Beyond medication: Exploring social prescribing for mental ill health in Portugal

Mental ill health represents a priority challenge in public health due to its considerable burden on people's health and well-being, as well as economic consequences. Individuals with mental health problems have been presented with limited alternatives for improving their mental well-being, with medication being the most widely adopted solution. It is imperative that the focus shifts to prevention and the promotion of positive mental health. This can be achieved through non-medical alternatives, such as social prescribing (SP), a person-centered and intersectoral intervention. Some studies reveal that mental ill health is one of the most common reasons for referral to a SP service, with encouraging results about SP's benefits in mental health. SP has been implemented in Portugal since 2018, a country that had one of the highest prevalence of mental health disorders in the European Union. The aim of this study was to establish the prevalence of mental health-related referrals in Portugal and to describe the type of community services patients were referred to. Sociodemographic, health, and referral-related data was collected for 714 patients at primary healthcare units in Lisbon between 2018-2021. Results show that 53.6% of participants were aged between 26-65 and 66.9% were female. Approximately 20% were referred for mental health reasons and 65.5% had been diagnosed with a mental health disorder. Patients were referred to a range of third-sector organizations (associations, ONGs, municipalities) and activities (swimming, music classes, volunteering, pregnancy club), but no specific mental health services were identified among them. This could suggest that there is a lack of available mental health responses in the community or that they are not yet accessible to SP team. Further efforts are needed to map out these resources and reinforce the intersectoral work to create and promote mental well-being responses, to ensure access to mental health support for all. KEY MESSAGES: • There is a need to shift the focus towards prevention and promoting positive mental health through non-medical alternatives, such as social prescribing. • In SP in Portugal, there is a lack of available mental health resources in the community, suggesting the need for further efforts to create and promote mental well-being responses for all individuals.