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Equal, equitable or exacerbating inequalities: patterns and predictors of social prescribing referrals in 160 128 UK patients. | LitMetric

Equal, equitable or exacerbating inequalities: patterns and predictors of social prescribing referrals in 160 128 UK patients.

Br J Psychiatry

Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK.

Published: October 2024

AI Article Synopsis

  • - The study investigates social prescribing in the UK, analyzing a large dataset of over 160,000 individuals to understand referral routes and the effectiveness of interventions aimed at addressing social determinants of health.
  • - Mental health was the primary reason for referrals, with most coming from healthcare providers; however, non-medical routes were found to reach underserved demographics more effectively.
  • - Despite 90% of referrals leading to engagement with a link worker, only 38% resulted in actual interventions, highlighting a shortage of community activities and uneven implementation across the UK.

Article Abstract

Background: Social prescribing is growing rapidly globally as a way to tackle social determinants of health. However, whom it is reaching and how effectively it is being implemented remains unclear.

Aims: To gain a comprehensive picture of social prescribing in the UK, from referral routes, reasons, to contacts with link workers and prescribed interventions.

Method: This study undertook the first analyses of a large database of administrative data from over 160 000 individuals referred to social prescribing across the UK. Data were analysed using descriptive analyses and regression modelling, including logistic regression for binary outcomes and negative binomial regression for count variables.

Results: Mental health was the most common referral reason and mental health interventions were the most common interventions prescribed. Between 72% and 85% of social prescribing referrals were from medical routes (primary or secondary healthcare). Although these referrals demonstrated equality in reaching across sociodemographic groups, individuals from more deprived areas, younger adults, men, and ethnic minority groups were reached more equitably via non-medical routes (e.g. self-referral, school, charity). Despite 90% of referrals leading to contact with a link worker, only 38% resulted in any intervention being received. A shortage of provision of community activities - especially ones relevant to mental health, practical support and social relationships - was evident. There was also substantial heterogeneity in how social prescribing is implemented across UK nations.

Conclusions: Mental health is the leading reason for social prescribing referrals, demonstrating its relevance to psychiatrists. But there are inequalities in referrals. Non-medical referral routes could play an important role in addressing inequality in accessing social prescribing and therefore should be prioritised. Additionally, more financial and infrastructural resource and strategic planning are needed to address low intervention rates. Further investment into large-scale data platforms and staff training are needed to continue monitoring the development and distribution of social prescribing.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7616880PMC
http://dx.doi.org/10.1192/bjp.2024.141DOI Listing

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