A first-of-its-kind study has found that “social prescribing” by a trained link worker is an effective way to improve the health and well-being of patients with long-term conditions such as asthma, cardiovascular disease, diabetes, epilepsy, and osteoporosis—which often exacerbate symptoms of depression and/or anxiety. These findings were published online July 16 in the journal BMJ Open.
Doctors generally prescribe pills to make people feel better. Social prescribing is a relatively new holistic approach to wellness in which primary care patients are partnered with a “link worker.” Link workers help each individual patient put together a personalized combination of community-based activities that are specifically chosen to fit his or her lifestyle, interests, and special needs in ways that complement any pharmaceutical prescriptions.
Social prescribing takes a four-pronged approach that addresses (1) physical health, (2) psychological well-being, (3) perceived social isolation, and (4) financial stressors. In addition to a traditional Rx from a pharmacy, someone's non-medical prescriptive might include a smorgasbord of such things as community gardening, cooking clubs, debt management workshops, walking groups, career coaching, gym classes, group dancing, making art, volunteering, etc.
Taking a comprehensive holistic approach that treats the "whole person" requires addressing just about every aspect of each patient's physical, psychological, fiscal, and societal circumstances. Unfortunately, most general practitioners and primary care physicians don't have the time, expertise, or direct resources to tailor a comprehensive non-medical prescriptive for their patients.
The good news is that link workers are a cost effective way to fill a critical gap in health care. Having a link worker tailor a drug-free prescriptive—and then hold the patient's hand through the process of sticking with it over the long haul—appears to break the vicious cycle of multimorbidity and has the potential to kickstart an upward spiral of psychological and physical well-being.
Researchers from Newcastle University in the UK are pioneers in the burgeoning field of social prescribing. In April 2015, a dedicated group of link workers launched Ways to Wellness. Since then, Ways to Wellness has provided social prescribing support to over 2,400 people. Now, the first in-depth review of the results of this program illuminates the multiple benefits of social prescribing.
For the recent qualitative study on social prescribing, dozens of interviews were conducted with Ways to Wellness participants to ascertain what impact the program had on their lives. The researchers conclude: "The intervention engendered feelings of control and self-confidence, reduced social isolation and had a positive impact on health-related behaviors including weight loss, healthier eating, and increased physical activity. Management of long-term conditions and mental health in the face of multimorbidity improved and participants reported greater resilience and more effective problem-solving strategies."
Suzanne Moffatt, of Newcastle University, described the study results in a statement:
"This is the first time that these kind of non-medical interventions have been fully analyzed for physical health problems and the results are very encouraging. The findings demonstrate that social prescribing, such as offering someone with heart disease the opportunity to take part in a gardening club, does work.
What the study also highlighted was the importance of a specific individual, a Link Worker, to help people with issues such as welfare benefits, debt, housing—so they were helping with the whole life and lifestyle which was shown to improve the person's health and well-being."
Many of those who participated in the Ways to Wellness program reported that prior to connecting with a link worker, the ripple effects of health problems and stressful life circumstances had led to anxiety and depression, especially as they got older. These findings dovetail with another July 2017 study published in BMC Geriatrics which found that anxiety presents the biggest single threat to successful aging. Depression was a close second.
Countless studies have found that perceived social isolation takes a heavy toll on our well-being over time. One of the biggest benefits of social prescribing is that it reduces subjective feelings of loneliness. Doing such things as gym classes, group dancing, community gardening, and volunteer work all boost someone's sense of belonging and face-to-face connectedness.
Alex Hall, who is an experienced link worker, said in a statement: "The Ways to Wellness service works because it helps our clients take control of their lives, and gives them access to services they may not have been aware of. It's amazing to see how small steps taken to empower someone can change their lives so drastically."
Hopefully, the latest findings on the benefits of social prescribing will inspire policymakers to support more programs that offer comprehensive non-medical prescriptions. Social prescribing has the potential to reduce skyrocketing healthcare costs and improve the psychological, physical, and financial well-being of people from all walks of life.
Suzanne Moffatt, Mel Steer, Sarah Lawson, Linda Penn, Nicola O'Brien. "Link Worker social prescribing to improve health and well-being for people with long-term conditions: qualitative study of service user perceptions." BMJ Open 2017;0:e015203. doi: 10.1136/bmjopen-2016-015203
Lukaschek, Karoline, Anushiya Vanajan, Hamimatunnisa Johar, Nina Weiland, and Karl-Heinz Ladwig. "“In the mood for ageing”: determinants of subjective well-being in older men and women of the population-based KORA-Age study." BMC Geriatrics, 17, no. 1 (2017): 126. DOI: 10.1186/s12877-017-0513-5