Prescriptions To Promote Health: The New Wave Of Social Prescribing
Doctors around the world are now giving their patients a new type of prescription. Instead of a drug or medication, they’re prescribing that their patients go to a museum, listen to a concert, or spend time in nature.
This new wave of prescriptions is called “social prescribing.” It’s a model that’s already being used in the UK, Netherlands, Canada, Japan and Australia, to name just a few. Rather than waiting for patients to become ill before receiving healthcare, this model focuses on taking a proactive approach to promote health and well-being. It recognizes that many factors contribute to a healthy life, including spending time in nature, engaging in the arts, and community. Social prescribing is being used to address loneliness, social isolation, and mental health conditions in consideration of addressing rising healthcare costs as well as healthcare shortages that are resulting in significant strains to health systems around the world. This has only worsened since the COVID19 pandemic.
A 2021 report released by the U.S. Surgeon General, Dr. Vivek Murthy, noted that “people who are socially isolated are at a 50% increased risk of dementia, a 29% increased risk of coronary heart disease, and a 32% increased risk of stroke compared with people who are not socially isolated.” Additionally, 1 in 5 adults reported feelings of loneliness and/or isolation in a 2018 survey. It’s important to note that this report and survey were completed before the COVID19 pandemic, which we know only heightened the prevalence of mental illness in adults, adolescents, and children.
So, what role can social prescribing play in all of this?
Much of what we know about the implementation and effects of social prescribing is based out of the UK, which was the first country to adopt social prescribing at the national level. The way it works is this: General practitioners (or primary care providers) refer patients to Link Workers. Typically, referred patients are those experiencing long-term health conditions and/or mental illness. Link Workers then meet with these individuals to assess their unique needs and connect them with non-clinical community resources. These community resources can vary greatly depending on the needs of the patient and can include painting, dance, music, gardening, walking, volunteering, or nature-based activities. This approach empowers people to play an active role in identifying their needs and improving their well-being.
A review published in December 2022 looked at peer-reviewed evidence for social prescribing of nature therapy for adults with mental illness. What they found was that participants reported perceived improvements in their sleep quality, fitness, pain, weight loss, and symptom management. They also found improvements in overall psychological wellbeing, feelings of social connection, community, meaning, and belonging.
Another systematic review published in May 2021 noted changes in loneliness, social isolation, well-being, and connectedness after social prescribing interventions. Direct causality was unable to be established, however these improvements were noted after the social prescribing interventions.
While more quantitative, peer-reviewed research is needed to assess the direct causality and correlation of the impacts of social prescribing on improvements in overall health and wellbeing, initial qualitative studies, like those described above, are promising.
Here in the U.S., a public-private partnership was initiated in 2021 called Commit To Connect. This partnership was developed by the Administration for Community Living (part of the U.S. Department of Health and Human Services) and a number of nonprofit organizations. Through online tools, this program aims to increase awareness of social isolation and loneliness while also matching people experiencing social isolation with community-based resources.
A number of pilot programs are also underway here in the U.S. In fact, our very own Wendy Goldberg, president and founder of the Benjamin Goldberg Foundation, attended an invitation-only event in New York City in April 2023 to explore ways that New York City, and other cities across the country, can coordinate efforts to bring social prescribing programs to their communities. We are honored that Wendy was personally invited to have a seat at the table for this pivotal discussion at the New York City Social Prescribing Conference.
To learn more about social prescribing, visit:
Global Social Prescribing Alliance
Resources:
Fixsen A, Barrett S. Challenges and Approaches to Green Social Prescribing During and in the Aftermath of COVID-19: A Qualitative Study. Front Psychol. 2022 May 16;13:861107. doi: 10.3389/fpsyg.2022.861107. PMID: 35651572; PMCID: PMC9149572.
https://pubmed.ncbi.nlm.nih.gov/35651572
Morse DF, Sandhu S, Mulligan K, et al. Global developments in social prescribing. BMJ Global Health 2022;7:e008524. doi:10.1136/ bmjgh-2022-008524 https://gh.bmj.com/content/bmjgh/7/5/e008524.full.pdf
Murthy VH. COVID-19 Pandemic Underscores the Need to Address Social Isolation and Loneliness. Public Health Reports. 2021;136(6):653-655. doi:10.1177/00333549211045425 https://doi.org/10.1177/00333549211045425
Thomas T, Aggar C, Baker J, Massey D, Thomas M, D'Appio D, Brymer E. Social prescribing of nature therapy for adults with mental illness living in the community: A scoping review of peer-reviewed international evidence. Front Psychol. 2022 Dec 6;13:1041675. doi: 10.3389/fpsyg.2022.1041675. PMID: 36562055; PMCID: PMC9765656.
https://pubmed.ncbi.nlm.nih.gov/36562055
Vidovic D, Reinhardt GY, Hammerton C. Can Social Prescribing Foster Individual and Community Well-Being? A Systematic Review of the Evidence. Int J Environ Res Public Health. 2021 May 15;18(10):5276. doi: 10.3390/ijerph18105276. PMID: 34063543; PMCID: PMC8156788.