Abstract
INTRODUCTION: Health care systems have failed to address the poor physical health outcomes of people living with severe mental illness. Interventions that focus on specific health behaviours and/or lack a co-design basis show little promise. There is a need for whole systems approaches that tackle the complex issues, including social isolation, discrimination, stigma, and low motivation, that influence poor health in this population. A social prescribing model that accommodates the needs and preferences may be a way forward. METHODS: A mixed methods approach that assesses the CHOICE model (Challenging Health Outcomes Integrating Care Environments) in relation to (a) the social exclusion, loneliness and social support of a cohort of people living in the community; (b) participants' experience of social prescribing and potential improvements to the intervention; (c) understanding the implementation factors, mechanisms and outcomes; (d) the engagement and sustainment of community partnerships; (e) institutional changes in policy and practice. DISCUSSION: Codesigned and community-based participatory interventions may be crucial in tackling the health and social inequalities experienced by people with severe mental illness. However, given the complexity of such interventions, the social prescribing model that we describe in this paper, requires considerable implementation data prior to a full trial.