Farina, I. Masella, C. Sangiorgi, D. (2021) Positioning Social Prescribing in the scenario of community-based interventions for the transformation of mental health services for children, adolescents and young people: a review. Book of Abstract “Health Management: managing the present and shaping the future” European Health Management Association (EHMA) Annual Conference, 2021, pg. 29

Context Social Prescribing is defined as a non-clinical and community-based service that addresses social needs through social solutions. Originated in UK for isolated and chronic-ill elderlies, the NHS has recently expanded Social Prescribing as an all-age model, including children, adolescents and young people (CYP). From the first results it is clear that Social Prescribing for CYP, as for adults, is a mental health and well-being service (Bertotti, 2021). The aim of this paper is to understand how social prescribing for adolescents and young people can be positioned in the current scenario of transforming mental health services as a community-based intervention for CYP. Methods A narrative review through systematic search has been developed. The systematic search has been conducted in electronic database (SCOPUS and PubMed) and integrated with grey literature capturing the material from 2000 to 2021, through keywords as “adolescent*” or “young people” and “mental health” or “wellbeing” and “community-based interventions” or “community-based services” or “integrated care”. Title/abstract and full text review was conducted. After screening 275 text at the title/abstract level and 119 at full-text level, including 8 papers that were found through citations and were not part of the initial results, a total of 36 papers have been included. Papers have been analysed through a framework based on broader literature that addresses the main challenges called out for youth mental health services innovation and community-based interventions: access, youth-friendliness, stigma-free, youth participation, care ecosystem, sustainability. Results Several models and policies have been found that address the challenges and need to reform statuary services of CYP mental-healthcare systems. Countries as Australia, Ireland, UK and Canada have developed different models of community-based interventions, that share common principles and are mainly positioned as integrated care services in the primary care tier with the aim to promote early detection of at-risk adolescents. Social Prescribing shares common principles and focus on the same challenges addressed by the other models: how to make services accessible, how to design a youth-friendly and stigma-free service, how to promote youth participation, how to integrate the care ecosystem around CYP and make services sustainable. The main difference is based on the nature of the models, where Social Prescribing focuses mainly on social determinants of health with a non-clinical approach. Another important element is the role played by the Link Worker as activator of the empowerment process of CYP through the recognition and activation of community resources. No similar role has been identified in other models. Discussion Social Prescribing, with its de-medicalisation and non-diagnosis centred principle, addresses an implicit gap in the current models and innovations of CYP mental-healthcare systems which is the potential of developing mental wellbeing through a non-clinical path and a relationship with the community, that for some people can work as an only solution. It has the potential to shift from the effort on how to make mental health services more accessible for CYP to transform how mental wellbeing is addressed and shared in the community. The role of the community in community-based interventions is still unclear as well in Social Prescribing. Especially when focusing on social determinants of health in CYP mental health, further research should look at the impact of services and models moving from on the individual as much as on the community and structural level.