Harms and Negative or Unintended Consequences of Social Prescribing: A Scoping Review

Background/Objectives: Social Prescribing (SP) seeks to address non-medical needs by connecting individuals to community-based resources through a person-centered "social prescription", such as group activities or support services. SP is increasingly being implemented internationally and has demonstrated potential benefits for wellbeing. However, potential harms and negative or unintended consequences (HNUCs) remain poorly understood. This scoping review aims to synthesize evidence on HNUCs reported in the literature. Methods: A systematic search of EMBASE, MEDLINE, and APA PsycInfo was conducted through September 2024 to identify full-text studies published in English or German that report HNUCs associated with SP for adults in health- or social care settings. Backward reference searches of relevant reviews identified additional studies. Two reviewers screened and extracted data independently, with disagreements resolved by a third reviewer. Study characteristics and HNUCs were categorized using the Consequences of Public Health Interventions (CONSEQUENT) framework, by level (service users, stakeholders, or system level) and degree of certainty (explicit, implicit, or potential). We followed the Joanna Briggs Institute manual and the PRISMA Reporting Guidelines for Scoping Reviews. Results: Of 2097 records identified, 18 primary studies met the inclusion criteria. In addition, 87 studies, identified through 35 included reviews, were analyzed. A total of 776 unique HNUCs were identified across the CONSEQUENT framework's domains. Most were related to the domains of "Health System", "Health" and "Acceptability and Adherence", and predominantly affected SP participants. Conclusions: SP may be associated with potential HNUCs affecting users, stakeholders, and systems. Identifying and addressing these risks is essential for designing, implementing, and evaluating SP programs, and guiding future research to mitigate potential HNUCs. Our findings underscore the importance of policymakers and practitioners incorporating the routine monitoring of unintended consequences and using this evidence to inform program refinement, resource allocation, and harm mitigation strategies.