opendemocracy | ‘Social
prescribing,’ where patients with depression join in community activities as a
part of their treatment, is moving from the fringe of medical practice to the
mainstream. Matt Hancock, the new British Minister for Health and Social Care, has
pledged £4.5m to promote it, but we should stop to think before we take this
medicine: linking patients to their communities is a positive step, but a better
move would be for people to get involved in social activism.
The Minister probably
has one eye on his budget, since social prescribing is
thought to stop patients coming back to doctor’s surgeries—so saving the
state money in the National Health Service (NHS). But this scheme, which
normally involves referring the patient to a link worker who then recommends different
types of community activity for them, is about more than balancing the books: in
fact the NHS is administering a large dose of social theory.
Almost 20 years
ago, the American Political Scientist Robert
Putnam published Bowling Alone. Since
then there has been a groundswell of interest in its central concept of ‘social
capital’—the idea that community bonds such as those developed in bowling
leagues in the USA make both individuals and societies happier and healthier.
Putnam is a
nuanced writer, but the core focus of Bowling
Alone is on community participation not social activism. He wants to unify
us not cause political fights, and hopes to develop a country of association-joiners:
religious service attenders, sports club players, park gardeners, members of knitting
circles and school governors. In one interview he
analogises this to a honeycomb, a social system of welcoming and interlocking
groups, each empowered as a part of a greater civic whole.
Charismatic, and
with the enigmatic appearance of a nineteenth century preacher, Putnam has
become an academic celebrity. His ideas on social capital have been met with
great enthusiasm by policy makers on both sides of the Atlantic. One
British policy group working right at the heart of the Cabinet Office has
called him the most influential political scientist alive. Before his promotion,
Hancock held the British Government’s brief for civil society, and the
influence of Bowling Alone can be clearly
felt in his new policy on social prescribing. Linking individual depression to
a lack of community activity takes a leaf straight out of Putnam’s book.
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