Understanding how and why social prescribing supports young people waiting for mental health services: a qualitative study of mechanisms and contextual factors

Background Long waits for child and adolescent mental health services (CAMHS) are leaving many young people without support during vulnerable periods, often with worsening symptoms. Social prescribing – an approach that connects individuals to community activities and resources – can support individuals with mental health difficulties and offers an interim support option. While evidence for adult social prescribing is growing, little is known about how and why it may benefit young people, particularly those on CAMHS waitlists. Methods This qualitative study was embedded within a wider trial (Wellbeing While Waiting) evaluating a social prescribing pathway for young people on waitlists across ten CAMHS sites in England. Semi-structured interviews were conducted with a purposive sample of 15 young people (aged 11–16) and 17 caregivers. Reflexive thematic analysis was used to identify mechanisms and contextual factors shaping engagement with, and perceived impact of social prescribing. Results Seven interrelated mechanisms were identified: (1) building trusting relationships, (2) enabling autonomy and agency, (3) supporting emotional recognition and regulation, (4) developing healthy coping strategies, (5) improving family communication and dynamics, (6) promoting behavioural activation and motivation, as well as (7) increasing social connection and participation. Four contextual factors influenced whether and how these mechanisms were activated: (1) past experiences of services, (2) complexity and severity of needs, (3) involvement of caregivers, and (4) availability and accessibility of local resources. Conclusions Social prescribing can activate a range of psychosocial mechanisms that support the wellbeing of young people waiting for mental health services, but these processes are influenced by contextual factors that can either enhance or constrain their impact. Equipping link workers with techniques that enable these mechanisms to unfold within safe professional boundaries, investing in accessible and inclusive community resources, and integrating social prescribing earlier in care pathways will be essential for maximising the potential of youth social prescribing.