Social prescribing for children, young people, parents and carers

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Why does social prescribing matter for children and young people?

  • A quarter of Londoners are children and young people, with this number predicted to rise by 13% by 2022.
  • Childhood and adolescence is a key period for establishing life-long health behaviours which develop in the context of family, school and the community. Early intervention and prevention promoting a sustainable healthy lifestyle is best achieved at a younger age when habits are easier to instigate and change before reaching adulthood[1] .
  • 40% of GP workload is for children and young people, yet 60% of GPs have not had training in paediatrics and child health.
  • Children and young people face a host of issues falling under the umbrella of social determinants of health; we know that these issues impact health and well-being yet cannot be addressed by the current health system.
  • Social prescribing provides a means to address these issues, but careful consideration of the needs, attitudes and behaviours of children and young people, their parents and carers will be necessary for social prescribing to be successful; grouping this population with adults and the elderly when designing and implementing social prescribing presents a barrier to success.
  • There is a need for children & young people and their families to have integrated care and partnership working between education, health and social care services.
Wider Determinants of Health (Dahlgren, G. & Whitehead, M. 1991)

Local population survey

Link to main article on local population survey

The Healthy London Partnership ran an engagement event with children and young people, and created surveys for children and young people and parents and carers to identify how social prescribing should operate best for this population; this co-production approach is imperative to ensure social prescribing is fit for purpose in a locality.

Parents and carers The survey from parents and carers received 67 responses, with respondents being evenly spread across London. The survey was advertised through parent and carer forums, Talk London, Twitter, parents groups on Facebook, netmums.com, mumsnet.com and was distributed among social prescribing colleagues to be promoted within their network on websites and e-bulletins. The top issues parents and carers want to support with include;

  1. coping with stress and anxiety
  2. education
  3. child behaviour
  4. self-confidence and self-esteem

The survey also identified a number of barriers parents and carers experienced when accessing services.

Barriers to accessing services from parent and carer survey

What can we learn from the survey?

In order for social prescribing to work for parents and carers, the following ‘success factors’ should be considered:

  • Community resources tailored to local need
  • Flexible opening times on the weekends and evenings
  • Convenient locations which are close to places already visited
  • More options of where to go for help and advice
  • Multiple forms of access, including online and phone appointments and chats as well as face to face

forms of help and advice

  • Community resources which incorporate an aspect of outdoor activities
  • A model which engages communities so friends and family can be aware of social prescribing, such

as Families First.

  • Primary care is an important access point for help for parents of young children
  • Local needs should be explored to see what people want, where they go, and how they access help

Children and young people The survey for children and young people received 19 responses, with respondents being evenly spread across London. There was also an engagement event with young people. The survey was advertised through the Association for Young People’s Health, the Anna Freud Centre, primary and secondary schools, the Greater London Authority outreach teams, the Young Person forum, social prescribing colleagues. Although the number of responses was low, the engagement was spread across boroughs. An engagement event run with children and young people was a mixed gender group of young people from different backgrounds. The top issues they would like support with are:

  1. Coping with stress and anxiety
  2. Sex and relationships
  3. Exercise
  4. Sleep
  5. Long-term conditions
Barriers to accessing services from young people's survey

What can we learn from this survey and engagement event? In order for social prescribing to work for children and young people, the following ‘success factors’ should be considered:

  • Community resources tailored to needs
  • Flexible opening times on weekends and evenings
  • Convenient, local, one-stop shop community centres
  • Environments with friendly, welcoming qualities e.g. You’re Welcome
  • There needs to be a range of ways for people to access support e.g. online, face to face and over

the telephone

  • Online forums and chats incorporated into models
  • Online information on websites in a ‘yellow pages’ style format
  • Family and friends can be helped to support young people
  • Education staff engaged in model
  • Opportunities which are attractive and relevant to children and young people

What community resources are available for young people? Local boroughs need an awareness of what community resources currently exist, where children and young people in the local population go and who they come into contact with in order for signposting to work effectively. The key to social prescribing is to increase connections within the community to existing resources that can improve health and wellbeing. Those available for the general population may be relevant, but there are also some for younger people specifically, such as youth centres and schools which need to be considered. Local knowledge will help to understand where children and young people currently go.

Workforce Children, young people, parents and carers show different preferences for who they go to for help and how they access help. Successful models should tailor social prescribing to suit these preferences and tap into their contacts.

Engaging and raising awareness of social prescribing and training in social prescribing skills would be useful for a number of individuals in local populations. These people could act to bridge the gap between the individual and social prescriber, for those who do not go to their GP. A breakdown of suggestions is included below:

Awareness and family members Training in social prescribing skills
Parents and family members Any statutory agency working with people at risk
Primary care mental health workers and nurses Any voluntary sector agency working with people at risk
Practice nurses Health visitors
HR Staff School nurses
Teachers and education staff Teachers and education staff
Faith leaders Faith leaders
Organised club leaders (e.g. scouts, sports) Organised club leaders (e.g. scouts, sports)
Family support workers Family support workers

Training programmes such as Me first and Making Every Contact Count can equip people that come into everyday contact with children, young people, parents and carers with the skills, behaviour and attitudes to identify people who could benefit from social prescribing.

Online and digital The prevalence of online activity in children and young people represents both challenges and opportunities; whilst internet usage often contributes to problems affecting children and young people, this heavily utilised resource can be used in a model of social prescribing, for example:

  • Online directories with sophisticated filters to search for community services and help
  • Online self-referral services which remove the need for referral seeking
  • Online signposting through online forums and chat lines

Example functionality from apps NHS Go is a health information and advice app coproduced by children and young people, featuring a directory of services and health topics tailored to those which are most important for children and young people. The app uses NHS Choices information and features specialist content such as advice around Fresher’s Week when students are going to university, or ‘Exam Stress’ during exam season. The app uses self-signposting in a directory format and is an example of good practice for those investing in digital social prescribing for children and young people.

Silent Secret has been developed by children and young people themselves. It is for teenagers aged 11-19 to anonymously talk about what is on their mind in a safe and supportive online community. Users cannot comment on each other’s secrets, but can interact using these buttons: ‘heart’ to express love, ‘me2’ to express empathy, and ‘hug’ to express sympathy. A ‘get support’ button appears with each secret, enabling users to connect with tailored support organisations should they need to. Users say the app allows them to be honest without being judged, provides a space for support with people like them so they don’t feel alone, with one user even saying they wish the world was more like the app. It reaches users that may not wish to use face to face contact and overcomes barriers for children and young people such as feeling unwelcomed and fear of going to get help.