations, so people need support to step out. Link Workers need to recognise the personal nature of loneliness and that different people find meaningful connections in different ways, so our offer must be flexible. For one person a community choir may be the answer, another may need support in plucking up the courage to reach out to an old friend.

By contrast there are ‘social prescribing’ services which I’m pretty certain would be no help to someone who was deeply lonely – where support is strictly time-limited, conversations are driven by check lists, and the ‘offer’ consists of a narrow menu of formal services.

Secondly, it’s not yet clear who will fund the community services and activities to which Link Workers will need to refer people. NHS England are only funding the Link Workers themselves. In some areas there are lots of services and activities available already, and so the biggest challenge for Link Workers will be staying up-to-date with what’s available, but in other areas there are gaps. In these areas Link Workers will inevitably identify demands that cannot be met. In some existing services Link Workers play a community development role, helping people develop their own community responses to need. However, it’s not yet clear whether Link Workers will have capacity to do this if they are also trying to meet needs across a PCN population of 50,000.

Finally, there are real risks of unintended consequences in this programme. Work on loneliness isn’t new, and nor are social-prescribing-type services: community navigators and connectors, mentors, and Local Area Coordinators all work in similar ways – as was demonstrated by the programme of shared learning we undertook with the British Red Cross and Co-op partnership. It’s really important that PCNs build upon existing expertise in their communities, but in the rush we risk existing services being decommissioned in favour of new ones. Communities can’t afford to lose that knowledge.

What needs to happen next

The roll out of social prescribing services could be really good news, but if we want it to work for loneliness then we need to build services with loneliness in mind. At the national level we need to keep focused on the issue providing the guidance and support PCNs need to understand loneliness and how to tackle it. We also need to measure the impact of new schemes on loneliness, otherwise we’ll never know if they’re working.

In communities up and down the country local organisations who are already involved in working with lonely and isolated people need to make their voices heard – especially by their local PCNs and other health leaders as they decide what to do. As we set out in this report, the time to act on this is now. 

What are your thoughts on social prescribing? Have health authorities in your area started consulting on new services? Do you believe this sort of community work could benefit you? Let us know in the comments below!

Roddy

Hi @KateJopling

Thank you for your interesting post.

In my own personal experience I did not realise how loneliness could affect me until 2 weeks ago when I moved to a new property. I have never been one to feel lonely or bored, but I now know that this was because there were always people around me 'if' I wanted any company and so I did have a choice. However, I have now relocated to a remote village where even if I look out my windows I may not see a single person in 2 0r 3 days.  Coupled with this, as I am new here I obviously have no idea where or to who I can approach or perhaps turn to for anything, let alone 'company' of any kind. It is also of course always embarrassing to 'ask' anybody whilst also being concerned about placing yourself at risk.


Many disabled people are totally isolated and their only communication with the outside world may be the internet for example or perhaps an occasional  carer or periodical hospital trips etc. In my own view, advertising and promotion about Social Prescribing Services, to incorporate the services available is VITAL.  There are far too many already existent services which many people have no idea about the existence of, and an already lonely person will also have difficulties in making the initial approach and/or be incapable to due to their physical disabilities etc. There are also many in the caring profession who will not have the ability to identify a persons loneliness, or be able to make a qualified decision or a risk assessment for example... Many people )like myself) will often mask or disguise their loneliness to others whilst suffering in silence due to embarrassment or from thinking it as a sign of weakness.


During the past 3 years many of the services that I require and for a whole variety of issues have ONLY become known to me via seeing posters & notices in Dr's surgeries or by making lots of searches on line in 'the hope' that a certain service is out there somewhere. I cannot imagine many lonely people spending their time doing this. I therefore think that printed material made available to those who have the ability to read it should be provided to the community at large, whilst all those that are seen or visited by paramedics/carers/occupational therapists etc., are made aware of all services available which are applicable, and loneliness is one such thing which can very much indeed affect anybody at anytime whether or not you are disabled.              

dolfrog

Hi  @KateJopling
I have a communication disability, which means that anyone trying to help me work around my communication disability to overcome my loneliness has to be trained regarding the complex nature of my disability, and especially the verbal communication problems i have everyday.
I have Auditory Processing Disorder, my brain having problesm processing and understanding the sounds my ears hear, which includes speech. Currently in the UK the main problem is the professional negligence of most UK Audiologists who fail to even understand the audiology of Auditory Processing Disorders let alone explain these complex issues to any multi discipline support medical professionals or support workers.
So you would have to have the 3 UK audiology professional bodies radically improve the minimum qualification requirements to include all aspects of audiology including the 4 types of Auditory Processing Disorder.
I am house bound as I need to avoid the lack of awareness of my communication disability causes by this professional negligence by UK audiologists, and the recommended multi discipline support team which should include psychologists, and speech and language therapists. They the major cause of the loneliness pure disability discrimination. 

April2018mom

Hello @KateJopling


I think making friends is a good idea. It is important for our wellbeing. In my local area, there is a established carers network that supports carers. Additionally there are several good care homes and independent care companies for disabled folk all over Surrey. This is a step in the right direction. It makes me proud seriously. 

But, I still have had issues trying to find out if there are activities for physically impaired kids however. It seems that many care providers and care homes automatically are created for those with learning difficulties/disabilities. This is not true disability inclusion. I have struggled to find information on clubs that are solely for those with physical impairments. Why is this? There is work still to be done. I don't want my son to be left out for no reason. Isn't it crazy?  

I am thinking of setting up my own care company for those with mobility issues. There seems to be a gap in the market that could be filled. I think it is a real shame. Who is with me on this issue? It is a tad disturbing and a little frustrating to me. One fully capable group is being left out when they should not be. 

Birdsnbees

@April2018mom agree and great idea. as someone who suffers from mobility issues it is a big gap in the market and affects me massively. social services local to me suggested goodgym who let people run while doing jobs for older people, i contacted goodgym who said they don't provide individual support and then told me about my local lend a hand service. however this service is only for older people. Something like goodgym but for individuals may also be a good idea

Roddy

April2018mom said:

Hello @KateJopling


I think making friends is a good idea. It is important for our wellbeing. In my local area, there is a established carers network that supports carers. Additionally there are several good care homes and independent care companies for disabled folk all over Surrey. This is a step in the right direction. It makes me proud seriously. 

But, I still have had issues trying to find out if there are activities for physically impaired kids however. It seems that many care providers and care homes automatically are created for those with learning difficulties/disabilities. This is not true disability inclusion. I have struggled to find information on clubs that are solely for those with physical impairments. Why is this? There is work still to be done. I don't want my son to be left out for no reason. Isn't it crazy?  

I am thinking of setting up my own care company for those with mobility issues. There seems to be a gap in the market that could be filled. I think it is a real shame. Who is with me on this issue? It is a tad disturbing and a little frustrating to me. One fully capable group is being left out when they should not be. 

Marvellous idea, as I firmly agree that there are many disabled people who would not only make good carers (as many do) but some of us do have a better understanding perhaps of the difficulties faced by disabled people, subject of course to a persons disability & medical needs. 

Not many able bodied people can fully appreciate some of the challenges that we face. This doesn't necessarily mean that they don't comprehend, but I am sure that somebody with a certain disability understands more and this in turn can assist others with the same difficulties etc... after all, many people do exactly that within our online community here on SCOPE and our help to others with the same challenges (including loneliness) is invaluable to each other…  Just imagine if this was one-to-one in person, for people who are not members but are perhaps within our local communities?

Such people would also be helping themselves and would feel more confident and less isolated too. 

There will always be disabled people who perhaps don't want to mix with people of their own disability or illness, but there are many who just need a good listening ear and an understanding voice, and this can make so much difference at times, with one supporting the other and vice versa... 

The disabled, caring and supporting the disabled in person, would be a milestone in every community, as there are many communities where the able bodied don't truly support or understand us at all. They only 'think' that they do.      

dolfrog

Roddy said:

April2018mom said:

Hello @KateJopling


I think making friends is a good idea. It is important for our wellbeing. In my local area, there is a established carers network that supports carers. Additionally there are several good care homes and independent care companies for disabled folk all over Surrey. This is a step in the right direction. It makes me proud seriously. 

But, I still have had issues trying to find out if there are activities for physically impaired kids however. It seems that many care providers and care homes automatically are created for those with learning difficulties/disabilities. This is not true disability inclusion. I have struggled to find information on clubs that are solely for those with physical impairments. Why is this? There is work still to be done. I don't want my son to be left out for no reason. Isn't it crazy?  

I am thinking of setting up my own care company for those with mobility issues. There seems to be a gap in the market that could be filled. I think it is a real shame. Who is with me on this issue? It is a tad disturbing and a little frustrating to me. One fully capable group is being left out when they should not be. 

Marvellous idea, as I firmly agree that there are many disabled people who would not only make good carers (as many do) but some of us do have a better understanding perhaps of the difficulties faced by disabled people, subject of course to a persons disability & medical needs. 

Not many able bodied people can fully appreciate some of the challenges that we face. This doesn't necessarily mean that they don't comprehend, but I am sure that somebody with a certain disability understands more and this in turn can assist others with the same difficulties etc... after all, many people do exactly that within our online community here on SCOPE and our help to others with the same challenges (including loneliness) is invaluable to each other…  Just imagine if this was one-to-one in person, for people who are not members but are perhaps within our local communities?

Such people would also be helping themselves and would feel more confident and less isolated too. 

There will always be disabled people who perhaps don't want to mix with people of their own disability or illness, but there are many who just need a good listening ear and an understanding voice, and this can make so much difference at times, with one supporting the other and vice versa... 

The disabled, caring and supporting the disabled in person, would be a milestone in every community, as there are many communities where the able bodied don't truly support or understand us at all. They only 'think' that they do.      

My wife and I both have the same communication disability, and we had d been together for over 20 years before we both had a clinical diagnosis of the same disability. Our diagnosis explained why we understood each other so well and provide the support each of us needed. 
So yes those of us who have some type of disability may be more empathetic to others who have the same or similar disabilities which we may be able to understand, and probably better than those who have no disability as all.

April2018mom

My local community gym has classes for disabled people. There is no one single approach. If it helps, I found some guidance on how to end social isolation. https://www.hee.nhs.uk/sites/default/files/documents/Social%20Prescribing%20at%20a%20glance.pdf

kami24

There are no groups in my area so I feel. Isolated

Roddy

kami24 said:

There are no groups in my area so I feel. Isolated

Hi @kami24 I know the feeling, and although there are many groups where I live, none are suitable for a disabled person other than coffee mornings at my local church, and groups which require physical activity like sports for example which I've never had an interest in, even before I was ill.  I am sure that there are many like myself, who don't like 'groups' as such and mix better with one or two people. We are not alone with these preferences, for we are human beings like everybody else and our characters are unique.

It is true that most 'groups' establish themselves without the disabled being in mind, and are usually formed by likeminded people with a keen interest in their particular field. Of course many of these same groups will perhaps allow you to join them, but they are not disabled friendly in terms of access or inclusion. I don't know what the answer is without the use of a Magic Wand, and the costs involved with travelling to some groups and/or using their facilities is also quite often the stumbling block too...


I must say though, that since I joined my local community group on Facebook, it has offered me as much information about what's on etc. and the facilities which are available in my immediate area. The people have also been very helpful as best they can and/or have pointed me in the right direction. 


By being referred to a certain place or an organization via my GP for example, only reminds me again of my illness & disabilities. I believe that our local Councils should do far more by making everybody aware what is on offer. After all, they will be totally aware of such places under their catchment areas. 

dolfrog

Roddy said:

kami24 said:

There are no groups in my area so I feel. Isolated

Hi @kami24 I know the feeling, and although there are many groups where I live, none are suitable for a disabled person other than coffee mornings at my local church, and groups which require physical activity like sports for example which I've never had an interest in, even before I was ill.  I am sure that there are many like myself, who don't like 'groups' as such and mix better with one or two people. We are not alone with these preferences, for we are human beings like everybody else and our characters are unique.

It is true that most 'groups' establish themselves without the disabled being in mind, and are usually formed by likeminded people with a keen interest in their particular field. Of course many of these same groups will perhaps allow you to join them, but they are not disabled friendly in terms of access or inclusion. I don't know what the answer is without the use of a Magic Wand, and the costs involved with travelling to some groups and/or using their facilities is also quite often the stumbling block too...


I must say though, that since I joined my local community group on Facebook, it has offered me as much information about what's on etc. and the facilities which are available in my immediate area. The people have also been very helpful as best they can and/or have pointed me in the right direction. 


By being referred to a certain place or an organization via my GP for example, only reminds me again of my illness & disabilities. I believe that our local Councils should do far more by making everybody aware what is on offer. After all, they will be totally aware of such places under their catchment areas. 

The nature of my communication disability means that I can only communicate with 2 or 3 people at a time, any larger group and I feel I can cope processing what is being said and i need to escape.
Some years ago I volunteered helping a local walk group, as you mentioned they were not really willing to help and understand those who had any real issues and problems with exercise, And eventually due to my communication problems I felt isolated from both those who ran the group, and those who attended on a regular basis. 
Added to which the majority of so called medical professionals who should be participating as part of the multi-disciple support team only want to deny that my disability exists in order to hide their ignorance and incompetence. This the reason I have been using international research papers to explain mine an other peoples various disabilities. 

Snowflake56

I am lonely everyday I just wait for my husband to get home,I dont see a soul or rarely a message off anyone,that includes my adult children.Since I stopped working it's like I dont exist with anyone anymore.Ive recently moved and what friends I did have dont keep in touch or visit. I go to bed with dread and sometimes wish I wasnt here,I'm depressed and so lonely its affecting my mental health.

newborn

Assuming there is no such thing as physical  disability  seems routine. "Go for a brisk daily walk ". Hmmm

Go to your g.p. is just as out of the question.

Ails

Hi @Snowflake56, just wanted to say that I am sorry to hear you are struggling at the moment.  I can relate to feeling isolated when I first stopped work too and can appreciate how upsetting this is, especially if you don't see anyone all day.  We live in a village and my friends and family are over an hour away from us, so I am thankful for getting out and about at times here, although sometimes pain keeps me indoors.  Just wanted you to know that the Community is here to support you at any time so please feel free to chat to us.  Do you have any hobbies?  Sometimes that can lead on to joining a group.  Just a thought.  Please keep in touch and let us know how you are getting on.  All the best. 

Snowflake56

Hi Ails I have hobbies eg arts and crafts but there is nothing were I live to get involved with sadly,there is basically nothing for those with disabilities. My neighbourhood is a little rural but not a million miles from town,I could manage a taxi to get there,but since I've been stuck at home I've lost my self confidence and also find it painful to walk and scared of falling and being alone,so no company to have a chat or a coffee,I feel everyday is like groundhog day,but I keep thinking maybe tomorrow will be better,my friends know i am still chatty and bubbly but dont make any effort even though i message them,i never mention my illness and never moan but feel for some reason I'm not thought of the same.The loneliness is horrible and i do get tearful but never let it show,I've so much to offer i feel I'm a genuine loving person,with no one to share my interests with,I would give anything to have my health back and out and about,so have to find a way around it all like so many others.Thankyou for your support.

Chloe_Scope

kami24 said:

There are no groups in my area so I feel. Isolated

Hi @kami24, I'm sorry to hear this. Have you spoken to your GP about social prescribing in your area?

Ails

Hi @Snowflake56, you are very welcome and thanks for your post.  Glad to hear that you have some hobbies.  I too like arts and crafts.  What kinds of things do you make?  I enjoy making cards myself.  I'm really sorry to hear you are struggling just now and can appreciate how difficult things must be for you if there isn't much in your area.  I can relate to being frightened of falling when going out and I take taxis out or use my mobility scooter if my husband can't take me places so am thankful for that.  Have you seen the thread on here about social prescribing?  It maybe an idea to speak to your GP to see if there is anything like that near you.  Just a thought.  Sometimes when pain keeps me in I can get quite down at times too so please don't think you are alone.  You are doing really great in keeping a positive mindset and not showing it is getting you down to your friends, but they might understand if you were to talk about it to them.  Again, please speak to us anytime that you fancy a chat.  I am on here most days or even pm me if you prefer.  I am always happy to chat and if I can be of any help to you then please just let me know.  Hope you are feeling a bit better about things today.  All the best.  x

Snowflake56

Thankyou Chloe and Ails,had a new carpet fitted today and just having 2 people to chat to was so lovely then reality set in when they left,that tomorrow there would be no one visiting or anyone to chat to,you never think being in your fifties that your life has taken such a downward spiral and you feel desperate for human contact,its Halloween the fitters had to leave the front door open,the children are all out with mums and dads it made me smile so much ? days like these are the best,i felt i was part of something again instead of feeling invisible. 

kami24

I am alone at 28 so count yourself lucky. Just irritating neighbours and an annoying weird man downstairs coughing constantly on drugs and god knows what 

Snowflake56

Kami24 sorry but I dont count myself lucky when I have a disability plus recovering from cancer and my husband also in remission from cancer.

Sam_Alumni

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