A growing number of countries have understood that we can’t look after our health with medicines alone. Social prescribing is a model that connects the patient’s emotional and social needs to cultural and community-based resources, with documented effects on well-being and quality of life.
The concept of health has evolved in recent years, reaching beyond the purely clinical sphere. Social prescribing sits within this new paradigm, acknowledging that a person’s well-being also depends on relational, social and cultural factors.
It was introduced to expand the range of treatment options available to general practitioners (GPs) and their patients, especially where health problems have their origins in socio-economic or long-standing mental health issues. As detailed by Brandling and House in 2009, the aim of this initiative is to provide a further alternative to traditional medical solutions, by addressing the root causes of health problems and connecting people to non-clinical community-based resources.
Social prescribing is a pathway used by doctors or other healthcare professionals to guide patients towards activities that can add meaning, forge new relationships or give the patient a chance to take responsibility or be creative.
The activities typically prescribed include creative workshops, urban gardening projects, walking groups, neighbourhood associations or cultural events. All this is done in a structured way, with the support of a dedicated figure called a link worker, who develops a personalised action plan with the patient.
The internationally accepted definition of social prescribing, as given by the National Academy for Social Prescribing (UK), is:
“A means for trusted individuals in clinical and community settings to identify that a person has non-medical, health-related social needs and to subsequently connect them to non-clinical support and services within the community by coproducing a social prescription – a non-medical prescription – to improve health and well-being and to strengthen community connections.”
This topic is also central to the work of the Global Social Prescribing Alliance, an international project set up to overcome the “doctor-centred” model that still dominates health systems today.
By fostering an approach built around prevention, early intervention and the promotion of local resources – whether cultural, social or community-based – the Alliance proposes an integrated system where health becomes a resource for everyday life, and not merely the absence of disease.
The Global Social Prescribing Alliance Playbook, put together in 2021 with the support of the World Health Organization (WHO), provides guidance, operational tools and measurement criteria to implement effective, sustainable and personalised social prescribing models on a global scale.
While GPs play an initial key role in the social prescribing operating model, by identifying eligible patients, the system is primarily driven by link workers.
Link workers are non-medical professionals with specific training who are appointed to build a shared pathway with the patient, by linking them to local resources. They do more than just provide information – their role also includes assisting and working with the patient, providing motivational support and monitoring their progress. Their work is personalised and developed through structured interviews, often spread over weeks or months.
Social prescribing is currently being implemented in at least 17 countries, albeit still in a fragmented manner – sometimes at local level and often informally in some countries, while others already have well-structured programmes in place. These countries include China, South Korea, Germany, Denmark, Australia, Finland, Sweden, Spain, Singapore, Ireland, the Netherlands, Portugal, Canada, New Zealand, the United Kingdom, the United States and Japan, as reported in an article published in BMJ Global Health in 2022 (data current as of 2021).
In England, the birthplace of social prescribing, the NHS has implemented the most extensive institutional social prescribing programme ever undertaken by a public health system, embedding it into primary care networks. One thousand social prescribing link workers were introduced in 2020/21 to make personalised support based on non-clinical community resources accessible to every single person in the country through their GP. The plan aimed to get over 900,000 people involved in social prescribing pathways in the 2023/24 fiscal year, as part of a wider strategy to provide universal personalised care that is set to benefit at least 2.5 million citizens. This unprecedented investment officially legitimised social and cultural activities as an essential part of healthcare in the English health system.
Including cultural activities among the tools of social prescribing is not just optional – it’s pivotal. The recent scientific literature shows that the arts may have a measurable impact on psychological, cognitive and social well-being in adults with depression or anxiety, older people at risk of isolation, individuals with chronic conditions and young people from disadvantaged backgrounds.
According to the report by Mughal R., Polley M., Sabey A. & Chatterjee H.J. (2022), entitled How Arts, Heritage and Culture can support health and wellbeing through social prescribing, published by the National Academy for Social Prescribing (NASP), the structured integration of arts, music, theatre and dance activities, as well as those related to cultural heritage, into social prescribing programmes brings proven benefits for mental health, social connectedness and the sense of belonging.
The activities analysed range from creative workshops to choir projects, museum programmes, expressive writing and community dance, showing significant effects on emotional resilience, self-efficacy and quality of life.
The real impact of art and culture on health is felt beyond the sphere of health itself, showing enormous potential to ease pressure on health services and strengthen the effectiveness of public healthcare investments. The article Health and culture: the economic value of cultural engagement mentions 13 models that analyse the impact of specific cultural activities on various population groups. The economic benefits of improved quality of life, optimised public health spending and health and social care savings were calculated for each model. In particular, greater access to culture is associated with a reduction in the use of medicines and fewer medical visits, and in some cases with increased autonomy in managing one’s own health. Some analyses also explore the value of investing in culture in terms of social returns, proposing a more structured integration of cultural policies into public health promotion plans.
Unfortunately, though, despite the growing body of evidence, art and culture – understood as social prescribing tools – are still poorly incorporated into health policies in many countries, Switzerland included. Nevertheless, the systemic adoption of social prescribing in numerous European, American and Asian contexts shows that this approach may be a turning point in 21st-century medicine. In Switzerland, the rich cultural fabric and thriving arts scene offer ideal conditions for testing a model that expands the notion of care. It isn’t just about new tools, but about changing our mindset and putting people – rather than patients – first.