What Is Social Prescribing and Its Impacts on Health?

May 14, 2024June 23, 2024 Dave

Submitted by Beth Rush
Founder and Managing Editor
Body+Mind Magazine

Western medicine has advanced dramatically yet hasn’t evolved enough to address individuals’ social needs meaningfully. Remedying such issues is usually outside the purview of healthcare professionals — until now. Social prescribing (SP) may be the missing link in holistic health.

What Is Social Prescribing?

SP is a way for clinicians — healthcare providers directly in contact and responsible for patients — to use local resources to deliver holistic care. This intervention acknowledges that social, economic and environmental problems may be behind a medical condition. Instead of treating physical symptoms, this non-medical approach aims to dig deeper to alleviate social determinants of health, and address an illness or a disease’s potential underlying causes.

A social prescription involves a referral to a specialist in non-clinical services within the area to promote wellness. That’s why the healthcare industry also calls it a community referral.

It’s particularly helpful for older adults with mild or long-term mental health problems, and individuals seeking social support to relieve their complex individual needs. A social prescribing scheme may also be advantageous if you rely on primary or secondary care — like for living with dementia — to improve your physical health.

Social prescriptions involve no pharmaceuticals. Instead, they revolve around personalized treatment plans that support and satisfy your unmet social needs, including friendship, belonging, acceptance, love and intimacy.

Community referral enables you to overcome what you go through more healthily. Being referred to passionate social workers who care about your well-being can expose you to productive and rewarding activities, helping you achieve better health naturally.

Although these social interventions don’t involve prescription drugs, they don’t discourage you from taking medication. The pharmaceutical industry has a positive view of social prescribers, believing these professionals are vital in addressing vaccine misinformation and promoting drug adherence.

How New Is Social Prescribing?

Social prescribing isn’t a new concept. The United Kingdom’s National Health Service embedded SP in its Long Term Plan in 2019. However, the U.K.’s publicly funded healthcare system has used this non-medical holistic approach since the 1990s. East England’s Bromley by Bow Centre practiced it much earlier.

So far, at least 17 countries across four continents have implemented this holistic approach to wellness in one way or another. Aside from the U.K., those embracing it include:

Australia
Canada
China
Denmark
Finland
Germany
Ireland
Japan
Netherlands
New Zealand
Portugal
Singapore
South Korea
Spain
Sweden
United States

The above nations have adopted SP programs differently, but the healthcare trends informing them include:

Asset-based community development, which identifies and mobilizes underutilized local assets to enable community members to organize and drive development.
Person-centered care, which empowers people to make informed decisions about their treatment and well-being.
Quadruple aim, which puts a premium on improved population health, enhanced patient experience, cost reduction, and balanced work and life of healthcare workers.
Self-determination theory, which capitalizes on the tendency of individuals to feel more motivated to take action and pursue better psychological health when they have the freedom of choice and more control over their lives.
Strengths-based approach, which emphasizes collaboration to achieve health outcomes based on patients’ strong suits.

Is Social Prescribing Primary Care?

Social prescribing is a non-medical intervention. It doesn’t fall under primary care, which refers to a range of services clinicians can provide to address most of your medical needs.

Health professionals such as general practitioners and practice nurses in primary care settings are generally your gateway to SP. They may take this route to intervene in the social determinants of health you experience.

If you live with this condition or know someone who does, secondary care providers — including neurologists, neuropsychologists, geriatricians and geriatric psychiatrists — may refer you to a social prescriber. They’ll assist you in discovering helpful activities to complement standard medical and therapeutic treatments.

What Does a Social Prescribing Link Worker Do?

Social prescribing link workers are the people your doctor may refer you to. Also called social prescribers, they can help you feel more connected to broader society and overcome whatever you struggle with.

This profession has no rigid qualifications. Still, social prescribers possess the life experiences, personal qualities and values necessary to guide you toward holistic wellness.

These liaisons have an in-depth knowledge of your local community. They’re familiar with your area’s community groups, organizations and agencies, which offer invaluable services to people in the same boat as you. They may even know individuals living on your street who experience similar challenges as you and connect you to them.

Link workers can speak with you over the phone or meet you in person. Chats with them are relaxed. They strive to make you feel comfortable, and encourage you to open up about your life and be receptive to changes that may improve your psychological well-being.

Forcing you to do something uncomfortable is the last thing social prescribers would do. Talking with them is like driving with voice-guided navigation. A link worker uses their resources — road network data and real-time traffic information — to help you find the shortest route to reach where you want to go. However, you hold the wheel and can decide which direction to steer your vehicle.

Social prescribers hope to inspire you to pursue constructive behaviors and come out of your shell. After understanding your situation, your link worker will match you with fitting local services, and co-design a personalized plan based on your social and emotional needs.

What Is an Example of Social Prescription?

A social prescription can be a digital or physical document containing a list of objectives and the activities that correspond to them. It can also include fields where you share your details — name, email address and phone number — and a section where you confirm you’re OK with link workers using your personal data to contact you.

The healthcare professionals who advocate for SP may use different templates, but the above is a typical social prescription’s gist.

What Are the Activities for Social Prescribing?

The activities social prescription recipients do to feel better are broad. They can include:

Animal handling
Art gallery visits
Making friends
Cooking and dining
Crochet tutorials
Gardening
Group exercises
Guided nature walks
Language classes
Legal consultation
Marathons
Recreational swimming
Sports
Support group meetups
Volunteering

The list is endless, as unique individuals require different activities to improve their circumstances

What Is Green Social Prescribing?

Green social prescribing focuses on nature-related interventions. Link workers may prescribe physical activity in green or blue spaces. If you care deeply about the environment and champion sustainability, a social prescriber may recommend you:

Participate in a community gardening project.
Join a tree planting event.
Get your hands dirty in a coastal cleanup drive.
Partake in an outdoor cultural activity.
Volunteer at a wildlife conservation organization.
Work out at a green gym.
Engage in urban farming.
Do guided meditation in a picturesque resort.
Play water sports.

Green SP is a way of tricking yourself into spending more time in nature. Being at one with the environment may holistically improve your health because of biophilia — the tendency of every human to connect with other life forms. Communing with nature may help reduce anxiety, enhance sleep quality, elevate cognitive performance, boost immunity, aid physical recovery and more.

What Is Proactive Social Prescribing?

Proactive social prescribing is a concept where health care providers within a community work collaboratively to give targeted groups with unmet needs improved access to SP. Its goal is to ensure nobody feels left behind when their needs change. Healthcare professionals use data from various sources — population health management records, health inequalities dashboards and intelligence from SP services — to identify the demographical groups that need support.

Aside from ensuring services are available to the individuals who need them most, proactive SP presents more opportunities to quantify the impact of non-medical interventions to promote holistic wellness. The more impactful they are, the easier it can be to secure funding instead of relying on a single one.

How Does Social Prescribing Help With Dementia?

Social prescribing can complement typical dementia medications and therapies. It currently has no cure, so the drugs patients usually take — such as memantine and cholinesterase inhibitors — can ease symptoms of cognitive decline only temporarily.

Many therapies initially teach dementia patients how to manage their symptoms, cope with the changes their condition brings about and live when their cognitive health further deteriorates. These treatments involve:

Breaking basic tasks into simpler steps to make them less frustrating.
Removing stressors like clutter or noise from the home environment.
Maintaining a routine to bring structure to everyday life.
Keeping unsafe objects out of sight.

Dementia medicines and therapies can be helpful but only do so much, especially for patients living alone. Anyone with degrading mental processes should have a healthier social life to slow their condition’s progress.

SP can make up for what therapies and drugs can’t do for dementia patients. Engaging in fun social activities may make their anxiety more bearable so they can stay in a good mood. Dementia caregivers can benefit from community referral, too, as they can experience social isolation.

Plus, it’s common to grieve while witnessing the effects of diminishing cognitive function in a person. Savvy social prescribers understand dementia’s impact on patients and caregivers, so they may consider both parties when curating local resources to promote holistic health to all.

What Is Social Prescribing for Dementia Patients?

Social prescribing activities may help people with dementia experience less frequent mood swings and forget about their declining cognitive abilities. Socialization may slow this condition’s progression and help dementia patients enjoy higher quality of life.

For instance, cognitive stimulation therapy (CST) shows promise in improving patients’ language skills and various mental processes. This treatment allows a group of people with memory challenges to engage with one another actively and do themed activities in an optimal learning environment. Members get to name their group, pick a theme song and more.

SP activities can replicate the gains people with dementia can reap from CST. Take joining a gardening club as an example. It enables them to be part of a group, eases their loneliness and gives them a sense of belonging. Combining therapeutic horticulture and social techniques helps cognitively impaired individuals stay sharp by being surrounded by like-minded people they can talk to. Learning gardening skills can be a significant confidence booster for individuals in low spirits, making them less likely to be distressed and agitated by their condition.

Going to a Memory Cafe is another SP activity worth trying. Such an establishment is a safe space for those with cognitive challenges. People living with Alzheimer’s disease and other dementia types can engage confidently with staff without fearing judgment or discrimination. This type of restaurant also helps dementia patients’ loved ones learn more about the condition.

In communities with dementia-friendly cinemas, cognitively impaired individuals can conveniently go to movies. These establishments serve refreshments before screening to help audience members familiarize themselves with the space. They also have lights on low, permit cinemagoers to move around and add a mid-movie interval.

What Are the Benefits of Social Prescribing?

Social prescribing has various merits. Its benefits include holistic wellness focus, activity variety, support personalization, patient control, affordability, community cohesion and primary care efficiency.

Heightened Holistic Care Focus

SP promotes wellness by enriching every aspect of a person’s well-being. Its proponents acknowledge that traditional medicine is inadequate to make people’s lives fulfilling.

This concept counters the notion of over-relying on chemicals to address the physical symptoms that psychological and emotional problems manifest. Considering how addictive some prescription drugs can be, they may create more problems than they solve.

Holistic care is a way to promote wellness at a population level. Implementing SP models suiting local cultures, values and sensibilities may be instrumental in ensuring everyone is socially, psychologically, and emotionally fit.

Furthermore, SP addresses people’s spiritual dimension. Spiritual care is fundamental in holistic wellness. It has nothing to do with religion, so individuals from various faiths, agnostics and atheists can benefit equally.

Social prescribers can link you to community members who can accompany you in your quest to find meaning in life and gain a sense of purpose. Being interconnected with the universe can nourish the soul and provide peace. Spiritual wellness can help you develop a set of beliefs, principles and values that can give you direction.

Wide Activity Variety

The bottomless list of activities social prescribers may propose means you only have to do what you enjoy to be healthy holistically. Link workers are a treasure trove of ideas.

They can inform you about events, charities, societies and services you might’ve never heard of. Together, you can curate the pursuits that fit your needs to broaden your horizons.

High Patient Control

SP gives you the freedom to march to the beat of your own drum. No one can dictate what’s best for you since nobody grasps your situation better than you.

Having such autonomy doesn’t mean you must battle your inner demons alone. A social prescriber’s job is to help you develop a proper mindset for your wellness journey. After all, you must understand your “why” for living a healthy life. Once you have clarity, you can co-design a personalized game plan to leverage your resilience and maximize community resources to accomplish your holistic health goals.

Less Cost

SP isn’t a cost-free alternative to medical interventions. Fulfilling social prescriptions costs time, money and energy, but there’s no denying it’s budget-friendly. You can choose social pursuits based on your means to create a financially sustainable treatment plan.

Moreover, being upfront about your financial health enables your link worker to propose suitable activities. Working with them can reduce any expense you may incur, giving you one less thing to worry about.

Increased Community Engagement

These non-medical holistic health interventions inspire stakeholders to band together to extend psychological, emotional and spiritual support to everyone. SP schemes can inspire community connections, promoting tolerance, consideration, diversity, coexistence and harmony.

In close-knit communities, individual members genuinely care about each other. They have a sense of shared destiny — what happens to one affects the others. Viewing one another as family naturally creates a robust support system that can catch even those who fall through the cracks because compassionate neighbors are there for one another.

Increasing your community engagement can motivate you to be an agent of change. Witnessing the value of social prescriptions first-hand may encourage you to pay it forward and inspire others to do the same.

Decreased Pressure on Primary Care

From a healthcare point of view, community referral is an unburdening force. Even the finest public health systems have finite resources. Having a full plate erodes primary care professionals’ ability to deliver quality care. Clinicians find it more challenging to prioritize who should get which service when individuals who may feel well more quickly through non-medical interventions seek medical attention.

SP programs create a virtuous cycle. They divert people with unmet needs to apt social workers, allowing primary care providers to treat individuals with more pressing medical conditions. In turn, a more significant segment of the population makes headway with their psychological, emotional and spiritual wellness journeys while conserving limited resources.

What Are the Criticisms of Social Prescribing?

Social prescribing critics usually point out the practice’s resource availability limitations, lack of conclusive and objective effectiveness evidence, social issue medicalization, and privacy concerns.

Limited Resource Availability

SP networks heavily rely on volunteers. Social prescribers can’t connect you to any person, group or organization unwilling to assist you. Therefore, link workers can only recommend their local partners, whose services may not best fit your needs.

Voluntary services are at the mercy of charitable donors. They can cease to exist once benefactors decide to stop bankrolling them.

Geographic Restrictions

SP schemes are community-based, so geography can act as a barrier to service availability. Without a national network of social prescribers, those in one jurisdiction may be unaware of resources in other areas.

Say social prescribers stay current with international and domestic community referral trends. They may only be able to suggest local services even when better options exist elsewhere.

Insufficient Efficacy Evidence

The body of research surrounding SP has been growing, but the studies on it haven’t conclusively determined the practice’s effectiveness. Detractors use many arguments to explain why there’s little proof of SP’s usefulness. They say that the proponents of this non-medical intervention poorly define and overhype it. Some argue its practitioners separate medical from other social aspects of care, saying SP creates an illusion of a solution to the social determinants of health.

Said oppositionists believe social interventions must be persistent to produce desirable health outcomes over the long term. They acknowledge that they can be beneficial to psychologically, emotionally and spiritually struggling individuals only when there’s staff involvement. However, patients usually revert to their old ways after losing touch with social workers.

Skeptics also have a problem with the word “social” in SP, as it implies that the state or healthcare system isn’t responsible for delivering such care. It sounds optional and voluntary, putting the blame on people who choose not to take such an opportunity to feel better.

Privacy Loss

SP raises sensitive information confidentiality issues. Individuals and organizations outside the healthcare sector aren’t subject to strict data privacy requirements like hospitals and clinics are. Non-medical parties are questionable custodians of sensitive patient information because they may not take extreme measures to combat hacking attempts due to budget constraints and lack of regulatory pressure. Entrusting your details to non-medical entities can endanger yourself and your loved ones.

Should You Give Social Prescribing a Try?

SP is worth considering, especially when your social needs are becoming too unbearable to deal with alone. Although the jury is still out on its effectiveness, it’s a harmless intervention if you don’t expect more than what it is — a nudge to reconnect with society to improve your holistic well-being.