Social prescribing is a non-medical intervention that enables health and social care professionals to refer people to a range of local, non-clinical services, primarily provided by the voluntary and community sector (HSE, 2021). It has been described as a holistic, person centred, community-based approach to addressing health and wellbeing concerns. Employing an assets-based approach to empower service users to improve their health and wellbeing, social prescribing aims to increase individuals’ social interactions and connections with community services, thereby decreasing levels of loneliness and isolation and improving overall well-being, both mentally and physically.

Social prescribing began in Ireland as a ground-up movement in partnership with the Health Service Executive and the community and voluntary sectors. This resulted in the establishment of the first social prescribing project in Mayo in 2012. Since then, Ireland, similar to other countries, has seen significant growth in the number of operational services and the development of a HSE Social Prescribing Framework in 2021. There are currently 44 HSE-funded social prescribing services in the Republic of Ireland, based on the funding of full-time link worker posts. Social prescribing has a significant policy mandate, with commitments to expand its reach for marginalised and vulnerable groups endorsed in key policy documents, including the 2020 Plan for Government, the national mental health policy, Sharing the Vision (Department of Health, 2020), the national Sláintecare Healthy Communities programme, and Pathways to Wellbeing, Ireland’s first National Mental Health Promotion Plan, 2024-2030 (Department of Health, 2024).

There are several theories that can be used to understand the mechanisms behind social prescribing. Salutogenesis theory, developed by sociologist Aaron Antonovsky, aims to explain how people maintain their well-being and health, rather than focusing on the causes and treatment of illnesses. Other theories that can be used to understand social prescribing include solution focused theory, social cure theory and social capital theory. Salutogenesis theory is the main theory underpinning this current study, together with the concepts of health literacy and empowerment, which are also central to understanding social prescribing.

The international evidence base for social prescribing is broadly supportive, highlighting multiple benefits, including improved mental wellbeing, physical health, health behaviours, and reduced social isolation and loneliness. However, there is a paucity of rigorous studies of effectiveness and relatively little is known about how social prescribing interventions can help improve the health and wellbeing of its service users. This evidence gap in social prescribing arises primarily due to small-scale evaluations studies that lack methodological rigour. Additionally, the varying aims and delivery models of these services make it difficult to synthesize, compare, or pool data and information. There is a lack of in-depth and robust evaluation studies, which are essential in order to establish the effectiveness of social prescribing and to examine how it works and for whom and under what circumstances it is most effective. Realist evaluations are increasingly being used to explore these questions. While there have been some small-scale evaluations of specific social prescribing services in Ireland, to date there has been no extensive evaluation that encompasses all the key stakeholders involved in this complex intervention.