I, like many another doctor, have been engaging in social prescribing for years, without knowing there was a name for it.
The term “social prescribing” can be loosely defined as a non-medical prescription for a medical problem, and it has been in use since the millennium. Social prescribing is widespread in the UK and if you watch Countryfile or Gardeners’ World you will often see groups of people happily engaged in structured walking, gardening and a host of other outdoor activities for the good of their health.
They may be people who have suffered injuries, or are recovering from addictions; they may have disabilities, mobility problems or mental health issues, but they are all enjoying fresh air, exercise and company which has been prescribed for them. The area is well researched and the medical evidence is compelling.
Nature, art and exercise therapies are always cheaper than hospitals and medications
Research shows that people who avail of social prescribing are happier, and they also have fewer consultations with their doctor. As the health system is now so stretched, anything that lessens the burden of multiple visits is welcome. There are also fewer prescriptions for medicines.
Drugs are sometimes necessary, but they all have risks and side effects. Nature, art and exercise therapies are always cheaper than hospitals and medications, and can be a valuable source of income to worthy causes like men’s sheds and community art projects.
Every doctor knows that uneasy feeling when they are faced with a problem for which they would rather not prescribe a drug at all. The people facing them may suffer from anxiety or loneliness, and they may comfort eat or self-medicate with tablets and drugs. They may be lacking in confidence, fitness and money, and there are no pills for those ills.
The doctors know the lifestyle changes that would help them, usually exercise, friendship, good food, nature and fresh air. They cannot be left suffer, and simple interventions could make a difference, yet they cannot afford a gym and would not know what to do in one, they do not have access to a garden, and lack the confidence to join a book club or choir.
GPs know that these things make you feel good but consultation time is too short to show them the way. If the doctor can take out the prescription pad and prescribe a few sessions with a walking co-ordinator or a gym coach, they have access to a very powerful tool. The prescription is a key part of the consultation. The client is given the piece of paper and sent to a trained guide who will start them off at a suitable level for them.
My first article for The Irish Times health supplement, many years ago, described how I suggested to an anxious and lonely widow in Wales that she should get a dog. She took my advice, which was surprising. Most GPs who volunteer what is optimistically called “lifestyle advice” are used to being ignored, but this lady promptly rescued a dog from the pound. She was happy. The dog was even happier and I was delighted.
That might not have fitted into a strict definition of social prescribing, but it is not too far away from it. It is gratifying to make a difference without drugs. Recently in the Irish Times Health supplement an article described how GPs working in Wales can now prescribe sessions on bicycles.
These ideas are practical and economical.
Several social prescribing initiatives have been undertaken in Ireland. A pilot scheme in Donegal was very successful, and so was one in Fatima Mansions. There is a new social prescribing initiative in Silver Arches Family Resource Centre in Nenagh, in my patch, and yesterday I was delighted to ask them to arrange a singing group for a woman with anxiety issues and a community gardening project for an older man with no other access to a garden of his own.
We are part of the great natural world, and what is good for that is good for us
Bloom Festival recently exhibited a garden for older people with memory issues. I have known many a person with dementia who cannot remember much, but their hands still know how to prune a rose and plant a bulb.
In Japan a natural prescription is called Shinrin Yoku which translates as forest bathing. It is the method of healing through nature. Again, the evidence is compelling. Short periods of quiet in a forest can make a huge difference to your mood and health. Japanese medical students take regular classes in Shinrin Yoku. At last we are realising that nature is crucial for our survival, our mental wellbeing and our health, that we are part of the great natural world, and what is good for that is good for us.