A few months ago, I read an article about something called “Social Prescribing.” Essentially it is an alternative to the pharmaceutical and clinical solution currently offered for people who suffer from chronic diseases or who have mood disorders.

Social prescribing comes from the understanding that not all the problems or factors impacting an individual’s health can be addressed through a standard care appointment, especially not in the 5-10 minute window that most family doctors are faced with. 

Social prescribing blends the worlds of clinical and community health complement traditional care methods, and allows the patient or client to bring their interests and assets to the table to further their health goals. 

Repeated studies show that exercise can treat mild to moderate depression as effectively as antidepressant medication but without the potential side effects of nausea, insomnia, and – unhelpfully – weight gain. We now know that moving your body promotes positive changes in the brain, including neural growth, reduced inflammation, and the release of endorphins, all of which help to energize your mind, body, and spirit.
 

Exercise can also bring a state of mindfulness; in my case, when I go to the gym or run, I don’t concentrate on anything else than what is in front of me. Many people describe this as a feeling of zen or being in the zone. I hear this often from surfers or people who play sports; the exercise helps them block out the mindless chatter that so often fills our heads. 

An example of this is the health campaign “This Girl Can Run” by Sport England.  The idea of the program is to help women with depression, and diabetes gets active in order to manage anxiety and stress in their lives.  The program also has the added benefit of allowing the participants to create social ties that can become a support system to create health instead of just managing the symptoms with drugs.

With an estimated 1 in 5 people taking antidepressants and usage increasing about 5% per year for the past ten years, the UK government has decided to do something about it.  Recently doctors have been discouraged from prescribing antidepressants to those with mild cases. Given the serious side effects of antidepressants, including emotional numbing, sexual dysfunction, and withdrawal effects when coming off them, this can be seen as a good thing.
Instead, GPs are to suggest options such as meditation, talking therapies, and “social prescribing,” including exercise. 

Across the pond in North America, the U.S. is trying to implement “social prescription” at the federal and state levels. One of the first government initiatives to rise to prominence is Compassionate Care Corps, a tele-support program run by the Department of Veterans Affairs. 

If veterans feel isolated and lonely or want to engage in regular conversation, they can talk to their clinician or advocate to receive a referral to the program, which connects them with a volunteer. Most volunteers are from veteran service organizations, and many are veterans themselves. The volunteers are trained in topics like compassion, empathy, support, privacy, and confidentiality, and screeners are used when matching veterans with volunteers with similar interests. Around 1,000 veterans are participating, and over 100 VA sites are utilizing the program.

Of course, the programs have their critics.  Lack of evidence of effectiveness is often quoted. Still, if the doctors or people working as “social prescribing link workers,” as they are known in the UK, have adequate training, this approach can be effective and have better long-term health outcomes for patients and the community. 

As we emerge from an unprecedented period of social isolation, the need for innovative ways to reconnect to our health and our support networks is more important than ever. 

For example, I recently worked with someone who is a carer for an immune comprised partner.  Together they have decided to shelter themselves from large crowds to avoid either one catching a transmittable disease.  This has led to decreases in fitness and contact with the community.

My challenge was to find a way for her to be active when she really didn’t have the motivation to be active.  We devised a plan for her to visit her cousin, who lives in the next town, once a week for a dog walk.  The benefits are that they get to walk outside for over an hour and, here’s the important bit, strengthen their friendship and social ties.

This is social prescribing. It shifts the questions providers ask away from “What is the matter with you?” to “What matters to you?

Sources:

https://visiblenetworklabs.com/2022/03/29/social-prescribing-in-the-usa/ 

https://www.telegraph.co.uk/health-fitness/mind/women-given-boxing-gloves-ballet-shoes-instead-antidepressants/