With its origins in the United Kingdom (Burgui-Murua, 2019), “social prescribing” is being proclaimed as a “new” model of providing healthcare. The last decade has seen a rapid growth of this approach, with diverse applications across the globe (Morse et al., 2022; Mulligan et al., 2024). Closer to home, here in British Columbia social prescribing has gained significant traction to support healthy aging (Fraser Health News, 2022; Lin et al., 2024; Lin et al., n.d.).
Social prescribing is defined as “a health and social model of care that recognizes community-based knowledge, resources, and other types of care or support. Informed by the social determinants of health, it aims to address people’s unmet social needs” (Lin et al., n.d.). Fraser Health (Fraser Health News, 2022) states that social prescribing enables health care professionals to refer older adults to a range of local, non-clinical services and seeks to address people’s unmet needs that may be impacting their well-being. The United Way British Columbia (2024) explains that it does much more than treat the symptoms of illness; it addresses the underlying causes of health and well being issues.
The social prescribing model has much to be lauded. The approach is client centred and grounded in the social determinants of health. The model encourages “holistic exploring of nonmedical needs and approaches” (Lin et al., 2024). Social prescribing is a strengths based approach that goes beyond looking at just the deficits. It recognizes the increasing evidence that social factors have a major impact on health and that it is not sufficient to address only the biomedical issues (Drinkwater et al., 2019).
Also on the positive side, we can celebrate that there is a growing acknowledgement of the impact of social determinants on health (finally). And it is also positive to see funding (e.g., United Way, 2025) directed towards positions that embrace this philosophy.
With these positive ideas in mind, why are many social workers concerned?
The claim that social prescribing is a new approach, an emerging intervention, or a paradigm shift (Drinkwater et al, 2019; Fraser Health News, 2022; Lin et al, 2024; Mulligan et al., 2024) frankly minimizes the the role of a social worker, whose longstanding duty has been to support and advocate for all social factors of a clients’ well-being. While social workers fully agree that the social prescribing model of health care reflects critical underlying values and is a much-needed approach, this model is nothing new.
For decades social workers have espoused the social determinants of health as fundamental values. For decades social workers have embraced a holistic view of a person’s health, looking at a much wider context than the presenting medical concern, including mental, emotional, social, spiritual, environmental and societal factors. For decades social workers have challenged the medical deficit-based approach in favour of a strengths-based approach. And for decades social workers have connected individuals with nonmedical resources and supports while, at the same time, advocating and organizing for structural changes to better meet the needs of those accessing services.
The contention that social prescribing is new and innovative reflects the continued lack of acknowledgement of the value of the profession of social work in the health care field. As Phil Mach, President of the BCASW (2025) states, “social prescribing is another way that other professions have taken on social work functions, believing that they’re innovators when in reality, they are simply coming into alignment with what social workers have been doing for decades”.
Yet, in British Columbia social prescribing work, presented as a novel approach, is being done largely without the involvement of social workers (Mach, 2025). Those employed to do social prescribing come from a variety of professional and educational backgrounds (Lin et al., 2024). Our concern is that when people in professions other than social work are hired into these positions, they do not have the education, training and expertise to complete comprehensive assessments and to integrate social prescribing into the wider context of client centred care. The Canadian Institute for Social Prescribing (n.d.) states that what they call “link workers”,
“... help to identify individual needs, interests and goals, offer encouragement, address barriers and provide supported navigation and access to social and community resources.”
Their competency framework states that:
“Link Workers practice person-centred care planning to tailor their support to the individual needs, strengths, values and desires of their clients, ensuring they are empowered and actively involved in making decisions about their own care.”
Social workers will clearly recognize the language here from their training on how to conduct assessments and develop care plans. In B.C., when non-social workers are hired for these social prescribing roles, they participate in an on-line training to prepare them for the complex functions of culturally competent patient assessment and care planning. We maintain that this is inadequate training for the worker and risks sub-optimal outcomes for the client.
Even if there is a social worker in the position, giving them such titles as “link worker” (Drinkwater et al., 2019) or “community connector” (Lin et al., 2024) and stating that they are “distinctly non-clinical professionals” (United Way British Columbia, 2025), may justify lower pay and exempts them from regulation of their practice by a regulatory body.
And then there is the name “social prescriber” itself; a name that clearly connotes medical terminology. In the article “Conceptualizing and Implementing Social Prescribing Programs: Guidance from our Community of Practice” (Wadman et al., 2023), the authors contend that this metaphor recognizes the influential role physicians can play in guiding patients towards healthier lifestyles but also cautions us to be careful about inadvertently reinforcing hierarchical relationships between health professionals and patients. While we appreciate the caution, the concerns with the term run deeper. The term “social prescribing” is an extension of the power of the medical profession to determine what interventions, even nonmedical, will be valued (Mach, 2025). Such a paradox; an attempt to move away from the deficit-based medical approach to health care, employs a term that reinforces the continued dominant influence of the medical model in health care.
We are pleased to see the adoption of a broader view of health. But we are also pleased that there has been some pushback. As previously noted, the President of the BC Association of Social Workers (BCASW) has detailed his many concerns in a recent LinkedIn post (Mach, 2025). In fact, because of the concerns, BCASW chose not to endorse a social prescribing initiative. In response to a British Medical Journal article on social prescribing (Drinkwater et al., 2019), a UK Social Worker published the following: “Do not invent names for the most adequate professional to administer this. Use the Social Workers you already have” (Burgui-Murua, 2019).
We ask all of you, as social workers, to challenge the narrative that social prescribing is something new. Through your work, demonstrate that social prescribing is in fact an integral part of the role and function of the profession of social work that requires clinical expertise to do effectively and responsibly. And when the idea of employing someone to do social prescribing arises, don’t miss the opportunity to ask the question, “why don’t you hire a social worker?”
Respectfully submitted,
Health Advocacy Committee
References
Burgui-Murua, D. (2019). Social prescribing – use what you have: Social Workers [Rapid Response]. BMJ, 364: l1285. https://www.bmj.com/content/364/bmj.l1285/rr-0
Canadian Institute for Social Prescribing (n.d.). https://www.socialprescribing.ca/link-worker-competency-framework
Drinkwater, C., Wildman, J., Wildman, J., & Moffatt S. (2019). Social prescribing. BMJ, 364:1285.
Fraser Health (News) (2022). A new approach to healthy aging. https://www.fraserhealth.ca/news/2022/Jun/a-new-approach-to-healthy-aging
Lin, M., Park, G., & Ashe, M. (2024). Integrating social prescribing in a Canadian regional health system to support healthy aging [Commentary]. Health Promotion and Chronic Disease Prevention in Canada, 44(9), 392–396.
Lin, M., Pitman, B., Sandhu, P., & Ashe, M. (n.d.). Building bridges: An overview of social prescribing for older adults in British Columbia. UBC Faculty of Medicine (Home Page). https://familypractice.ubc.ca/building-bridges-an-overview-of-social-prescribing-for-older-adults-in-british-columbia/#:~:text=Building%20Bridges:%20An%20Overview%20of,further%20growth%20across%20the%20province
Mach, P. (2025). What is social prescribing and why am I against it? President of BC Association of Social Workers LinkedIn Post
https://www.linkedin.com/posts/phil-mach_what-is-social-prescribing-and- why-am-i-against-activity-7370974979678507008-SH6A
Morse, D. F., Sandhu, S., Mulligan, K., Tierney, S., Polley, M., Giurca, B. C., Slade, S., Dias, S., Mhtani, K. R., Wells, L., Wang, H., Zhao, B., De Figueiredo, C. E. M., Meijs, J. J., Nam, H. K., Lee, K. H., Wallace, C., Elliot, M., Mendive, J. M., Husk, K. (2022). Global developments in social prescribing. BMJ Global Health, 7: e008524.
Mulligan, K., Card, G. C., Allison, S. (2024). Social prescribing in Canada: Health promotion in action, 50 years after the Lalonde Report [Editorial]. Health Promotion and Chronic Disease promotion in Canada: Research Policy and Practice, 44(60).
United Way British Columbia (2024). Social Prescribing Implementation Guide. https://bc.healthyagingcore.ca/resources/social-prescribing-implementation-guide
Wadman, A., Palmer-Fluevog, A., Hoverman, A., Allison, S., Morgan, A., Fowler, B., French, K., & Card, K. G. (2023). Conceptualizing and implementing social prescribing programs: Guidance from our community of practice.” The Canadian Alliance for Social Connection and Health. https://casch.org/
