Literature Collection

Despite social prescribing being promoted by the UK government for the last decade, the evidence supporting social prescribing remains weak and has mainly been confined to clinical contexts. Our study aimed to evaluate the impact of a Social Navigator (SN) service in South Tyneside on the health and well-being of users who experience financial hardship with complex health needs and limited access to mental health services.Using a mixed-methods design combining secondary analysis of service data (n=330), qualitative interviews with service users (n=15) conducted by peer researchers, and a social return On investment analysis that matched service data with health economic indicators from the UK Social Value Bank.Our findings demonstrate clear value for money with a £3 return for every £1 invested in the service, with a positive return confirmed in sensitivity analysis. SNs were able to improve the confidence of service users, with statistically significant changes across all eight confidence-related outcomes, and helped them to access other advice and financial services. This resulted in one-off financial gains (average £1237) and annual financial gains (average £1703) for service users. The interviews identified that relieving financial burden and stress improved the quality of life and mental well-being of users as a result of their involvement with the service.SN can break the cycle of multiple visits to crisis teams by building trusting relationships and providing emotional and practical support, while being responsive to the service users' needs and available when they have needs. They play a key intermediary role in integrated care systems with a unique focus on the wider determinants of health and financial hardship, advocating for service users without time limits and navigating the complexities of the system across local government. Greater integration of local support services could be achieved by mapping all available pathways for support.

AIM: To determine the association between types of mental illness, levels of social disadvantage and metabolic risk factors (obesity, tobacco smoking, high blood pressure and high cholesterol) and to investigate whether mental health care plans modify metabolic risk. METHODS: Two cohorts (2016-2023) of all primary care patients in Western Sydney with active mental illness or never having a mental illness (reference cohort) were compared on metabolic risk and change in metabolic risk during the period of the care plan (12 months) using random effects regression. Also, the social gradient of metabolic risk in patients with active mental illness was determined. Analyses were adjusted for age, sex and social disadvantage. RESULTS: There were 29,592 patients with active mental illness and 962,416 never having mental illness. Care plan utilisation ranged from 35% to 51%, with the lowest utilisation for Schizophrenia (33%). Daily tobacco smoking rates were elevated for all mental illness types. Care plans were associated with a reduction in daily tobacco smoking rates (0.7 odds ratio; 95% confidence interval: 0.6-0.99). Patients with schizophrenia had excess body mass index (+5.6 body mass index; 95% confidence interval: 2.1-9.1). Care plans reduced the excess body mass index (-6.6 body mass index; 95% confidence interval: -17.7 to +4.5)). Obesity and daily tobacco smoking followed a social gradient in patients with mental illness, but cholesterol and blood pressure did not. High blood pressure and high cholesterol was not elevated compared to the reference group in all types of mental illness. CONCLUSION: Metabolic risk was particularly elevated in tobacco smoking rates for patients with any active mental illness and for obesity in patients with schizophrenia. Care plans were associated with a reduction in much of this risk.