Paris Alston: This is GBH’s Morning Edition. We know there’s plenty to explore in the world of arts and culture. It’s something we discuss almost every Thursday with GBH as host of the Culture Show Jared Bowen. But did you know that if you’re experiencing emotional challenges such as anxiety or isolation, you can be directed into that world with something called a social prescription?
Jeremy Siegel: This is a service now being offered by a health care provider called Art Pharmacy, which has teamed up with the Massachusetts Cultural Council to create the country’s first statewide program that uses social prescribing for physical and behavioral health treatment. Joining us now to talk more about this is Art Pharmacy CEO Chris Appleton. Good morning.
Chris Appleton: Good morning. Thanks so much for having me today.
Siegel: Thanks for joining us. So what exactly is social prescribing?
Appleton: Social prescribing is a practice that has been around for a long time, formally and informally, through which health care providers prescribe or refer patients to non-clinical interventions to support their health. So a social prescription may be participation in an arts and culture activity. It may be a nature activity, exercise, or even volunteering.
Siegel: So, Chris, we want to put you on the spot a little bit here to help walk us through the process with the understanding that this is not a health care setting, but we thought that we could give a couple of examples of things that we’re experiencing, and you could give an example of how prescriptions might work in this situation. So I’m actually a new father. I just had a daughter a few weeks ago, which is the most amazing experience on the planet, but I’m also under-slept and also juggling work and having a new child at home. So how might you prescribe something for this situation, using a social prescription?
Appleton: Well, Jeremy, congratulations.
Siegel: Thank you.
Appleton: This is fantastic. I am also a father of young children and know what it is like to have less sleep and less time than I used to have. So, perhaps, Jeremy, if you, were maybe struggling to manage your stress and anxiety related to just the natural course of life that happens, you may go see your primary care provider, and your doctor would screen you for a mental health concern. And, in this case, let’s say you have a diagnosis for an anxiety disorder. The doctor would prescribe you 12 doses of arts and culture, and they would call that prescription into Art Pharmacy, very similar to how they would call in a prescription for an antidepressant, or anti-anxiety medication to CVS or Walgreens. We would get some baseline information on you, and help you build a unique member profile. Then using Art Pharmacy’s technology, you would get matched to the highest efficacy arts and culture engagements that are nearby and appropriate for your specific goals. You’ll get 3 or 4 recommendations for your first dose of arts and culture, and you may choose, let’s say in this case, you need some calm and you need some time alone. So you would maybe choose to participate in a guided tour of an exhibit at a museum in Boston. From there, our pharmacy would provide you the ticket or access to that museum. If you wanted a companion ticket, you could opt in to one. Though, in this one, maybe time alone or perhaps time with your partner or spouse is what’s desired. And you make that choice. You’re going to participate in that activity, our pharmacy is going to remind you to take your dose of arts and culture tomorrow. Then you have the opportunity to select your second dose of arts and culture. You may choose to go back, to the museum, or you may choose something totally different. Perhaps you’re going to end up in a dance class or, go to the theater.
Alston: I love this. How does this sound to you?
Siegel: It sounds great. And I just want to ask, is this something that I could make happen now? Like, I would go to the doctor, and then I would get this prescription, and insurance would be able to cover it?
Appleton: There are — the short answer to the question is that there are some doctors and some insurance companies in Massachusetts that enable this and many that don’t. Not just anyone can walk into the doctor and say, hey, give me a script. Like with actual pharmaceutical prescriptions, there are requirements to participation.
Alston: So, Chris, I am under-slept. Not because I have a baby at home, but just because our schedule is so unconventional. Jeremy and I get up very, very early in the morning and have to go to bed pretty early as well. And as a result, on my end, I don’t get to see my social safety net, or at least I don’t get to see my friends as much. And so I spend more time isolated during the day than maybe my friends do. I’m hearing what you’re saying about, like, we get this prescription and we go out and do it. Are there things that would be designed for someone like me to be social at the times that would be more convenient to this schedule?
Appleton: Paris, thanks for this question. I think it’s so important. We know that participation in arts activities — participation, really any activity that elicits strong feelings and emotions — when done with other people, creates a stronger sense of connection and belonging with those other people. And so, in your case, Paris, perhaps the Care Navigator and our software would recommend to you to participate in a workshop or a dance class with a companion or a loved one. And to really strengthen that sense of belonging and togetherness.
Alston: And how do you know if your prescription is working?
Appleton: We utilize validated measures to evaluate whether or not a prescription is working. It’s really connected to the specific health goals of the patient or member that we serve, as well as the priorities that the prescribing partner, the referring health care provider, has identified for that patient. So we may be looking to address stress management, or hypertension — so blood pressure readings would be able to answer that question. And we also may be looking to address social isolation and loneliness, and measures like the UCLA Loneliness Index help us to understand if we are improving people’s sense of belonging and social connection.
Siegel: So Chris, this is the first statewide program that does this in the country. What do you think this tells us about the future of health care?
Appleton: The U.S. health care system has really been built to address the bio- and psycho-components of care. And it’s not until recent years that the system at large has really started to dig in and address the social leg of the stool. Art Pharmacy is oriented towards the bio-psycho-social model of care, really thinking about whole-person health. And what I believe is happening is that the system — and it is a slow moving system — But the system is moving in a direction where in addition to thinking about our physical and mental health, it is also thinking about our social health.
Alston: Well, that is Art Pharmacy CEO Chris Appleton. Chris, thank you so very much.
Appleton: Thank you so much for having me.
Siegel: This is GBH News.
Doctors can prescribe medications, order tests and suggest behavioral changes — and now, a Massachusetts organization hopes more clinicians will prescribe their patients interactions with the arts.
It’s a service now being offered by a health care provider called Art Pharmacy, which has teamed up with the Massachusetts Cultural Council to create the country’s first statewide program that uses social prescribing for physical and behavioral health treatment.
“Social prescribing is a practice that has been around for a long time, formally and informally, through which health care providers prescribe or refer patients to non-clinical interventions to support their health,” Art Pharmacy CEO Chris Appleton told GBH’s Morning Edition.
A social prescription could be going to a museum, taking dance classes, a nature activity, exercise, or volunteering, he said.
It starts with patients going to their regular health care providers: Primary care physicians, mental health therapists, or specialists like oncologists.
“There are some doctors and some insurance companies in Massachusetts that enable this and many that don’t,” Appleton said. “Not just anyone can walk into the doctor and say, 'hey, give me a script.’ Like with actual pharmaceutical prescriptions, there are requirements to participation.”
Doctors who want to participate in Art Pharmacy would contact the organization, much like they’d call in a prescription to a regular pharmacy, and relay some information about the patients’ goals.
Perhaps the patient is dealing with high blood pressure and is looking for a calming physical activity, or struggling with isolation and seeking ways to connect, Appleton said.
“We would get some baseline information on you, and help you build a unique member profile,” he said. “Then using Art Pharmacy’s technology, you would get matched to the highest efficacy arts and culture engagements that are nearby and appropriate for your specific goals. You’ll get three or four recommendations for your first dose of arts and culture.”
Art Pharmacy staff can also help with securing tickets, accessibility concerns and reminders, he said. After the arts prescription day, staff will check in with patients and prescribe a second dose, usually the following month. People can chose to repeat the same activity or try a new one.
Meanwhile, Arts Pharmacy staff can keep an eye on health outcomes, Appleton said.
“It’s really connected to the specific health goals of the patient or member that we serve, as well as the priorities that the prescribing partner, the referring health care provider, has identified for that patient,” he said. “So we may be looking to address stress management, or hypertension — so blood pressure readings would be able to answer that question. And we also may be looking to address social isolation and loneliness, and measures like the UCLA Loneliness Index help us to understand if we are improving people’s sense of belonging and social connection.”
The goal is to address people’s health within the context of their community ties, he said.
“The U.S. health care system has really been built to address the bio- and psycho-components of care,” he said. “And it’s not until recent years that the system at large has really started to dig in and address the social leg of the stool. … The system is moving in a direction where in addition to thinking about our physical and mental health, it is also thinking about our social health.”