Social Prescribing Nomenclature, Occupational Therapy and the Theory of Institutional Work: Creating, Maintaining and Disrupting Medical Dominance

Abstract

Social prescribing is a process of helping people to access non-medical activities and services which address health and wellbeing needs. The process is frequently (although not exclusively) initiated by primary health care professionals and often involves prescribing activities or initiatives provided by community and voluntary organizations. To occupational therapy, the links between activity, social-connectedness and health are clearly not new, although there are emerging international examples of social prescribing initiatives, and examples of newly developed roles, processes and funding opportunities, all of which are creating momentum behind the agenda.

In this commentary, we draw upon the theory of Institutional Work to examine how the language of “prescription,” and the purposive action of policy-makers and practitioners, is shaping thinking and action in relation to activity and health. Arguably, this language has helped to translate the recommendation of activity to meet a range of health needs in to an accessible and implementable concept. However, it has also potentially contributed to positioning the concept within a medical model of health, upholding medical dominance, and leaving occupational therapy on the margins of the debate.

Keywords:

• Institutional work
• occupational therapy
• social prescribing

Acknowledgements

We would like to thank Simply Connect Solutions Ltd for giving permission to adapt the case study used in Box 1. Thanks also to Dr Tom Sanders and Dr Phillip Whitehead for their review of this manuscript.

About the authors

Dr Gemma Bradley is a Senior Lecturer in Occupational Therapy at Northumbria University, Newcastle-Upon-Tyne, UK.

Dr Jason Scott is a Senior Lecturer in Public Health at Northumbria University, Newcastle-Upon-Tyne, UK.