Loneliness is a growing public health crisis, with profound implications for mental and physical health. Social prescribing offers a proactive solution by connecting individuals to non-clinical supports, such as arts programs, peer networks and physical activities. In Canada, social prescribing is gaining traction, with initiatives addressing loneliness among youth, caregivers and older adults. By integrating social prescribing into healthcare systems, policy makers can enhance well-being, reduce healthcare strain and promote social inclusion. This paper explores social prescribing's role in addressing loneliness, its implementation across different life stages and its potential to transform mental healthcare in Canada.

Introduction

Loneliness and social isolation are pressing public health concerns, affecting millions of Canadians across all age groups. Loneliness – a subjective feeling of disconnection from others – is distinct from social isolation, the measurable absence of social interactions. However, these experiences often overlap, reinforcing cycles of poor mental and physical health. Research links loneliness to higher rates of depression, anxiety, cardiovascular disease and even premature mortality (Murthy 2023). Yet, this is not merely a personal issue; it reflects broader social inequities.

The social determinants of mental health (SDMH) – including income, employment, education, healthcare access, housing stability and social support – significantly shape mental health outcomes (Allen et al. 2014). Financial stress limits access to social and recreational activities, while discrimination erodes a sense of belonging (Refaeli and Achdut 2021; Stewart et al. 2009). Indigenous, racialized and lesbian, gay, bisexual, transgender, queer, Two-Spirit, intersex and asexual and other sexual and gender minority (LGBTQ2SIA+) populations face disproportionately high risks of loneliness due to systemic barriers that restrict social inclusion and healthcare access (GenWell Project 2024a, 2024b) The COVID-19 pandemic further exposed and exacerbated these vulnerabilities (Abrams and Szefler 2020).

Policy makers worldwide are taking notice. The UK appointed a minister for loneliness (Pimlott 2018). The World Health Organization (WHO) launched a Commission on Social Connection (WHO n.d.), and in 2023, the US Surgeon General, Vivek Murthy, warned that loneliness carries health risks comparable to smoking 15 cigarettes a day (Murthy 2023). In Canada, the National Institute on Aging's 2024 recommendations highlighted the urgent need for collective action, emphasizing that loneliness is not merely an emotional struggle but a significant risk factor for poor mental and physical health (Conn et al. 2024).

However, healthcare providers remain constrained by systemic pressures. Mental health services are overstretched, and physicians recognize the toll of loneliness but often lack tools to address it (Moroz et al. 2020). The growing demand for mental health services highlights the need for interventions that extend beyond medical treatment alone. One promising solution is social prescribing, an evidence-based approach that is gaining traction worldwide. Rooted in the understanding that health is shaped as much by social connection as by medical care, social prescribing links individuals to non-clinical supports such as art programs, peer networks, exercise groups and cultural activities to enhance well-being (Muhl et al. 2023).

Already making inroads in Canada, social prescribing has the potential to transform mental health care by shifting focus from treatment to prevention (Mulligan et al. 2023). By integrating social prescribing into healthcare systems, providers can reduce loneliness, improve well-being and alleviate strain on healthcare services, fostering a more resilient and connected society (Mulligan 2024; Reinhardt et al. 2021).

Transforming Mental Health Care Through Social Prescribing

Canada's mental health system is under immense strain. Overburdened clinics, months-long waitlists and a patchwork of services fail to meet the growing demand (Moroz et al. 2020). Many young individuals struggle to find connection in an increasingly digital world, caregivers manage overwhelming responsibilities with little support, and older adults face isolation due to mobility challenges and shrinking social networks (Kerr and Kingsbury 2023; Stall et al. 2019; Wister et al. 2022). These challenges are even more pronounced for Indigenous, racialized and LGBTQ2SIA+ communities, deepening existing health disparities.

The COVID-19 pandemic did not create these problems, but it made them impossible to ignore. Rates of depression and anxiety surged, loneliness spiked and the consequences rippled across physical health – from cognitive decline to cardiovascular disease (Pietrabissa and Simpson 2020). According to the Canadian Social Survey, one in ten Canadians report feeling lonely, with young adults (aged 18–24 years) and older adults (65+ years) at highest risk (Statistics Canada 2021). Addressing this crisis requires more than clinical interventions – it calls for a holistic approach that integrates physical, social and emotional health.

Social prescribing bridges the gap between healthcare and community-based support. A medical prescription alone cannot cure loneliness, but meaningful engagement – whether through a local running club or neighbourhood choir – can be transformative. Social prescribing fosters cultural safety, equity and upstream approaches to health promotion. More than just a tool for individual well-being, it strengthens social ties and builds healthier, more connected communities (Mulligan et al. 2023; Mulligan 2024).

Furthermore, social prescribing shifts mental health care toward empowerment and positive mental health promotion. By equitably co-producing their social prescriptions, patients and communities cultivate self-determination, which is essential for healthy people and communities (Bhatti et al. 2021). This includes autonomy and sense of purpose in healthcare decision making, competence and self-esteem through activities of daily living, and a sense of belonging within their communities and health systems. It also encourages a cognitive shift away from a deficit-based sense of self to a strengths-based sense of self rooted in beneficence, and recognizing one's capacity to give back to others. This approach is particularly effective for people with non-urgent conditions and those on waitlists for more acute mental health care, and can reduce pressures on acute care for people in crisis or with complex multi-morbidities (Fancourt et al. 2023).

Canada's Social Prescribing Movement

Social prescribing is gaining momentum in Canada as policy makers and health leaders recognize the power of social connection in improving well-being (Mulligan et al. 2023). The Canadian Institute for Social Prescribing (CISP; https://www.socialprescribing.ca/), launched in 2022, is leading efforts to integrate social prescribing into healthcare by linking health practitioners, researchers, system leaders and funders. Several provinces are already piloting social prescribing initiatives with promising results.

In British Columbia, the Fraser Health social prescribing model connects older adults to community resources through seniors community connectors (SCCs), who help develop wellness plans and link individuals to social clubs and exercise programs (Lin et al. 2024). In Ontario, Black-focused social prescribing connects individuals to culturally relevant interventions such as attending culturally significant performances and practicing Kemetic yoga for Black seniors (Ramirez et al. 2024). Meanwhile, in Alberta, social prescribing initiatives, led by Healthy Aging Alberta, are connecting older adults with community-based services to enhance social well-being and reduce isolation. Programs in Edmonton, Calgary and Lethbridge partner with healthcare providers to link seniors to social, recreational and support services, including coffee meetups, senior companionship programs and community meal programs, fostering meaningful connections and improving overall well-being (United Way of Calgary and Area n.d.)

These initiatives signal a broader shift in how health is understood – recognizing social connection as fundamental to well-being. As social prescribing expands, adapting it to serve diverse populations will be critical. The following sections explore its impact across different life stages, from youth to caregivers and older adults.

Loneliness, Children and Youth: The Role of Social Prescribing

Adolescence is a time of rapid growth and self-discovery, but it is also a period of heightened vulnerability to loneliness (Twenge et al. 2021). In Canada, one in four adolescents reports experiencing recurring loneliness, making social connections a key determinant of mental health (Statistics Canada 2021). However, systemic gaps in youth mental health services often make it difficult for young people to access the support they need.

One promising solution is Integrated Youth Services hubs, which provide a one-stop access point for youth (12–25 years) to receive support for mental health, education, employment and housing (Halsall et al. 2019). These hubs integrate clinical care with community-based supports, ensuring low-barrier and tailored interventions (Settipani et al. 2019). Social prescribing fits seamlessly within this model, helping young people access social and recreational activities that enhance well-being. A case study from Youth Wellness Hubs Ontario demonstrated that integrating social prescribing into its care model improved service access and continuity of care, particularly for equity-deserving populations (Turpin et al. 2024).

Beyond healthcare settings, social prescribing is expanding into schools and community programs. The Vanier Social Pediatric Hub in Ottawa pioneered a social prescribing approach where connectors worked directly with children and their families to co-create personalized social prescriptions (Muhl et al. 2024). These prescriptions included activities such as exercise programs, arts and cultural activities, nature-based experiences, mentorship programs and volunteer opportunities, ensuring that opportunities were tailored to individual interests and barriers were addressed. By addressing social determinants of health, this model not only fostered social connection and emotional resilience but also improved access to basic needs such as food security and housing support, reinforcing a holistic approach to pediatric well-being. This approach not only improved mental, physical and social well-being but also reduced the pressure on the pediatric mental health system.

Canada can also learn from international models. In the UK, the National Health Service (NHS) has developed a social prescribing pathway for young people aged 12–18 years who are on waiting lists for mental health services. By providing structured social engagement while they await formal care, this initiative helps prevent deterioration in mental health outcomes (Fancourt et al. 2023).

Meanwhile, new research at the University of Toronto is exploring how campus-based social prescribing pathways can address loneliness among post-secondary students, bridging gaps between academic and community support systems (Nath 2025). By fostering social connections, these initiatives hold significant potential to improve youth mental health outcomes in Canada.

Caring for the Caregivers: Addressing Loneliness Through Social Prescribing

Caregivers form the invisible backbone of Canada's healthcare system, providing essential but unpaid support to the loved ones – often at great personal cost. One in four Canadians will take on a caregiving role, and at some point, half the population will become caregivers, contributing an estimated $97.1 billion annually to the economy (Fast et al. 2024). Despite their essential contributions, many caregivers experience loneliness, isolation and financial stress.

Approximately 6.4 million Canadians provide unpaid support to dependent adults, of whom the majority are middle-aged, with 61% aged between 45 and 64 years (Statistics Canada 2022). Women are more likely to be caregivers than men, and 52% of women aged 15 years and older provided some form of care to children and care-dependent adults, compared with 42% of men. These responsibilities are often balanced alongside full-time work, with caregivers averaging 5.1 hours of unpaid caregiving per day. This toll is immense: one of four caregivers reports poor or fair mental health, while 87% experience loneliness. For racialized and LGBTQ2SIA+ caregivers, these challenges are compounded by financial and social barriers (CCCE 2024a).

Social prescribing provides vital support for caregivers, connecting them to peer support, respite services and community resources that alleviate stress and improve well-being (CCCE 2024b). Recognizing this need, the Canadian Centre for Caregiving Excellence and CISP launched a Pan-Canadian Social Prescribing Initiative in 2024, backed by $1.8 million in funding. In collaboration with Caregivers Alberta, Caregivers Nova Scotia, Family Caregivers of British Columbia and the Ontario Caregiver Organization, this initiative aims to reduce isolation, foster community and empower caregivers to prioritize their own health (CCCE 2024b).

Loneliness in the Aging Population: Harnessing Social Prescribing for Connection

Loneliness among older adults is a growing public health concern. As many as 41% of Canadians aged 50 years and older are at risk of social isolation, and up to 58% experience loneliness (Bull et al. 2023). The COVID-19 pandemic worsened this situation, with rates of loneliness increasing from 33% to 67%, particularly among older women living alone (Wister and Kadowaki 2021). The stakes are high – loneliness is linked to higher risks of stroke, dementia and premature death (Wister and Kadowaki 2021).

Traditional healthcare models often overlook the social dimensions of aging, but social prescribing offers a way forward. The Canadian Coalition for Seniors' Mental Health (CCSMH) has developed clinical guidelines to help healthcare providers and community organizations implement multifaceted strategies – connecting older adults to social clubs, wellness activities and volunteer opportunities to foster meaningful relationships and reduce loneliness (CCSMH 2024).

One standout example is the Fraser Health social prescribing model in British Columbia. Between 2019 and 2023, the initiative supported more than 1,000 individuals and 126 healthcare teams through a strength-based model of social prescribing (Fraser Health 2022). Developed in partnership with the British Columbia Ministry of Health, United Way British Columbia and community organizations, the program introduced SCCs to help older adults navigate community resources, co-create wellness plans and stay engaged with their communities. These SCCs also worked closely with healthcare providers, addressing the gaps between medical care and community support. The program led to fewer hospital readmissions, improved care efficiency and strengthened connections between healthcare and social services. It also underscored the need for equity-focused approaches, ensuring that Indigenous and LGBTQ2SIA+ seniors have access to culturally relevant and inclusive supports.

Social prescribing is redefining care for older adults by fostering connection, reducing loneliness and promoting well-being. It is a model that has the potential to be scaled nationwide, creating a more inclusive and compassionate healthcare system for Canada's aging population.

The Co-Benefits and Economic Potential of Social Prescribing

Social prescribing offers a unique opportunity to improve healthcare by addressing the social determinants of health, ultimately benefiting patients, providers and healthcare systems as a whole. By promoting healthier lifestyles, social connections and access to community resources, social prescribing aligns with the quintuple aim – enhancing patient experiences, improving outcomes, reducing costs, supporting provider well-being and fostering health equity (Mulligan et al. 2024).

One of the biggest barriers to scaling social prescribing in Canada is the need for dedicated link workers – professionals who connect individuals to social and community-based resources. Yet, the investment required is relatively modest. For $100 million per year – just 0.03% of Canada's $372 billion healthcare budget – a national initiative could fund 1,000 link workers across the country, roughly one per 40,000 people (Mulligan 2025). This mirrors the UK's NHS, which introduced 1,000 link workers in 2019 at a ratio of 1 per 30,000 people (NHS 2019). With further investment, Canada could expand this workforce and introduce evaluation tools to ensure that healthcare dollars are directed where they will have the most impact.

The economic case for social prescribing is compelling. Economic modelling from the KPMG estimates that for every $1 invested there is a $4.43 return, driven by improved health outcomes and reduced healthcare costs (CISP 2024a). Among older adults, social prescribing has been shown to reduce hospital admissions and emergency department visits, with potential savings of $268 million per year. For youth, it could save $114 million annually by reducing mental health-related primary care visits and improving long-term outcomes such as lower depression rates and higher school completion rates.

Beyond cost savings, social prescribing fosters stronger, healthier communities. It aligns with the Ottawa Charter for Health Promotion (Mulligan et al. 2024), empowering individuals to take control of their health while fostering stronger, more connected communities. Across Canada, social prescribing has helped people engage in arts programs, exercise groups and volunteer work, boosting social connectedness and emotional resilience. Crucially, it shifts healthcare from a reactive to a proactive model, addressing upstream factors that contribute to poor mental health.

Implementing Social Prescribing: A Call to Action

Social prescribing is no longer just an idea – it is gaining traction as a scalable, evidence-based solution to address the SDMH and loneliness. Healthcare providers and system leaders now have the opportunity to embed it into routine care, ensuring that health systems move beyond treating illness to fostering social connection and well-being.

Getting started is straightforward, because social prescribing works well when it begins with small steps and builds on existing strengths – an asset-based community development approach (Howarth et al. 2020). Often, teams begin by sitting down with community partners and people with lived experience to create an “asset map” of known resources and strong interorganizational relationships. From there, a pilot social prescribing pathway and simple evaluation and learning plan can be established, from which the teams iterate and grow using learning health system principles. The WHO's online training (2025) and the Alliance for Healthier Communities social prescribing course (2024) provide step-by-step, equity-focused training for implementation teams. The key principles are to start with “what's strong over what's wrong” and “what matters over what's the matter” with patients, caregivers, communities, professionals and systems.

In the longer term, education is key to this transformation. Clinicians and healthcare administrators need a clearer understanding of how social prescribing works and why it matters. CISP is leading the charge, offering a training roadmap to help professional and community partners define their roles with confidence (CISP n.d.). CISP's Educator's Guide supports the integration of social prescribing into medical, nursing, pharmacy and allied health curricula (D'souza and Clarke-Mendes 2024). These resources are already equipping both current and future providers with the tools to make social prescribing a practical and sustainable part of care.

Building strong partnerships between healthcare providers and community organizations is essential. Social prescribing succeeds when clear referral pathways connect individuals with social service agencies, cultural groups and recreational programs. While Canada does not yet have a formal system-wide link worker model, frameworks are in place to define competencies for link workers and equivalent roles (CISP 2024b). This task-sharing approach enables the integration of social prescribing into existing health and social care infrastructure without adding undue burden to providers.

Sustaining and scaling social prescribing requires ongoing support, collaboration and evaluation. The CISP's national community of practice provides a platform for healthcare teams to exchange best practices, access peer education and refine implementation strategies. The WHO's Social Prescribing Toolkit (WHO 2022) offers global guidance on how to embed social prescribing within diverse healthcare systems. Meanwhile, evaluation and research are critical. By tracking patient outcomes, healthcare service utilization and cost-effectiveness, social prescribing programs can demonstrate their impact on patients and build the case for long-term funding.

This is more than a shift in healthcare practice – it is a paradigm shift in how health itself is understood. Social prescribing redefines care, moving beyond prescriptions and consultations to address the social roots of mental health and well-being. With education, collaboration, provider support and evidence-based implementation underway, Canada is well-positioned to scale social prescribing as a core pillar of health and well-being.

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