SPEAR IN BRISTO L
Social prescribing for equality and resilience: the SPEAR project Collette Brown Social Prescribing Co-ordinator, Southmead Development Trust
SPEAR is a holistic social prescribing model operating across Bristol’s areas of highest social deprivation and health inequity. It is a partnership between four community anchor organisations based in geographically discrete areas. Individuals are mostly referred to SPEAR by a health professional, but they can also self-refer. They then meet a social prescribing link worker for an initial one-to-one session. This article explores the ways the communities in which SPEAR operates have determined the shape that the project has taken, showing the context specificity of social prescribing.
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After leaving the Bristol student bubble in 2012, my eyes were opened to the stark inequality faced by the city’s residents. Volunteering played a big part in this – from the niggling feelings of discomfort during my internship with Oxfam where my walk to work took me past people who were struggling with homelessness, to facilitating peer support groups for people struggling with their mental health. The former saw me campaigning for equality overseas (while we seemingly ignored our own country’s failures in this area) and the latter brought home just how much cuts to mental health services were affecting everyone, but especially those living in more deprived areas of Bristol. I’m passionate about challenging inequality in all its forms and yearn for a more equal society in which labels will only be used for packets of food.
‘We can only provide the dancefloor. It’s up to individuals how, or even if, they dance.’ Michael Marmot, 2015
In the interview for my job as social prescribing co-ordinator a few years ago, I told a story – a story that I felt reflected the idea of the way in which social prescribing would support people; that it was about the individuals that we were helping, rather than about saving the world. The story goes like this: A man was walking along a beach, and he saw someone dancing in the distance. As he got closer, he saw that it was a young boy and he saw that he wasn’t dancing – he was eagerly throwing starfish back into the sea, one by one, as they had become stranded on the beach. ‘What are you doing?’ he asked the young boy curiously. Without looking up, the boy replied ‘I’m saving these starfish. If they aren’t thrown back into the sea then they’ll die.’ The
man laughed. ‘But there are thousands of starfish on this beach, and only one of you! What difference can you possible make?’ The boy picked up a starfish, tossed it into the water and, turning to the man replied, ‘I made a difference to that one’. From: Eiseley(1978)
And this is how a lot of people see social prescribing. Someone is really struggling with something visible, they go to their GP, and their GP suggests a non-medical activity to that person – gardening, for example. And the individual attends merrily with no barriers, feels their life has purpose once more, feels able to participate in self-care and reduce their use of NHS resources. But, as I began to design our holistic social prescribing model, and actually began to support people one-to-one in a truly person-centred way, I realised just how far away from holistic social prescribing this analogy was. It’s not about just throwing starfish back into the ocean. It’s about finding out why they’ve become stranded in
© Journal of holistic healthcare
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Volume 15 Issue 3 Autumn 2018
