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Social Prescribing – The Time Has Come for Adoption in the U.S.

Social prescribing is a means of enabling health professionals to refer people to a range of local, non-clinical services. The rationale is that health and wellbeing are determined mostly by social, economic and environmental factors such as food insecurity, housing, work, education, living conditions, access to health care, etc.

Social prescribing addresses people’s needs in a holistic way, helping them to take greater control of their own health. 

For example, a recent study of more than 27,400 Women’s Health Initiative (WHI) participants ranging in age from 71 to 104 showed that loneliness increased among women when measured during the early months of the pandemic compared to when they were surveyed a few years before the pandemic began.

According to the study, 19 percent of women reported clinically significant depressive symptoms during the pandemic. 

Connect the Dots

Loneliness can cause stress, which can eventually affect sleep, nutrition, mental and physical health. If you tell your doctor, “I’m lonely,” they may not be able to offer much in terms of care.

Social prescribing changes the conversation. There is a wide range of services that can be offered from volunteering, gardening, cooking, art activities, sports, socializing and of course, music. That is why we created Sage Stream, a Senior Education and Entertainment Network.

Sticking with music for a second – using music with social prescribing can have a great impact on people living with dementia or memory loss. Live music programs, music therapy, personalized playlists, singing groups, and more can be helpful. For homebound elders, virtual programming has the same value as long as there is social interaction.

The key is to design a personalized solution. With music, this could involve finding out whether music is important to the individual, how they enjoy music, and what kind of music they like.

U.K. a Leader in Social Prescribing

Social prescribing has been practiced and funded in the National Health Service (NHS) in the U.K. dating back to the 1990s, and some programs even earlier. It works through primary care physicians who become gatekeepers.

It enables physicians, nurses and other primary care professionals to refer people to a range of local, non-clinical services to support their health and wellbeing. These professionals are called link workers. There are at least 1,000 social prescribing link workers in place with significantly more coming and at least 900,000 people will be referred to social prescribing by 2023/24.

The U.K. model is changing the conversation from health care as a deficit model to a wellbeing model. We struggle in the U.S. with this as we treat the presenting illness more so than looking at the systemic causes and overall wellbeing of people.

Social prescribing link workers are becoming an integral part of the multi-disciplinary teams in primary care networks. Social prescribing legitimizes community-based activities and support alongside medical treatment as part of a personalized care routine.

The NHS has several partnerships that assist their endeavors including the National Academy of Social Prescribing and Royal Voluntary Service. Thriving Communities is a national support program for voluntary, community, faith and social enterprise groups, supporting communities impacted by Covid-19 in England, working alongside link workers.

Benefits to People and Organizations

Programs can reduce demand on healthcare services. A U.K. study found that after three to four months, 80% of patients referred to a social prescribing scheme had reduced their use of outpatient appointments and inpatient admissions.

One example in London showed a potential average saving of £1,403,770 pounds per year for a physician group benefitting from arts on prescription. The National Health Service estimates that for every pound spent there is a saving of 27.50 pounds.

For people who are prescribed, it facilitates social connection, which can help relieve loneliness and improve quality of life. It provides pathways to change. Even when you know some change could help, you might not know how to begin. Research indicates reduced anxiety, a more positive outlook on life and ultimately better health outcomes for those who participate. 

A brand new study released in March found that social engagement alone can IMPROVE cognition over five years for people diagnosed with mild cognitive impairment (MCI).

The “prescription” is not just an in the moment solution. There is the expectation of the prescribed program (music, dance, etc.); the experience of it; the reflection afterwards; and the connections made before, during and after.

Takeaways for Caregivers

In the U.S. there has been a lot of talk about the social determinants of healthcare, similar to what I outlined in the first paragraph, but there is little funding, therefore little incentive to prescribe. And there is far less of an appetite to look at the arts as a prescriptive solution.

That is where caregivers can step in.

  • First, consider that things mentioned earlier – volunteering, gardening, cooking, art activities, sports, socializing, music – are real solutions and see how they can fit into your loved one’s life.
  • Advocate with your local physician to have them start thinking about these solutions. Find progressive physicians who embrace social prescribing.
  • On a societal level, let others know about social prescribing and when opportunities arise, talk to local and national leaders about the need to fund social prescribing and the benefits of doing so.

What do you know about social prescribing? Is this therapy initiative something you’d be interested in? Have you tried its effects? Do you know where to look for a physician who supports this type of care for your wellbeing?

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The Author

Anthony Cirillo is founder of Sage Stream, the Senior Entertainment/Education Network and president of The Aging Experience, which helps people and companies prepare for aging before it becomes a crisis. A health and aging expert, professional speaker, and media influencer, he is a Fellow of the American College of Healthcare Executives with a master’s from the University of Pennsylvania. Anthony serves as a Policy RoundTable member for Nationwide Financial and Bank of America.

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