While a pharmaceutical solution to treat loneliness may not exist, an emerging healthcare movement known as social prescribing is seeking to bridge the gap between clinical care and community well-being.
Social prescribing is an approach that goes beyond treating symptoms to address the root causes of ill health, particularly social isolation, and loneliness, which have been recognised as independent risk factors for poor health outcomes.
It connects patients with local resources to improve their social, physical, and mental wellbeing.
National chair of the RACGP Social Prescribing Specific Interest Group Dr Kuljit Singh said the concept addresses both physical and mental health.
“We are trying to connect our patient back to community resources or assets, preferably group settings, to improve their social wellbeing as well as a physical and mental wellbeing,” she said.
While the concept of recommending community activities to patients may not be completely new to GPs, the movement advocates for a more formal approach.
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Dr Singh stressed the importance of a physical prescription, whether it is a printed handout, a written note or a text message, rather than simply making a verbal suggestion.
“There has to be some sort of transaction where the patient is receiving that information, it’s been found to be much more successful if they take something home,” she said.
Dr Singh said a formal prescription, individually tailored to the patient, demonstrated that a GP had taken the time to listen and offer a thoughtful, personalised solution.
“It should be a very individualised script where we’re looking at what actually matters to that individual patient.”
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Given loneliness and social isolation rarely present as the primary reason for a GP visit, Dr Singh said it was vital to incorporate screening for social isolation into routine practice.
She noted that social disconnection had become an independent risk factor for disease, potentially more harmful than smoking 15 cigarettes a day or physical inactivity.
Specific cohorts, including those with chronic medical or mental health conditions, individuals with a disability and those from socio-economically disadvantaged backgrounds were particularly vulnerable to loneliness.
Dr Singh suggests GPs could use the three-point UCLA loneliness assessment scale to screen patients and identify a need for social connection.
While the evidence for social prescribing continued to grow, there remained a lack of a national, standardised approach.
Currently, GPs are left to create their own local directories of community resources to refer patients to.
Dr Singh suggests that GPs and practice staff invest time in building their own databases of local organisations, charities, and non-profit groups which may be able to provide the connections that will benefit patients.
She is supportive of a nationwide system and pointed to countries such as the UK and Canada, where social prescribing had been implemented on a larger scale and had shown promising results.
“In Canada, GPs have even been given vouchers for national parks to prescribe to patients, a program shown to improve both mental health and blood pressure.”
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It is also a good financial investment. Dr Singh pointed to a study from Canada that showed a $4.45 return on every dollar invested and data from the UK that indicated a reduction in emergency department visits and general practice appointments by up to 25%.
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