Addressing the crisis in child mental health: the feasibility of primary prevention through social prescribing as the missing link

Abstract

Background The mental health (MH) and wellbeing of our children is in crisis. Increasing prevalence of disorder and need is placing extreme stress on under resourced and over stretched services. Most at-risk are those living in areas of social deprivation who experience multiple adverse effects of poverty and inequality in health access and care. Within the health sector Social Prescribing (SP) as a provision to target mental health and wellbeing has gained in popularity in adult MH, yet there is little exploration of SP practice addressing children’s MH or the value of embedding SP into education as well as the health sector. This study explores the feasibility of SP for children within an at-risk community, utilising cross-sector collaboration to design and implement a SP programme with health and education referral. Methods Taking place in the West End of Newcastle, SP programme design involved community consultation with 60 primary school children, 38 cross-sector professionals, and 9 parents. Implementation involved a hierarchy of three governance groups of cross-sector stakeholders. Results ‘Zone West’ (ZW) was designed in response to a gap in the provision of support for children with MH needs below clinical thresholds but generating repeat attendance at primary care or poor educational engagement. Referral pathways for health and education sectors were defined, and the value of implementing SP into education were highlighted. Key to implementation was ‘buy-in’ from cross-sector partners and embedding ZW into community services. Conclusions SP offers the opportunity for early identification and intervention of child MH difficulties. Success requires cross-sector collaboration which presents unique challenges; unclear processes for information sharing and separate funding streams. More work is required to ensure these are streamlined and to evaluate evidence of impact to provide sustainable and replicable models in the future.