For Dr. Michael Routledge, the future of health care includes medical professionals writing prescriptions to increase patients’ social connections.
“Historically, the [health-care] system is built around being able to respond to acute health emergencies, and we’re pretty good at that,” said the Manitoba-based public health doctor.
“We’re quite poor at trying to promote health and wellness. It’s not really a health-care system as much as it’s an illness care treatment mechanism.”
Routledge is one of Manitoba’s leading advocates for social prescribing. The practice has been available in the province for just over a year and is becoming more well-known across Canada.
In social prescribing, a medical professional writes a prescription that connects a patient with some form of social activity or support. The World Health Organization lists social prescribing as a practice that can reduce social isolation and loneliness among older adults, although it can be used for people of all ages.
A recent paper by the Public Health Agency of Canada says that while social prescribing is new in Canada, it is well-supported by clinicians who make the referrals and various community organizations. The most common form of social prescribing, the paper says, involves medical professionals connecting patients to individuals whose job it is to help people find community resources.
These individuals — who often have titles like community connector or navigator — have a variety of professional backgrounds. The most important characteristics are that they be good listeners who are capable of helping people find the resources they need, sources say.
Changed family dynamics
When Connie Newman first heard about social prescribing, she thought, “This is exactly what we need.”
Newman is the executive director of the Manitoba Association of Senior Communities, which represents organizations that provide social supports to seniors.
Two years ago, the association received funding to implement social prescribing. The funding is being used to hire consultants who can help connect family doctors with senior resource coordinators.
Family doctors in Manitoba complete a social prescription by filling out a simple form that refers an elderly patient who is struggling with loneliness or social isolation to a senior resource coordinator.
These resource coordinators, who work at health authorities across the province, then connect these patients with community supports. They may help people find help for yard maintenance or identify educational opportunities, for example.
Newman expects this program to be in place in all the province’s health authorities in the next year.
A former schoolteacher, Newman says she saw students struggle because they lacked social connections. As a retiree, she knows how social isolation can do the same for seniors.
“It’s very important for older adults to be connected, because family dynamics have changed,” she said. More people live alone, or far away from their families. “The whole dynamic has changed.”
Routledge, who previously practised family medicine, says doctors often see patients with medical conditions that are exacerbated by loneliness and isolation. Doctors want to help fix that, but they are not trained to do so.
“You’ve got a limited amount of time per patient, and a lot of these conversations, they don’t need a half-an-hour discussion with a family physician. But they do need a half-an-hour discussion with a community-based resource,” he said.
Information about health promotion programs “often tend to get to people who know how to access them, are already well supported, already have pretty good health and wellness,” he said.
“The advantage to having this tied to the health-care system — whether it’s an emergency room or primary care site — is that these are the folks who are more vulnerable.”
Living well
In British Columbia, social prescribing programs are currently limited to seniors who are socially vulnerable, says Bobbi Symes, director of healthy aging at United Way of British Columbia. The healthy aging program is funded primarily through the province’s Ministry of Health.
The United Way is in the middle of a project to hire more community connectors — people who can help seniors find community resources. The goal, says Symes, is to have community connectors in every health region. Connectors work with referred seniors for five or six weeks, helping them connect to appropriate programs.
Not every senior qualifies. Seniors must be vulnerable in at least two ways, including having lower incomes, experiencing social isolation or being from an underserved community, such as Indigenous or LGBTQ seniors.
The United Way is also providing more funding to the community programs themselves.
“We didn’t want to inject a bunch of money into social prescribing and community connectors, and have it be an added burden on an already over-serviced non-profit world,” said Symes.
For Rod McKendrick, the key to social prescribing is finding what meets an individual’s needs.
“This really is about individuals living well in their own community,” he said. “This is about the individual. We’re not trying to make people fit in boxes.”
Since last year, McKendrick has worked for Saskatchewan Seniors Mechanism. He was hired because the organization received a donation of $4 million over four years to implement social prescribing programs in 14 communities.
The program model is similar to B.C.’s: the goal is to hire community coordinators to whom doctors can refer patients who are 55 and older.
Moose Jaw and Shaunovan are already involved, and McKendrick often speaks to other locations that are interested in joining. In some cases, municipalities will hire the community coordinators and the seniors mechanism will provide support as needed.
In a lot of ways social prescribing is not a new idea, McKendrick says.
“There are people who will go out of the way to find what that individual needs, rather than just saying, ‘Oh, there’s a phone number. Away you go.’”
But with people moving more, that is harder to do, he says.
Symes agrees that social prescribing is not new. But it is receiving more attention now.
“We’re at an exciting time now, because it is a buzzword and because there’s a lot of interest in it,” she said.
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