1.Can you tell us about your journey into the field of complex mental health and social prescribing? What motivated you to pursue this specialty?

My journey wasn’t very easy to be honest. As a professional moving to work in the UK, I can state that I have faced several challenges. Some of the challenges include cultural differences, language barriers, and adjusting to the new work environments and some other unexpected challenges that I prefer not to share.

My profession is very rewarding as I can help individuals who were once institutionalised indefinitely by supporting them in the community so that they can live at their own homes supported by an MD Team (even partially), work, and have relationships with people.

As a Mental Health Specialist, I have the unique opportunity to improve the mental health of my patients and improve their quality of life.

2. What are some of the most challenging cases you’ve encountered in your career related to complex mental health issues? How did you approach these cases?

As a mental health professional, I have encountered various complex cases throughout my career. These cases can present unique challenges and require a thoughtful and comprehensive approach.

I have supported individuals suffering from severe and persistent mental illnesses, such as schizophrenia or bipolar disorder, that often require long-term and intensive treatment. It was essential to develop a collaborative and multidisciplinary approach involving psychiatrists, psychologists, social workers, metal health nurses and other professionals. Treatment plans were focused on medication management, therapy, social support, and rehabilitation services to address the individual’s specific needs.

Individuals with a dual diagnosis meaning that they have both a mental disorder and a substance use disorder, those cases were challenging as both conditions often interact and exacerbate each other. A crucial assessment was required to identify the underlying causes and develop and integrated treatment plan.Collaborating with addiction specialists to provide both mental health an substance use issues was essential for successful outcomes.

Other challenges were faced when supporting individuals diagnosed with trauma-related disorders, Personality Disorders, suicidal ideations and self-harm.

When approaching complex cases I have always adopted a holistic and person-centred approach. This would involve considering the individual’s unique circumstances, strengths, and challenges.

Collaborating with other professionals, was necessary to provide quality and comprehensive care.

3. In your experience, how would you define social prescribing, and how does it compare to other techniques?

Social prescribing or community prescribing is a healthcare approach that involves connecting individuals with non-medical sources of support within their community to improve their overall well-being. It recognises that health is influenced by various social, economic, and environmental factors and aims to address these factories alongside traditional medical interventions.

In comparison with other techniques, social prescribing offers a more holistic and person- centred approach to healthcare.

While medical, conventional treatments and therapists are essential for managing specific health conditions, social prescribing recognises that addressing the social determinants of health is equally important. It acknowledge that individuals are not just patients with medical needs but also members of the community with social and emotional needs.

4. Could you share a particularly rewarding success story from your work with patients dealing with complex mental health issues? What interventions or approaches were key to their progress?

One rewarding success story involves an individual that I will call “ Jane” to protect her identity.

Jane was dealing with complex Mental Health issues, including severe depression, anxiety and a history of trauma. “Jane” had been struggling many years and had tried various treatments without significant improvement. However, through a comprehensive and collaborative approach, her mental health improved significantly.

Some of the interventions that were key to her progress were, comprehensive assessments in order to understand “Jane’s” needs, challenges and goals. Medication management, she was prescribed appropriate medication to manage her symptoms of anxiety and depression, trauma-focused therapy, given her history of trauma a trauma – focused therapy was a crucial component of her treatment. “Jane” engaged in EMDR and CPT to address her traumatic experiences. CBT was also used to help “Jane” identify and challenge negative thought patterns and develop healthier coping strategies. Social Support and community engagement were promoted and “Jane’ joined community groups and community activities providing her with a sense of belonging and understanding. She was also encouraged to prioritise self-care activities such as exercise, healthy eating and adequate sleeping. ‘Jane’s”treatment involved an extensive team of professionals from different fields. Over time “Jane’s”mental health began to improve significantly. She reported a reduction in depressive and anxiety symptoms , increased self -esteem, and improved overall functioning. She developed healthier coping mechanisms, gained a sense of empowerment, and started to rebuild her life.

5. Social prescribing is gaining recognition as an important component of mental healthcare. How do you see social prescribing fitting into the broader mental health landscape, and what are its potential benefits?

Social prescribing plays a crucial role in the broader mental health landscape by offering a holistic and person-centred approach to mental health care. It recognises that mental health is influenced by various social, economic, and environmental factors, and aims to address these factors alongside traditional medical interventions. Some of the ways social prescribing BG it’s into the broader mental health landscape and its benefits are a complementary approach, prevention and early intervention, Empowerment and self-management, Holistic Support, reduced stigma and increased social inclusion and Cost- effectiveness.

6. What types of non-traditional interventions or activities have you found most effective in your social prescribing initiatives for patients with complex mental health needs?

There are some effective interventions that can complement the traditional medical treatments such as Nature-based interventions such as ecotherapy or horticultural therapy, Arts and Creative therapies including dance movement therapy, mindfulness and meditation for example Yoga. Animal- assisted therapy which involves interactions with trained animals, such as dogs or horses. Peer support groups, physical activities an sports as exercise releases endorphins, improves mood and reduces stress enhancing overall well-being. Community Volunteering as this can provide individuals with a sense of purpose, social connection, and fulfilment.

It is important to highlight that the effectiveness of non-traditional interventions may vary for each individual. Therefore, a person-centred approach is crucial in social prescribing initiatives to identify the most suitable interventions based on the individual’s preferences, needs and goals. Collaborating with trained professionals in these non-traditional interventions ensures safe and effective implementation within the social prescribing framework.

7. Many people may not be familiar with the concept of social prescribing. Can you explain it in simple terms and provide an example of how it has positively impacted a patient’s mental health?

Social prescribing is a healthcare approach that connects people with non-medical support in their community to improve their mental health and wellbeing. Instead of just relying on medication or therapy, social prescribing recognises that things like social connections, hobbies, and community activities can also play a big role in mental health.

For example, let’s say that there is a person named John who has been feeling lonely and down. He visits his GP, who suggests social prescribing. The GP refers John to a social prescribing coordinator who meets with him to understand his interests and needs. After talking with John, the coordinator connects him with a local gardening group.

John starts attending the gardening group regularly, where he meets new people and learns about plants. He enjoys being outdoors, getting his hands dirty, and chatting with others who share the same interest. Over time, John starts feeling happier, more connected, and less lonely. The gardening group becomes a source of support and friendship for him, and he finds a sense of purpose and enjoyment in tending to the plants.

In this example, social prescribing positively impacted John’s mental health by addressing his social needs and providing him with meaningful activities. The gardening group helped him build social connections, reduce loneliness, and find joy in a new hobby. By focusing on non- medical interventions, social prescribing improved John’s overall well-being in a holistic and personalised way.

8. How do you collaborate with other healthcare professionals, community organisations, and support networks to provide comprehensive care for patients with complex mental health issues?

Collaborating with other healthcare providers and professionals is essential to provide comprehensive care for individuals with complex mental health conditions. This ca be achieved through regular communication, sharing of information, and coordinated care planning. Establishing formal partnerships and referral

network with mental health clinics, social services agencies, community supporting providers, community support groups, and primary care providers can ensure a holistic approach to care, additionally, utilising technology platforms for secure information exchange and implementing care coordination models can facilitate seamless collaboration and enhance the continuity log care for individuals with complex mental health needs.

9. In your opinion, what are the most significant barriers or challenges in addressing complex mental health conditions in today’s healthcare system, and how can these be overcome?

There are several significant barriers and challenging in addressing complex mental health conditions in today’s healthcare system. Overcoming these challenges requires a multi-faced approach involving various stakeholders. I do believe that the key barriers are Stigma and discrimination, Limited access to Mental Health Services, Fragmented Care and lack of coordination, Limited focus on prevention and early intervention, Socioeconomic disparities, Limited focus on social determinants of health, Lack of public awareness and understanding. There are key strategies to overcome all these challenges such as Educational campaigns and awareness programs, increasing investment in mental health services including, expanding

mental health workforce, integrating mental health into primary care settings, implementing integrated care that promote collaboration among different healthcare professionals, including primary care physicians, psychiatrists, psychologists and social workers, shifting towards a preventive approach that emphasises early identification and intervention, addressing socioeconomic disparities such as poverty, unemployment and inadequate housing, integrating social prescribing initiatives into healthcare systems and public education campaigns that promote mental health literacy, challenge stereotypes and encourage empathy can help to improve society understanding.

10. As a mental health practitioner, what advice would you give to individuals and families dealing with complex mental health challenges, and how can they proactively seek the right help and support?

I would encourage family members to have open and non-judgmental conversations about mental health, provide the family with information about the specific mental health condition, kit’s symptoms and available treatment options.

Would be important to also encourage the family to look after their own well-being, seek support from their own networks, and engage in activities that promote their own well-being. The referral process would also be included as at times things can become really challenging and it’s important that families have a link support and are familiar with the local mental Health services, support groups and helplines.

As a professional it’s paramount that I help the families to develop resilience and coping strategies to navigate the challenges they may face, it is also important to empower the family to advocate for their loved one’s needs within the healthcare system.

I would remind any individual’s family members dealing with complex mental health challenges to practice self-compassion and avoid blaming themselves or their loved ones, highlighting the importance of celebrating small achievements or victories and I would indeed acknowledge their efforts in supporting their loved one’s mental health journey.

For all families out there facing various challenges pertaining this matter, I recommend you educate yourself about mental health conditions to better understand your loved one’s experiences. Practice active listening and provide a non-judgmental space for them to express their feelings. Encourage your loved one to seek professional help and support including support groups. Take Care of your own well- being and also seek support from others, you will be surprised of how many families are facing the same challenges you are facing right now.