MPH student Keeley Ffrench on social prescribing to improve the health impacts caused by loneliness and isolation

 

When COVID-19 shut down the world, many people experienced what it was like to feel lonely and isolated, which took a toll on our mental, physical and emotional well-being. However, these health effects, especially on elderly and vulnerable populations, were prevalent long before the pandemic and persist today.

In May 2023, U.S. Surgeon General Dr. Vivek Murthy released an advisory on the serious physical health consequences of social disconnection, which emphasized increased risks of heart disease, stroke, dementia, and premature death.

One place where addressing the health impacts of loneliness and social isolation has gained momentum is in Canada, particularly through social prescribing. This refers to a holistic approach connecting individuals to a range of non-medical supports, resources and activities to improve social and community connectivity and well-being. 

For her practicum, Keeley Ffrench, a Master of Public Health student in Global Health at the University of Washington School of Public Health, worked with the Vancouver Island Social Prescribing Community of Practice. Their goals were to scale up a social prescribing pilot project using evidence-based interventions implemented elsewhere in Canada through outreach, promotion and education. 

“The way in which practicum students (like Keeley) were able to assist in these efforts within the time frame of their practicum was a tremendous boost for the energy, enthusiasm, and early momentum building in this process,” said Adam Hoverman, Ffrench’s practicum site supervisor. “Their presentation efforts, webinar evaluation tools, and summative report of the 2023 cycle of community of practice efforts will have an exponentially greater impact going forward in further promoting these efforts.” 

In this Q&A, Ffrench shares her MPH practicum experience, what it was like working with practitioners at a public health organization, and advice for students beginning their practicum. 

What first drew you to public health and why do you enjoy studying it?  

While enrolled in a health management and policy undergrad degree, I quickly learned that I was more drawn to the evolving world of global health than just working in a hospital financial department. I started taking international policy and health courses and found an academic avenue to blend domestic health policies with international issues and situations. I enjoy how professionals of vastly different cultures, languages, values and agendas can come together to solve complex health issues.

As we learned from the COVID-19 pandemic, diseases and epidemics don’t yield to country specific borders and neither should our thinking and collaboration on how to tackle and enhance the general well-being of the global population. I enjoy blending my passions and curiosities into a profession that aims to alleviate suffering and promote healthy lifestyles.

Why did you decide to pursue your MPH degree from UW SPH?

Like many health and medical professionals during the pandemic, I was burned out from working a demanding job that focused on COVID-19 preparedness and response for vulnerable populations. I wanted to shake up what I was doing and the prospect of being back in a classroom and having academic dialogue with different perspectives on a variety of issues that the pandemic exacerbated seemed like a good place to start. I wanted to connect with people face to face rather than looking at a screen which had become the norm for me for two and a half years. I had always known I wanted to go back to get an MPH to solidify and build my commitment to this field, but I really enjoyed the idea of going to school in an area where I was living to get a better understanding of local, state and global knowledge and expertise on public health and the implications of those choices on their specific populations. The UW is an integral part of Seattle, especially in the health care realm. Numerous mentors recommended seeking out a degree at the UW, thus it was the only graduate program I applied to and wanted to pursue my education at.

What is social prescribing and how does it work?

Social prescribing is a holistic, person-centered approach to health care, which connects individuals to non-clinical supports. This results in promoting community-based integrated care to improve overall health and well-being, primarily in underrepresented and historically underserved communities in the Vancouver Island landscape such as older adults, unsheltered persons, Indigenous persons, migrants, sexual minorities, people living with chronic diseases and people with disabilities.

Tell us about your practicum. What impact do you hope it will have?

For my practicum, I worked with the Vancouver Island Social Prescribing Community of Practice. The goals were to scale up the pilot project using evidence-based interventions implemented elsewhere in Canada and build capacity among health care and community-based workers to establish sustainable social prescribing referral pathways.

The small team that I worked with focused on outreach, education and promotion of social prescribing which culminated in a webinar series for practitioners interested in learning and spreading awareness to their own patients, colleagues, personal and professional connections. The webinar featured provincial projects, small group discussions, case studies and lessons learned for improving social health and wellness across the island. There were also opportunities to engage partner organizations in hopes of supporting their needs and educating their staff on best practices.

While learning about another country’s health care system, and the ways they prioritize marginalized communities, curate health promotion messaging for different professions, and implement strategies for continued uptake were introduced to me in the classroom, it was really cool to see this blend into a single project that so many people could learn and benefit from. I hope that the minor waves I created for this practicum turn out to be the building blocks for a global reckoning of how important social connection is for our public’s health.

How can social prescribing be used to help those who may be lonely or socially isolated?

Before starting my practicum, I had never heard of social prescribing, but have since learned it has been implemented in 17 countries, the U.S. included. In May 2023, the Surgeon General of the United States released an advisory about the public health crisis of loneliness, isolation and lack of connection. Additionally, the World Health Organization established a Commission on Social Connection to recognize it as a global public health priority. This shows that loneliness and social isolation are not only an issue we experienced during the pandemic, but a worldwide issue that needs to be addressed.

Contrary to its name, social prescribing doesn’t focus on writing prescriptions. Rather, social prescribing creates links between individuals and their communities, aiming to nurture a sense of belonging, improve mental health, and enhance overall well-being. Because individual needs differ, social prescriptions are wide, vary in scope and are based on individual needs. They could include physical activity and recreation, arts and culture, education and learning, social engagement, health and wellbeing, mental health supports, environment and nature, or economic and material supports.

Describe your experience working with practitioners at a public health organization. How will it help better prepare you to enter the workforce?

It was important for me to work alongside and learn from public health practitioners with different perspectives and from a different discipline than my own. Most, if not all of the people I worked with in my practicum, were working and located in Canada. Their backgrounds include Indigenous health, social epidemiology, family medicine, gerontology students, leadership from adult family homes, homeless service providers, preventive medicine physicians, etc. It was a steep learning curve for me to learn about the different models of health care delivery, and the approaches that regional and national governments were trying to incorporate social prescribing and community connection. This aspect of bringing together a variety of professions to brainstorm and synthesize their years of experience in order to enhance the delivery and uptake of social prescribing just reinforced how integral collaboration and communication with various stakeholders is to quality public health interventions.

What is one piece of advice that you have for students beginning their MPH practicum?

I would encourage students to take a moment to figure out what skills they want to strengthen and what has been lacking in their MPH coursework that could be learned in a practice-based setting. Many students are bombarded with opportunities to work on a practicum, but not all projects may not be most beneficial to them. The first year can be daunting — trying to stay afloat with classwork, maintaining a job or a social life — it’s easy to fall into the trap of settling for a practicum in your wheelhouse just to “check the box.” I would inquire about practicum opportunities from faculty you are interested in working with, and organizations whose mission and values you align with. Be specific about the skills you want to work on and how that fits into your professional trajectory. Don’t shy away from advocating for your education.

What interests do you have outside of (or related to) public health? Any extracurricular activities?

I had been living in Seattle for a few years before starting graduate school at the UW. I came here on a whim, as a friend told me there is an eclectic food scene, and the area is surrounded by snowy mountains. Whether it is skiing on the Cascade volcanoes, trail running, rock climbing, hiking or kayaking around the Puget Sound, I enjoy re-charging outside surrounded by the beautiful landscape of the Pacific Northwest.