Social prescribing: why purpose is good for your health

23 July 2024

In a bid to improve health and wellbeing, social prescriptions can cover everything from volunteering and art classes to support with household bills. But do they really work?

Akeela Shaikh is a natural carer. After becoming a mother at 19, she realised she loved caring for people and decided to pursue it professionally – first at a home care agency, then in a residential care home. "I just knew, that's me: caring," she says.

But the care jobs she loved so much started to tax her physically. They came with literal heavy lifting: moving patients, pushing beds, being on foot 24/7 to tend to patients' every need. Gradually, the caring took a toll on her back and she realised it wasn't going away; she had developed chronic pain. 

Her doctor urged her to rest, and eventually the pain got so bad Shaikh agreed. But instead of making her feel better, Shaikh found resting only made her feel worse, and she found she could no longer get out of bed. "It was a nightmare, and I became a nightmare," she says.

Shaikh couldn't imagine her life without work and became distraught at becoming the one who needed the care. When her husband and kids called doctors and therapists to try to help her, she became even angrier.

When both her mother and mother-in-law then became ill at the same time and she couldn't take care of them, she sank to the lowest she'd ever felt, she says, and began to have suicidal thoughts. "I just kept thinking, 'There's nothing left. I can't do anything anymore, and I don't want everyone to do everything for me. I don't belong here anymore. It's just too much'."

But as she watched her mum suffer, she had a lightbulb moment: "My mum worked so hard for everyone else, but she never listened to her own needs until she became very, very ill. And I just thought, 'Wow, I'm doing what my mum did, and it's not fair to my kids or to my husband'."

The thought prompted Shaikh to finally get help. She tried antidepressants, then counselling although neither worked for her. But then a nurse gave Shaikh a different kind of medicine: "She gave me a card that read 'social prescribing'." The card led to a phone call with Joanne Gavin, at the time a link worker with Bolton Community and Voluntary Services in Greater Manchester in the UK.

Instead of asking "what's the matter with you", link workers ask patients "what matters to you" and find suitable community activities that fit their answer.

Whereas some chronic pain patients might benefit from medication and therapy, others might find that activities in nature or the arts help with their pain. But it was clear what mattered to Shaikh was really another chance to take care of someone. 

Gavin intuited this. And when she asked Shaikh what she thought might help her feel better, she honoured her answer: "a job".

In 2018, the local healthcare system in Bolton, England, had asked Gavin to help run a pilot programme for this ambitious idea of "prescribing" volunteer work. Her job would be to listen to patients and refer them to spots in charities based on what mattered to them.

At the time, Gavin had never heard of social prescribing, which "was very, very new", she says. But the logic clicked immediately.

"My approach is to listen to someone's story and look at not just what's going on now but what they were like before they started to feel depressed or anxious," says Gavin. "You're still that person you were before you felt ill. It's just a question of how you get back there."

The power of social prescribing – helping patients to improve their health and wellbeing by connecting them to community resources and activities – is increasingly backed by scientific studies. Prescriptions can cover everything from art classes and cycling groups to food and heating bills.

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