How social prescribing helps combat loneliness – and strengthens your health

Imagine walking into a café, and the coffee machine is beeping and whirring loudly. When you sit down, the noise fades into the background. Only when the coffee machine stops making any noise do you realize how loud it actually was.

Debbie Teale likes to tell this story when she wants to describe the effect painting has on her well-being. It's an analogy: "Through art, I realized that I could switch off my racetrack brain, which I was so used to," she says. It was a form of deceleration she hadn't known before.

Due to mental health issues, the British woman had been taking medication and undergoing therapy since childhood. It hardly helped. "The medication slowed down my thinking, but it slowed down everything in my life and at times rendered me incapable of acting," she says. "It works for some people, but not for me." It was only the art course that changed her life. Today, Teale is one of the most dedicated advocates for social prescribing in healthcare.

Medically prescribed creativity or social activity has long been part of the National Health Service (NHS) in Great Britain. General practitioners can prescribe this type of social activity. The problems of most patients are not as severe as those of Debbie Teale. There's the 71-year-old caring for her partner with dementia, or the 15-year-old who can no longer sleep through the night due to anxiety. This is evident from case reports in the NHS . Loneliness, financial difficulties, or family problems are often the reasons for a social activity prescription.

In the UK, positive effects are already being seen. A study by the University of Westminster shows that social prescriptions reduced the frequency of visits to the GP by people with social problems by an average of 28 percent, and to the emergency room by 24 percent. Social prescriptions could also influence calls to emergency services due to loneliness or social isolation, according toa study by the British ambulance service .

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As part of a feasibility study by Berlin's Charité hospital, the social prescription is currently being tested in Germany. The social prescription aims to address situations where general practitioners lack the time and resources – specifically, where patients report social problems. While general practitioners in Germany are often confronted with these issues during consultations, they are frequently unable to provide comprehensive support.

Benjamin Senst is a general practitioner at the Zerbaum & Colleagues Medical Care Center (MZV) in Brandenburg an der Havel, one of seven practices to participate in the feasibility study. He explains that physical symptoms are often the initial focus during consultations. "However, in addition to medical aspects, psychosocial factors also play a role," he says. During the conversation, it often becomes clear that the patient has social problems, suffers from loneliness, addiction, or workplace bullying.

As a general practitioner, the options are limited: issuing sick notes, advising on rehabilitation or spa treatments, or recommending support services and counseling centers. With the introduction of social services, a "link worker" also moved into a consultation room at the medical center for six months and helped those affected find local clubs, neighborhood gatherings, or new hobbies – tailored to each individual. "A key moment was when our link worker placed her list of services next to ours – and it was many times longer," says Senst. "We don't even know all the services available; how are our patients supposed to know them?"

There are no figures available on the effectiveness of the social prescription in Germany. The feasibility study is not yet complete. However, study leader Professor Wolfram Herrmann is optimistic: "The social prescription is being well received by doctors' offices and patients," he says. "It also shows that we are reaching the right patients, for example, those suffering from multiple chronic or mental illnesses." Furthermore, the interviews revealed that many patients would like to be asked about their social difficulties at their family doctor's office.

The measure is explicitly not intended to be a substitute for psychotherapy. "The goal is to empower patients to independently access local services," says Herrmann. "The link workers are meant to build bridges, not provide therapy." Therefore, there is currently no formal training program. Professor Herrmann and his team train people with experience in a health or social work profession to become link workers.

He warns against viewing social prescribing as a panacea. "Social prescribing cannot eliminate social inequalities or create more general practitioners' offices or local services. What it can do is mitigate the effects somewhat and relieve the burden on practices by connecting them with services."

What role will the social prescription play in Germany? Nicola Buhlinger-Göpfarth, Federal Chairwoman of the German Association of Family Physicians, praises the concept. "We experience daily in our practices how high the need is," she says. "We would therefore like to see the social prescription – or a comparable system – become a more prominent part of healthcare in Germany in the future."

Nils Goldschmidt, director of the Global Ethic Institute at the University of Tübingen and member of the German Ethics Council, sees potential for savings: "Social proposals are a smart addition to our social systems, both ethically and economically." The low-threshold support services ideally combine medical care and social work – with relief effects also for statutory health insurance companies.

The Techniker Krankenkasse (TK) health insurance company is taking a cautious approach. A spokesperson said they will review the study results once it is completed. However, given global crises and personal challenges, regular measures to strengthen psychological resilience should, in the long term, become a "natural part of everyday life."

The AOK health insurance company believes that social referrals can be an effective tool for increasing the active participation of those affected. However, the company sees "considerable potential for conflict" in the fact that the effectiveness of social referrals depends on the local services available. "There is a risk that a social referral would be ineffective if no corresponding services exist in the respective region."

General practitioner Senst says the social prescription has seamlessly integrated into daily practice. "Experience has shown that many of our patients leave feeling relieved after being able to talk about their problems at the practice," says Senst. "The Link worker didn't just recommend a rowing club or a choir; she took the time to listen. That has already made a big difference."

For Debbie Teale, the art course worked also because it helped her discover other sides of herself – and not just focus on the problems. "We talked about art and about what made us feel good or annoyed during the week," she says.

In addition to the feasibility study , an EU-wide study on the social prescription is currently underway, also led by Professor Herrmann. It focuses on vulnerable groups such as LGBTIQ people, refugees and first-generation immigrants, as well as older adults living alone, because these groups, among other things, have a higher risk of loneliness.