Social Prescribing Pilots in Ontario - where does OT fit it?

In December, the Alliance for Healthier Communities announced an 18 month project to pilot and evaluate Social Prescribing in Ontario.  11 participating Community Health Centres (CHCs), with a diverse mix of urban, rural, Francophone, and northern communities will participate in the project which provides an innovative way for CHCs to ensure the practice of social prescribing is included by design. Using client- and community-centred design thinking, participating centres will identify all that they do in terms of non-clinical interventions, build a structured clinical pathway, and track the impact of this work on health outcomes through a robust data collection and evaluation framework.

What is Social Prescribing?

Social prescribing is a means of referring people to a range of local, non-clinical services, seeking to address people's needs in a holistic way and supporting individuals in taking greater control of their own health.  Sound familiar to occupational therapists?!  Examples of social prescribing include referring patients to participate in a nature club, walking group, community band, drama society or woodworking group.  Social prescribing is a concept that has been gaining traction internationally in the medical community, especially in the UK.  In practice,  the Ontario pilots will engage a model that looks like this:

One of the factors that Social Prescribing addresses is social isolation - a very real issue for many, especially amongst the elderly. The United Kingdom recently appointed the world's first Minister for Loneliness and a national Loneliness Strategy which includes goals to enable all GPs to refer clients through social prescribing by 2023.  Studies put the harm from social isolation on par with smoking and obesity and identifies the increased risk of depression and dementia.

In Ontario, the project goal is to demonstrate, in a data-driven and evidence-informed way, what we know anecdotally – that people are healthier when they’re connected to social and community supports, and when they are empowered to play meaningful roles in both their own health and the health of their wider community.   Occupational therapists will recognize fundamental tenants of their profession in this approach which, though not labelled "occupational therapy", "occupational performance" or "participation in occupations that are meaningful to a person", recognizes the holistic focus required to truly address a person's health and well-being.

Implications for Occupational Therapists

Occupational therapists have been enthusiastic about the increasing focus on the broad determinants of health and attention to participation and engagement in meaningful activity to promote health and well-being in Ontario's primary care system.  There is a real synergy with the focus and goals of occupational therapy.  In different ways, many occupational therapists are engaging in practices and promoting strategies that help clients engage in community based activities that are meaningful to them.  This may be targeted at both the individual client level and at a community or population level.  Based on the model above, occupational therapists may see good fit for roles as Navigator links or as leaders/consultants to programs and/or primary care professionals who link with these programs.  Where do you see OT fitting?

Recent media attention to the developments in social prescribing in Ontario have created both awareness and reaction of the OT community to this emerging practice.  A December 17, 2018 Globe & Mail article was particularly visible (although others exist - see below) and drew response from the Society in a letter to the Editor from President Sylvia Davidson.  In her letter Ms. Davidson emphasized that the concept of social prescriptions recognizes the need for an approach to health & wellness that goes beyond medications…an approach fundamental to the practice of occupational therapy.

OSOT's Primary Care Health and Mental Health Teams will be reviewing developments of the Social Prescribing Pilots and considering implications and opportunities for occupational therapists.  Member input is welcomed!  Forward your comments to osot@osot.on.ca.

Additional Media Coverage