Social prescribing: 'GPs can treat the symptoms but we can get to the root cause'
Medication not working? Social prescribing, which helps people address their physical and mental wellbeing through things like nutrition, counselling and exercise by connecting them with sources of support within their community, is showing promising results
WAKING up in pain every morning due to fibromyalgia was having such a detrimental effect on Karen O'Reilly's wellbeing that she often felt like staying in bed and avoiding the world.
Before developing the condition, the 47-year-old Derry mum-of-one had been fit and active and a regular member of a running group affiliated with the Bogside and Brandywell Health Forum.
The crippling pain all over her body was accompanied by headaches, brain fog and tummy upsets, leading to depression and anxiety. The Creggan woman was at her wit's end when her GP referred her to Spring Social Prescribing; a community initiative delivered by the same health forum which organised the running club.
Social prescribing is a fairly new concept which helps people address their physical and mental health and wellbeing by connecting them to sources of support within the community. Options include activities such as art, counselling, exercise classes and befriending schemes.
GPs and medical practitioners refer patients to their local Spring Social Prescriber for one-to-one support for social, emotional and practical needs.
Karen, who has a 15-year-old son, met with her social prescriber Bronagh Cooper, and was advised to join a pain management group at the Bogside and Brandywell Health Forum. Not only has the group been a source of support and camaraderie for Karen, but she has since become a health facilitator herself at the forum.
“The pain started a couple of years ago and I was constantly running to the doctor's,” she says. “I was given medication but nothing seemed to work. “There were mornings I'd wake up and feel like I'd been hit by a bus. My entire body was sore. Other days, my legs would be heavy and painful and I'd find it hard to walk.
“I just felt awful and it got to the stage that I felt really depressed. My friends would ask me to go out, but I couldn't. I was in too much pain. Then the anxiety took over.
“What made it worse for me was that I used to be fit and run a lot. Five years ago I ran a few half marathons. I felt so down, insecure and my confidence was gone.”
When Karen realised the pain management group met at the Bogside and Brandywell Health Forum, she was initially hesitant about going. She fretted that some people who had known her in her running days might judge her or doubt she was struggling with pain. But Bronagh was at her side the first day she walked in, which made it easier for Karen.
“There were about 20 in our group and to begin with I thought that it wasn't for me,” Karen admits. “But then meeting other people in the same situation, talking to people who were much worse than me, made me realise I wasn't alone.
“With something like fibromyalgia, people don't always understand. I've had things said to me like 'there's nothing wrong with you'. That can be tough, so being around people I could relate to and talk to, really helped. It was the best 16 weeks; I got so much out of it.”
As well as looking at nutrition, CBT counselling and mindfulness, Karen was also introduced to Chi-Me, a low-impact and light-intensity exercise based on Tai Chi. She took to it so well that Bronagh suggested she train to be a Chi-Me instructor – plus she is currently training to be a yoga facilitator as well. Social prescribing has been beneficial for her in so many ways.
“Walking in the door that first day was really hard for me. It's so easy to lie on in bed, feeling sorry for yourself. But I'm so glad I did it; it completely changed my life. I've met so many other people who understand me and I've been so lucky to have Bronagh's support too. She's been amazing,” Karen says.
As the social prescribing coordinator at the Bogside and Brandywell Health Forum, it's Bronagh Cooper's job to identify each individual's needs and link them up with the relevant support group or activity. The Culmore woman has worked within the community for many years and is well-known at grass-roots level, which means she is aware of the various programmes, clubs and support groups in the city.
When a referral comes in, it's up to Bronagh to meet with the person, identify their needs and 'co-create' a support system for them.
“Everyone is different,” Bronagh says. “An older person, for example, might have mobility issues and want to take part in a Falls Prevention programme. Someone else might have mental health problems and need counselling or moving up a tier, might need more intensive therapy. Or, as in the case, of Karen, may need chronic pain support.
“I'm on the ground so know exactly what is available and what would work for them. A lot of people know they need help but don't know where to go to get it. It's about finding the right support for them and then empowering them to look after their own health and well-being.”
If a programme isn't readily available, Bronagh and her team can set it up; such as the chronic pain group and a Nature's Way walking club for those who want to exercise at a leisurely pace.
Bronagh has noticed a huge spike in referrals and puts that down to the success of social prescribing.
“Once a GP starts to see that a patient has reduced their appointments; they then know social prescribing is working well so refer more people on,” says Bronagh.
“During lockdown our programmes had to stop and many doctors were busier with patients coming back to them. GPs can treat the symptoms but we get to the root cause.”
With programmes now resuming following the lifting of Covid-19 restrictions, Dr Paul Molloy, a GP at Clarendon Medical in Derry, is full of praise for the social prescribing scheme.
“Social prescribing has been a tremendous success,” he says. “It shows us that taking a holistic approach to someone’s health by looking at their social, psychological and spiritual needs are just as important as addressing physical illness.
“Socially isolated people have benefited from tailored programmes to increase their confidence. The benefits to physical and mental health have been reflected in positive feedback and reduced levels of attendances at medical facilities for those who have participated. The most important thing is that this group realise that someone cares about them.”
Spring has partnered with 15 other mental health charities, the PHA and the Departments for Communities and Health to deliver the Covid Wellbeing NI hub, an online resource with tools to help cope with the impact of Covid-19 on mental health and wellbeing. The hub can be found: https://covidwellbeingni.info/