Qu'est-ce que la prescription sociale - et peut-elle améliorer votre santé ?

Imaginez ce scénario : vous vous sentez légèrement déprimé en raison de l'isolement social ou une faible estime de soi. You take a trip to your GP, expecting a dose of antidepressants, but instead, you're put in contact with a local community gardening group and recommended to attend weekly sessions. Would you give it a go?

This new approach is called 'social prescribing' and more and more GPs are exploring it. Doctors are now linking their patients with sources of support within the community. These non-medical referral options can complement existing treatments to improve health and well-being.

Des programmes tels que des cours de danse et de l'art-thérapie, ainsi que des activités agricoles comme le jardinage, sont devenus popular options pour la prescription sociale car ils aident à combattre la solitude et à améliorer la santé mentale, grâce à leur exigence physique et leur orientation sociale.

Et il y a des preuves pour soutenir cette nouvelle initiative. Par exemple, un nouvelle étude par le Conseil National des Organisations Bénévoles (NCVO) a interrogé plus de dix mille adultes sur les effets du bénévolat sur leur santé mentale. 77% des répondants ont déclaré que l'activité avait amélioré leur bien-être mental et réduit la solitude, et 74% ont également convenu qu'elle avait renforcé leur confiance en eux.

La Collège Royal des Médecins Généralistes (RCGP) s'est également associé à Parkrun, encouraging GP practices to develop close links with their local running group for the benefit of both the patients and the staff. They aim to help those with conditions such as multiple sclerosis, osteoarthritis and depression.

Looking at your lifestyle

Les problèmes que de nombreux patients présentent à leur médecin généraliste ne sont pas toujours directement médicaux, c'est là que la prescription sociale peut être utile. Par exemple, le risque de développer des conditions telles que diabète de type 2, high blood pressure and high cholesterol depends on an individual's level of physical activity, diet and a number of lifestyle factors.

"Et nous avons constaté une énorme augmentation du nombre de patients présentant des problèmes de santé mentale," révèle Dr Sarah Jarvis, clinical director of Patient. "Social prescribing looks both at lifestyle elements that will help people's physical health and social elements which will specifically target loneliness and social isolation."

A two-way street

"Overall, social prescribing offers huge advantages to both patients and GPs," says Jarvis. "It may well free up more time for GPs to spend with other patients whose problems are more specifically medical."

This means more efficient and appropriate care for everyone.

Cependant, "les avantages de la prescription sociale pour le patient peuvent ne pas sembler immédiatement évidents," conseille Kate Carney, cofondatrice de My Community Referral, a platform that enables GPs to find appropriate social prescribing options for their patients.

"Some patients find it difficult to understand that there is not 'a pill for every ill'," Jarvis agrees, admitting that some may struggle with the idea of their GP referring them for a gardening session when they make an appointment for depression.

But social prescribing could be more effective than you think. For example, GPs have been trying to reduce prescribing medication for mild to moderate depression for two main reasons:

"Firstly, antidepressants are not very effective in many people with mild depression, and can cause marked side effects in some people," reveals Jarvis. "And secondly, tablets only work while you're taking them."

Et même si vous suivez un traitement antidépresseur, rejoindre un groupe communautaire ou une activité pourrait aider davantage à traiter la solitude et l'isolement social.

Social prescribing gives GPs the option to explore reliable, non-clinical treatment options for patients they may be unable to assist further but who still require support.

"When there is no clear, clinical pathway, social prescribing activities provide an alternative and often complementary approach," suggests Carney.

Malheureusement, un problème majeur pour les médecins généralistes est l'absence d'une base de données centrale pour ces initiatives. Comme de nombreuses activités sont financées par le secteur tertiaire, au moment où un cabinet en prend connaissance, elles peuvent avoir fermé. Cependant, cela devrait s'améliorer à mesure que le proposed NHS funding est mis en œuvre.

"Not only are we going to be able to refer patients to 'social prescribers', but if we feel a patient is either resistant to being referred to a social prescribing worker or that they will respond better to advice from us, then by having local services and databases that are up to date we may be able to refer some patients directly," says Jarvis.

In it for the long run

The potential long-term benefits of social prescribing are enormous for patients, says Jarvis.

"Pour quelqu'un qui a une faible estime de soi, effectively believes their life is over and is sinking into a negative spiral of social isolation, if we can turn that around then the benefits for individuals may be vast."

But unfortunately, there are currently huge problems getting patients to engage with the scheme for long enough to have a benefit, Jarvis points out. This not only greatly lowers your chance of effective treatment, but it potentially takes a space from someone who may also have benefited from the scheme.

If you are thinking of participating in a social prescribing initiative it's important to stick with it, even if you don't feel any immediate benefits.

"If we can improve lifestyles then we can often treat the root cause rather than just the symptoms and improve endurance and resilience for the longer term," assures Jarvis.

Carney believes that social prescribing has long-lasting effects, even if you only participate for a short amount of time, as it gives patients something that traditional prescription services may not be able to.

"Becoming part of a community of like-minded people has advantages that far outweigh the immediate benefits to someone's physical or mental health."

What about medication?

Carney argues that social prescribing gives patients additional, sometimes alternative, options to medication, but only where appropriate. For example, social prescribing could assist with pain management in physical conditions.

"Personnes avec l'arthrose ceux qui participent à des services de gestion de la douleur holistique, où ils ont des séances de groupe axées sur la réduction de l'impact de la douleur sur leur vie et une équipe multidisciplinaire, ainsi que des « prescriptions » d'exercice, sont beaucoup plus susceptibles de pouvoir réduire leur dépendance aux médicaments à long terme," révèle Jarvis.

Of course, some people rely on medication to manage their illness and social prescribing is not an alternative to antidepressants for everybody.

"Depression is very much an illness every bit as much as asthma, diabetes and even a broken leg," says Jarvis. "We must remove the misconception that you can 'cure' depression by doing a bit of gardening."

She shares a great analogy: "If you've got type 1 diabetes, you are always going to need insulin. That does not mean that diet and lifestyle are unimportant - if anything they are more important. But this is not 'either or'; it's a combination of the two."

If you are taking antidepressants and want to try out a social prescribing programme, talk with your GP before you stop taking them. They will be able to assess your needs, and you may find that social prescribing will be a complementary addition to your treatment, rather than an alternative.

How can I get involved?

Carney shares a few top tips for those wanting to learn more:

"Before you start any new activity it's best to consult your GP," she advises.

Depending on your condition and abilities, they will be able to recommend programmes to try. Then, once you’ve consulted your GP, you can also do your own research.

"Look for community clubs, and social activities, and try to find other people with some of the same challenges as you," Carney suggests.

Social prescribing is an opportunity to try something new and make a long-term positive change for your well-being, she believes.

"Remember that social prescribing activities are not clinical solutions; they have a more holistic approach to your well-being, so try to go feeling optimistic and with an open mind."