title: Primary-care-based social prescribing for mental health: an analysis of financial and environmental sustainability.
abstract: Aim To assess the effects of a social prescribing service development on healthcare use and the subsequent economic and environmental costs.
  
  
  BACKGROUND
  Social prescribing services for mental healthcare create links with support in the community for people using primary care. Social prescribing services may reduce future healthcare use, and therefore reduce the financial and environmental costs of healthcare, by providing structured psychosocial support. The National Health Service (NHS) is required to reduce its carbon footprint by 80% by 2050 according to the Climate Change Act (2008). This study is the first of its kind to analyse both the financial and environmental impacts associated with healthcare use following social prescribing. The value of this observational study lies in its novel methodology of analysing the carbon footprint of a service at the primary-care level.
  
  
  METHODS
  An observational study was carried out to assess the impact of the service on the financial and environmental impacts of healthcare use. GP appointments, psychotropic medications and secondary-care referrals were measured. Findings Results demonstrate no statistical difference in the financial and carbon costs of healthcare use between groups. Social prescribing showed a trend towards reduced healthcare use, mainly due to a reduction in secondary-care referrals compared with controls. The associations found did not achieve significance due to the small sample size leading to a large degree of uncertainty regarding differences. This study demonstrates that these services are potentially able to pay for themselves through reducing future healthcare costs and are effective, low-carbon interventions, when compared with cognitive behavioral therapy or antidepressants. This is an important finding in light of Government targets for the NHS to reduce its carbon footprint by 80% by 2050. Larger studies are required to investigate the potentials of social prescribing services further.
authors.affiliation: 1Royal College of Psychiatrists,London,UK.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Maughan
authors.affiliation: 4Medical School,University of East Anglia,Norwich,UK.
authors.forename: Alisha
authors.initials: A
authors.lastname: Patel
authors.affiliation: 4Medical School,University of East Anglia,Norwich,UK.
authors.forename: Tahmina
authors.initials: T
authors.lastname: Parveen
authors.affiliation: 5Medical School,University College of London,London,UK.
authors.forename: Isobel
authors.initials: I
authors.lastname: Braithwaite
authors.affiliation: 6Nuffield Department of Orthopaedics,Centre for Statistics in Medicine,Rheumatology and Musculoskeletal Sciences,Oxford,UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cook
authors.affiliation: 7Life Sciences Department,Warwick University,Coventry,UK.
authors.forename: Rob
authors.initials: R
authors.lastname: Lillywhite
authors.affiliation: 2Warwick Medical School,Coventry,UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Cooke
mesh_terms: D058572:Carbon Footprint; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D006801:Humans; D011320:Primary Health Care / Q000191:economics* / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012017:Referral and Consultation / Q000458:organization & administration*; D013222:State Medicine / Q000191:economics; D006113:United Kingdom
chemical_list: D011619:Psychotropic Drugs
keywords: carbon footprint; cost-benefit analysis; environment; mental health; primary healthcare; social prescribing