The Effectiveness and Active Ingredients of Social Prescribing Interventions Targeting Mental Health: A Systematic Review

Matthew Cooper, Leah Avery, Jason Scott, Kirsten Ashley, Cara Jordan, Linda Errington, darren flynn

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Abstract

Objective To establish the effectiveness and active ingredients of UK-based social
prescribing interventions targeting mental health and well-being outcomes.

Design Systematic review adhering to PRISMA guidelines, and a published protocol. Data Sources Nine databases were systematically searched up to March 2022.
Eligibility Criteria Social prescribing interventions in the UK involving adults aged >18 years, which reported on mental health outcomes. Data extraction and synthesis Two reviewers extracted data on study characteristics; outcomes; referral pathways; treatment fidelity strategies; person-centredness; intervention development processes; and theory-linked Behaviour Change Techniques (BCTs). Data were narratively synthesised.

Results 52,074 records were retrieved by the search, 13 interventions reported across 17 studies were included in this review (N=5,036 participants at post-intervention). Fifteen studies were uncontrolled before and after designs, one a randomised controlled trial and one a matched groups design. The most frequently reported referral pathway was the link worker model (n=12), followed by direct referrals from community services (n=3). Participants were predominantly working age adults, and were referred for anxiety, depression, social isolation, and loneliness. 16 out of 17 studies reported statistically significant improvements in outcomes mental health, mental wellbeing, general health, or quality of life). Strategies to enhance treatment fidelity were sub-optimal across studies. Only two studies utilised a specific theoretical framework. Few studies reported engaging service users in co-design (n=2) or usability and/or feasibility testing (n=4). Overall, 22 BCTs were coded across 13 interventions. The most frequently coded BCTs were social support-unspecified (n=11), credible source (n=7) and social support-practical (n=6).

Conclusions Robust conclusions on the effectiveness of social prescribing for mental health related outcomes cannot be made. Future research would benefit from comprehensive intervention developmental processes, with reference to appropriate theory, alongside long term follow-up outcome assessment, utilising treatment fidelity strategies, and a focus on principle of person-centred care.
Original languageEnglish
JournalBMJ Open
DOIs
Publication statusPublished - 28 Jul 2022

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