Home Mental Health & Well-Being New Framework for Social Prescribing Aims to Combat Loneliness by Leveraging Social Identity

New Framework for Social Prescribing Aims to Combat Loneliness by Leveraging Social Identity

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Researchers have introduced a comprehensive three-tier social identity framework for social prescribing (SP), aiming to address the pervasive issue of loneliness.

This innovative approach, detailed in a recent study, seeks to enhance the effectiveness of social prescribing by integrating theoretical insights from social identity research. This framework not only provides a robust foundation for understanding the mechanisms through which SP can mitigate loneliness but also offers practical guidelines for designing and implementing SP programmes.

The findings were published in the journal Group Processes & Intergroup Relations.

S. Alexander Haslam from the University of Queensland, Australia, said: “Given the alarming increase in loneliness around the world, and evidence that this is a major cause of poor health, there has been an increasing interest in social prescribing as a possible solution. This involves an array of strategies designed to increase people’s social connectedness. This can have some very positive results, but it is clear that it doesn’t always work. Our paper was an attempt to integrate insights from research teams all around the world to provide a framework that helps us understand when social prescribing works (and when it doesn’t) and why. We think this is essential for the development and refinement of social prescribing on the ground.”

Loneliness has increasingly been recognised as a significant public health issue, with severe implications for mental and physical health. Recent surveys reveal alarming statistics: only 42% of UK adults reported that they “rarely” or “never” felt lonely, highlighting the widespread nature of the problem. Similar patterns are observed globally, with countries like Australia reporting that one in six people experience severe loneliness​.

Loneliness, often described as “the leprosy of the 21st century,” has prompted governments and health organisations worldwide to seek effective interventions. Among these, social prescribing has emerged as a promising strategy. Social prescribing involves health practitioners referring patients to non-clinical services to improve their social connectedness. However, the effectiveness of SP has been mixed, largely due to the lack of a strong theoretical foundation guiding its implementation​​.

Social prescribing encompasses various interventions aimed at improving social integration and connectedness through participation in community activities. These activities range from recreational and cultural events to structured group programmes. Despite their potential, the success of SP initiatives has been inconsistent, partly because they often overlook the importance of group dynamics and social identity in fostering meaningful social connections​​.

The new framework delineates three tiers of social prescribing interventions:

  1. Tier 1: Community initiatives. These proactive, preventative interventions are designed to support social connectedness across broad community settings. Examples include local neighbourhood activities or nationwide programmes like Australia’s Neighbours Every Day, which fosters community spirit and social bonds​​.
  2. Tier 2: Group programmes. These targeted interventions focus on specific populations and are delivered in group settings. Programmes like Groups 4 Health (G4H), which has demonstrated significant success in reducing loneliness, social anxiety, and depression, fall into this category. Participants in G4H reported sustained benefits, particularly during the Covid pandemic, underscoring the resilience provided by group memberships​.
  3. Tier 3: Person-centred interventions. These reactive, remedial interventions involve personalised support where social prescribers work closely with individual clients to facilitate their integration into suitable groups. The therapeutic alliance between prescriber and client, grounded in shared social identity, is crucial for the success of these interventions​.

Central to the framework is the concept of social identity – the sense of belonging to a group and the psychological benefits derived from this connection. Research indicates that social identity significantly influences health outcomes by providing individuals with self-esteem, a sense of control, and social support. The framework posits that SP interventions are more effective when they help clients join groups with which they identify, thereby enhancing their sense of social identity​.

Highlighting the key findings and implications, Haslam noted: “A key insight that comes out of our team’s work and that of many others in the field is that social prescribing helps people to join groups that they find meaningful and which therefore provide them with a sense of belonging and identity (a sense of we-ness). It is the loss or lack of this, we argue, that has fuelled the loneliness pandemic, and that is essential to efforts to tackle the range of mental health problems that it has created — particularly in young people and those who are marginalised in our communities.”

Empirical evidence supports the framework’s hypotheses. Studies have shown that SP interventions, particularly those that build social identity, are effective in reducing loneliness and improving mental health. For instance, a meta-analysis of 27 intervention studies found that social identity-enhancing interventions had a pronounced positive impact on mental health outcomes​​.

Moreover, community-based interventions that foster neighbourhood identification and social cohesion, such as Neighbour Day, have proven effective in reducing loneliness and enhancing social integration. These interventions’ benefits were sustained even during the isolating conditions of the Covid lockdowns​​.

Discussing future plans, Haslam added: “We have a range of large-scale trials underway that are looking to see if we can draw on the model we present in this paper to improve social prescribing practices in communities around the world. Early evidence from a number of innovative projects has been very promising. We are really grateful for the investment that charities and other agencies have made to help us progress this work, but mindful that we need to secure more funding to take this work forward.”

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