Social prescribing service boosts mental health of Sheffield young people
Joanne Parkes
Tuesday, April 27, 2021
Sheffield Futures’ social prescribing model offers early mental health intervention for common problems faced by young people.
- “Link workers”, working from GP surgeries and other community settings, create bespoke wellbeing “prescriptions” in partnership with young people
- Action plan matches young people to local services and activities, with high rates of wellbeing improvements recorded
ACTION
Advice on making a lifestyle change, activities that improve mood, pathways to feeling less socially isolated, or boosting opportunities for work, are among the support available through Sheffield Futures’ social prescribing service.
At the heart of the initiative are three “link workers” employed by the charity, who work with 13- to 25-year-olds to identify their needs and develop a personalised plan.
This “enables young people to control the direction of their support, thus promoting independence”, says the charity’s social prescribing co-ordinator Christos Louca.
Louca explains that support is offered in-house and by other organisations across the city.
In-house, the charity’s Door 43 service, funded by Sheffield Clinical Commissioning Group, provides wellbeing advice and counselling. Wellbeing practitioners focus on early intervention and low-level support, and can refer elsewhere should a specialist mental health assessment be needed.
The prescribing covers financial and social welfare, drug and alcohol treatment/self-care, sports and fitness, as well as skills and employment.
Sheffield was among the first areas in the country to trial social prescribing for children and young people, as part of a pilot funded initially by the Department of Health and Social Care in 2018 and later by Sheffield City Council.
Sporting charity Street Games managed the pilot, which was evaluated by the University of East London.
Louca explains that it was not until mid-2019 that the initiative began to develop into the service it is today, with just one link worker operating city-wide and based in the city centre.
Later that year marked its first involvement with Primary Care Networks (PCNs) and the employment of two more link workers to expand the reach of social prescribing within two PCNs.
This was followed by three more PCNs between December 2019 and February 2020.
Louca says: “The team developed from one single link worker covering all of Sheffield to a supportive team working specifically across six PCNs, covering 29 GP surgeries in total.”
While young people or their families/carers can self-refer to Door 43, a key route for young people to access the rest of the offer is via a general practitioner (GP).
The charity has forged links with six of the city’s 15 PCNs, who refer directly to them.
The PCNs fund the work, which is carried out in GP surgeries and in the wider community.
Link workers, who are Level 3 or equivalent qualified youth, social or health workers, are based in a central charity-run hub, enabling the sharing of resources and best practice. But importantly, they rotate around GP surgeries where they meet young people for appointments, though they have been operating remotely during the pandemic. They also carry out community outreach in settings such as schools.
For those young people who live in a PCN area where no GP is signed up, young people can refer directly to one of the link workers.
“The workers build up their own knowledge of activities and groups that are local to the area the young people live to support them,” explains a charity spokeswoman.
In addition, link workers connect with young people at a weekly drop-in, The Wellbeing Cafe at Door 43, which provides a space for young people to relax and talk. Here, the team is bolstered by volunteers and peer supporters.
IMPACT
A total of 416 children and young people have been supported by the charity since 2018.
Impact is monitored using a number of measures including the benefits for individuals, quantifying referrals and professionals who are referring, detail of activities and services referred to, number of personalised support plans, length of link worker time spent on each client and how many young people they are seeing.
Many of these measures also help the PCNs and surgeries assess their impact.
In three of Sheffield’s PCN areas, both the Short Warwick-Edinburgh mental wellbeing scale and goal-based outcomes scores increased significantly from the first to last measurement in young people (see graphics).
Louca adds: “While the thresholds for children’s mental health services continue to increase, the Sheffield Futures social prescribing model remains mostly an open service.”
He adds: “While many young people are on waiting lists for clinical services, social prescribing has regularly supported young people to engage in wellbeing-boosting activities in an attempt to reduce further decline in health and wellbeing in the meantime.”
THE WORK OF A SOCIAL PRESCRIBER
By Megan O’Byrne, social prescribing link worker, Door 43
Day-to-day, we encourage young people to see that you don’t always need medical help to feel emotionally well. Exploring things in the local community, maximising hobbies and interests, and improving social contacts can help you feel better.
Together, we take these ideas and see what changes people want to make to increase their own wellbeing in a manageable way.
By exploring their passions, and even discovering new ones, young people begin to see an improvement in their mental health.
At Door 43, our social prescribing team believes that social connection is more important than ever and with some creative thinking, we’ve helped young people connect in numerous covid-friendly ways.
Young people have logged on and enjoyed all kinds of activities from making music, producing poetry, creative writing, singing, baking, art, and learning instruments online. As time away from screens is so important, we’ve also supported young people to enjoy sports and nature.
Anxiety can drive low confidence and self-doubt; depression can reduce our motivation and decrease our pleasure in activities. As a result, sometimes young people struggle to engage in positive activities that might help.
Solution-focused approaches
Social prescribing link workers are trained to use solution-focused wellbeing and behaviour change approaches to help people improve their confidence, become more motivated, overcome personal barriers, and reduce overall symptoms of anxiety and low mood.
Resilience, strength, and determination shown by young people, while faced with so much change and uncertainty in their lives, has been truly awe-inspiring and a key positive to the role.
A young person came to me struggling primarily with anxiety and panic as well as some issues with exam stress.
My work with them has focused on learning to manage these feelings, we did workshops on some grounding techniques such as square breathing and the ABC game as well as developing safe spaces and a grounding toolkit.
I have also been working alongside their school to support their learning. I have now signposted them to an app that supports putting what we have worked on into practice.
Another young person I have been working with was looking for support with their team-working skills, energy levels and weight.
Our work started with a focus on exploring their eating pattern and appetite as well as looking into more specialist support from a dietitian. Alongside this we have been highlighting their interests to support them into group activities that will allow them to explore themselves in a social environment and build the skills they want to develop.
Some ideas so far have included a mental health boxing club, a choir and a film club.