Medications and psychotherapy help some with psychiatric conditions greatly, but for others, they work only partially or not at all. “Social prescribing” is different; it doesn’t look like health care. Journalist Julia Hotz, takes up this topic in her book The Connection Cure: The Prescriptive Power of Movement, Nature, Art, Service, and Belonging. Hotz defines social prescribing as “a nonmedical resource or activity that aims to improve a person’s health and strengthen their community connections.” Examples include classes, volunteering, gym memberships, job training, concert tickets, art supplies, even food. Studies have shown that when health care providers use social prescriptions, patients have better health outcomes.
If you live in the US, it seems ludicrous that insurance companies would pay for this (some are actually starting to). The UK’s National Health Service (NHS)has been funding social prescribing and since the 1980s, and more formally doing so since the late 2010’s. NHS paraprofessionals connect patients with resources, the social prescribing link worker.
Hotz spends the first part of the book interviewing people who have benefitted from social prescriptions. Frank is prescribed a cycling club to reverse diabetes, Amanda attends a cold-water swimming club to lift depression, Khuyen takes an art class to help with PTSD, Akeela volunteers to better manage chronic pain… and many others. She acknowledges that these accounts are repetitive, but the redundancy illustrates her point; social prescribing works for many people, living in different circumstances, and suffering with various ailments, physical and mental. The patient anecdotes are interspersed with history and clinical research.
Lastly, Hotz stepped out of her reporting role and applied social prescribing to herself. She brings the reader along for the ride by aptly titling the section: Social Prescribing for You and Me.
In the final part of this book, I try to… do social prescribing without a formal social prescription. And to do it for the person who’d been most unwilling to accept she needed social prescriptions: me.
I have to admit, as a reluctant patient myself, I got a flutter in my chest when she revealed her personal experiences. She doesn’t go into tons of details about her struggles but communicates that she was going through difficult periods tinged with loneliness, particularly following a break-up. She mourns friendships that have waned, not because of conflict, but because of life circumstances; moves, family obligations. It’s a familiar refrain. Hotz dove into social self-prescribing. She volunteered, attended a group geared toward sharing and life review, participated in art viewing, engaged in forest bathing, and dropped in at a running club that welcomed homeless people. Hotz found these activities to be of great benefit; they were enriching, nourishing, and healing.
One reason Hotz’s book spoke to me is that social prescribing is different than any health care interventions we have seen before. It takes one’s focus off of oneself, redirecting towards community. This may be the key element. We evolved to focus on the survival of our extended family groups. Excessive focus on the self can be counterproductive, we can feel stuck and languish, like Narcissus starving to death after becoming enraptured by his own reflection.
Psychotherapy can help, but I have encountered many people who have been in therapy for years, and have not seen much improvement in their mental health, or even become worse. Same with medications. People are ready for new modalities. Hopefully, social prescribing will grow in the US and the world as the benefits gain recognition.