ABSTRACT
Better alternatives to improving population health have been sought by healthcare policymakers and the front-line clinicians who see patients in everyday care settings. While public health experts and primary care clinicians recognise the significant effects on health from social determinant factors they have limited tools for addressing these causal factors in their patients’ lives. Systemic improvements to a population’s social ecology are considerable challenges from within the envelope of a healthcare system. In mental health and primary care contexts, systemic factors, social determinants of wellness and illness (such as environment, housing, social lifestyle, food accessibility) account for a significant proportion of presented conditions. Social determinants are embedded in a community setting, are multicausal and interrelated, have indeterminate risks and are not typically perceived by individuals as health threats. A community’s population and traditional primary providers have few resources for intervening or changing source social causes and contributing factors that diminish individual wellbeing. Without addressing these social sources and determinants through channels other than ensured care delivery, their pervasive influence will persist and will continue to be accommodated as effects in larger healthcare systems.
A systemic design approach developed from the theories of flourishing mental health and flourishing societies has been adapted to identify and guide supports for socialising collective health. Flourishing entails individual and family health, the movement toward ‘a good life’, and ultimately the sustainment of human and all life. Toward these ends we present a framework for community-centred approaches to facilitate flourishing through the design of soft services. Current cases in university campus mental wellness, and peer health coaching are developed as models for eliciting design principles and approaches that have been effective in interventions in the social systems surrounding practices of care, outside the envelope in which the healthcare system operates.
