Social prescribing helps ‘combat social exclusion’

Loneliness is on the rise throughout every sector of society, but in rural Ireland one of the starkest indicators of a lonely population is the number of people presenting to their GP on a weekly basis, for what is their only social interaction.

The pandemic forced so many people to isolate, particularly the elderly, and it has been a very slow process convincing people to re-engage in their communities and restore connections. But that is the premise of a HSE led initiative, operating throughout the country, which is connecting people with each other, through common interests and social pursuits.

Social prescribing is a non-clinical intervention aimed at supporting people with one or more long term health conditions that may be an obstacle to them participating in society.

The phenomenon, which originated in the UK, offers those who are lonely or isolated, or who have complex social needs, the chance to enhance their health and well-being by socialising more.

People are typically referred by their GP to a local social prescribing service, but there is a facility for self-referral if someone feels they would benefit from the support.

Loneliness

Ronan Bilbow, is the social prescriber for Roscommon Well Connected Social Prescribing Project. He says the service offers a lifeline to those who find themselves struggling with their mental health.

“The service supports people aged 18 and over to link with others to increase their social connections, which enhances their overall wellbeing,” he explains.

“We offer early intervention and post support but social prescribing isn’t a prescription for crisis mental health. It is however for everyone who isn’t necessarily in crisis but is feeling their mental health or overall wellbeing could be improved.

“Encouraging people to take that step to engage is the main objective of social prescribing but most people get stuck in their comfort zone and it’s hard to come out of it.”

When social prescribing was first introduced as a pilot programme in Mayo in 2012, it was based on GP referrals to non-medical services to get people more involved in society as a way of tackling loneliness and isolation which can exacerbate pre-existing health conditions.

The support covers financial concerns, employment, health and social issues. The service is now available in over 30 locations, supporting thousands of people throughout the country as part of a National Social Prescribing Framework launched by the HSE in 2021.

Bachelor farmer

For rural people living alone, random events can plunge them into isolation that can be very hard to emerge from.

“A recent client I supported was a bachelor farmer who had fallen and needed to use a walking frame as part of his physical recovery. But the accident had affected him emotionally as he hadn’t anticipated age catching up on him,” says Ronan.

“His physiotherapist made contact with me and I went out to meet him in his house. He was reluctant to engage at first but by taking small steps, he started to emerge from darkness into the light. He needed support to reconnect with society after his accident and he needed that connection with me to bring him out of himself, as he had retreated into himself and his mental health suffered.”

Sarah Carey, social prescriber with the Breffni Family Resource Centre in Carrick-on-Shannon supports people across Leitrim and holds regular clinics in the most rural parts of the county to ensure she reaches those who need the service most.

“People who have farmed or worked all their lives in rural Ireland find they’re at a loss when they retire,” she says.

“When someone is referred to us or contacts us of their own accord, we develop a wellbeing plan to cover all the bases from physical, mental, social, and financial health.

“We offer people between six and eight sessions and then follow up care, and we also can offer subsidised counselling, if people feel that would help.

“Mental health is the same as dental health, we all have it and we all have to stay on top of it. You brush your teeth every day, so you need to give the same time and care to your mind. Sometimes you need a filling and when you do, that’s not a big deal so coping with mental health issues needs to be considered in the same vein.”

Social interaction gone

Sarah says older men are willing to acknowledge issues with their mental health, even if they don’t describe it in such terms.

“People are falling through the cracks a little, especially older people who visit their GP every week simply because it’s their only social outlet,” she says.

“We find that farmers who would have gone to the mart every week are very lost when they retire and that social interaction is gone.

“There’s a pretty even split between men and women availing of social prescribing. Older men are more willing to discuss their mental health which they won’t necessarily describe as such but they will be aware of the fact they have low mood or are feeling anxious.

“Some men come in and reject the notion of counselling initially but after a few sessions of talking to me and figuring out what they think might help them, they reconsider and avail of the supports available.

“The women we see typically want to be connected to groups in their communities but don’t necessarily want to join active age groups, they want something more specific to their interests, be it gardening or reading or whatever.”

Sarah says it doesn’t matter what prompts a person to seek support, the first step is the most important one to take.

“I had an 80-year-old woman come to me who was encouraged to reach out for help having attended a funeral mass where the deceased had died by suicide. During his homily, the priest urged anyone in the congregation who was struggling with their feelings to get help. She ended up going to her GP, not realising that people felt like she did. Her GP referred her to us and we worked with her to identify her interests and to support her with counselling. It’s about building connections even though we’re a short-term intervention service.”

Positive experience

Gill Sheridan relocated to Leitrim in recent years and has had a very positive experience with social prescribing.

She wanted to make new connections, new friendships and join social groups but she didn’t know where to begin looking. A meeting with Sarah led to a wellbeing plan being developed and she joined a local gardening group and a women’s group.

“My aim when I contacted the service was to improve my health and I feel that this has done so,” she says.

“On the days that I go to the groups, I find my positivity levels increase and my mood is brighter. I’m not sitting at home in my head with just my thoughts, I have made local social connections and it has really helped me to settle after the move.”

Social prescribing spans all generations and both Sarah and Ronan are helping support young people living in rural Ireland who also experience isolation and loneliness.

“Younger clients look for help with education and courses and we have strong links with Leitrim Development Company and Mayo Sligo Leitrim Education Training Board,” adds Sarah

“Our younger people can often have issues with mental health and where its mild or moderate anxiety, we can help with support on calming the nervous system through journalling or other such measures. It’s all about reassurance and giving people pathways through difficult times.

“Those who left school early or are newly arrived into a community are those we typically see coming through the door.

“The benefits of social prescribing are becoming more known. We see it ourselves here with people who refused to leave their house during the pandemic but are still signed up to and attending the weekly gardening group meetings, where they have forged friendships and developed their own interests.”

If you often feel lonely, it can be hard to change this on your own. There are services and organisations that can help.

Social Prescribing: This service connects you with activities and supports in your area. allirelandsocialprescribing.ie

ALONE: National support and referral line for people over 60. You do not need to live alone to access these services. Phone: 0818 222 024, alone.ie

Seniorline: Confidential listening service for older people provided by trained older volunteers. Phone: 1800 804 591, 10am to 10pm every day. thirdageireland.ie/seniorline

Age Friendly Ireland: Programmes and networks to support older people. agefriendlyireland.ie