Social Prescribing for the Arts: A Promising Framework for Arts & Health Collaboration in the U.S. & Beyond
Diantha Dow Schull talks with arts and health professionals on the emerging research and practices of social prescribing for the arts (SPA) in the U.S. and other countries.
A participant during a painting program held in Gouda as part of the Culture on Prescription international program. Credit: Culture on Prescription
In this issue, we explore the emerging research and practices of social prescribing for the arts (SPA) and discuss the future of SPA efforts as a vital component of arts and health services in the U.S., especially for older adults. This issue starts framing answers to key questions related to the challenges and opportunities this practice surfaces in healthcare and creative aging. Featured in this issue is a recorded conversation between three leading experts on SPA in the U.S.: Tasha Golden, Sudha Shreeniwas, and Käthe Swaback.
*This email is an abridged version of our our full issue, which contains in-depth analysis and numerous resources on social prescribing. You can read the full issue here.
“Whether you are the maker or the beholder, engaging in the arts can benefit you, especially if we can address issues of isolation. [Arts and culture] is just a way to say a big, ‘Yes!’ to life and provide those avenues for older adults to thrive in.”
— Käthe Swaback, Program Officer, Mass Cultural Council (Creative Youth Development and CultureRx: Social Prescription Pilot Program)
What is Social Prescribing for the Arts (SPA)?
This short animation (2:12 mins) explains what social prescribing is, how it works, and the benefits to individuals’ health and wellbeing. Credit: Transformation Partners in Health and Care
Social Prescribing for the Arts (SPA) is a framework enabling doctors or other health service professionals to connect patients with non-clinical health problems to local cultural resources for improved health and wellbeing. These non-clinical referrals may include museum visits, theater or dance performances, or participatory arts programs. SPA is a variation on social prescribing — a more general model for community referrals — that enables health providers to link patients with non-clinical health problems to a range of local services, including housing assistance and food support, nature experiences, physical activity, social centers, and/or the creative arts.
Unveiling SPA in the U.S. with Arts and Health Professionals — Roundtable + Transcript (35:42 mins)
“There's so many different things to consider in our society. It's not always just the financial barrier, but all of the other components that can come along with that. If we had more connected communities, there's something to be said, not just for the systems and the structures that could be more helpful to the communities, but for interconnected communities that are doing mutual aid and mutual care. We can help shore up some of that to help these programs advance as well.”
— Tasha Golden, Director of Research at the International Arts + Mind Lab at Johns Hopkins Medicine
The adoption of SPA as a health improvement and cultural equity strategy is leading to revised health care policies, practices, and funding in some localities internationally, and even prompting new public and private investment at regional and national levels. In the U.K., where SPA is more highly developed than anywhere else, the 2019 NHS Long Term National Health Plan states: "Within five years, over 2.5 million people will benefit from Social Prescribing.” Read about a variety of international pilot projects in our full version.
Given this international context, it is not surprising that there is discussion, experimentation, and initial investment in SPA programming in the U.S. While U.S. activities are still relatively limited, many professionals in medicine, arts education, community health, social services, and related research are intrigued by SPA and are raising questions about its potential as a framework for addressing the social determinants of health. Lifetime Arts convened the roundtable discussion above with Tasha Golden, PhD, Director of Research at the International Arts + Mind Lab at Johns Hopkins Medicine; Sudha Shreeniwas, PhD, Professor in the Department of Human Development and Family Studies at University of North Carolina Greensboro; and Käthe Swaback, Program Officer, Mass Cultural Council (Creative Youth Development and CultureRx: Social Prescription Pilot Program) on the key issues involved in the assessment of SPA as a new or enriching strategy for arts and health collaborations in the U.S. Download an enhanced transcript (with links).
For more resources on this topic, please reference this document which includes research and studies, reports, programs, and initiatives developed, researched, and/or supported by Tasha Golden, Sudha Shreeniwas, and Käthe Swaback.
SPA Initiatives in the U.S.
A word cloud of responses and testimonials from participants in the CultureRx Social Prescription Pilot Program launched at the Massachusetts Cultural Council. Credit: Massachusetts Cultural Council
The following initiatives stand out as models in the U.S. landscape, with a selection being led by SPA specialists featured in our roundtable discussion. Although each initiative is distinctive, together they offer the beginnings of a framework for a national SPA agenda.
CultureRx, Massachusetts
CultureRx, a three-year pilot program launched in 2020 at the Massachusetts Cultural Council, is the first fully developed Social Prescribing for the Arts (SPA) program in the U.S. This statewide pilot aims to, “advance the wellbeing of Massachusetts residents and to provide a U.S. model for improving community health via increased access to arts and culture.” The program is soon to move into a fourth phase. With 12 diverse health services and cultural agency partners, participants of all ages, and dedicated staff, CultureRx offers an instructive example of how social prescribing for the arts could help address social determinants of health while expanding access to culture in the U.S. In addition to completing the complex program, a parallel evaluation was carried out by an independent research team. The researchers developed a tailored approach to assessing the effectiveness of the program for participants, partner organizations, and health care providers. The final evaluation offers a model for other complex, multi-partner, geographically distributed projects. The conclusion to the evaluation states that, “…integrating arts/culture assets into health and social care approaches can enrich and improve traditional U.S. models of community referral.”The Cleveland Clinic, Ohio
The Cleveland Clinic is one of the few hospitals in the nation that is incorporating SPA into its clinical practices. Under the leadership of Dr. Ardeshir Hashi, Chief of Geriatric Medicine, a team has organized a program that emphasizes community activities, including participatory arts, over medications or procedures. Clinicians interview patients about their interests and health goals and work with a referral specialist to connect participants with local cultural opportunities. Dr. Hashmi states that this approach means “really digging in to understand each patient’s personal priorities – the things they live for.” This program offers not only an example of a hospital based SPA program; it also provides a beacon for other physicians and hospital administrators who need to see peer-led programs before launching their own SPA initiatives.University of North Carolina Greensboro, North Carolina
Dr. Sudha Shreeniwas, PhD, Human Development and Family Studies Professor at the University of North Carolina at Greensboro, is lead investigator on an international research project designed to determine whether and how SPA could be effective as part of the U.S. healthcare system, particularly for older adults. “Encouraging arts participation can work as a lower cost health intervention,” says Shreeniwas. “It can improve a range of physical and mental health conditions.” To date, she has carried out a portion of the international interviews and will soon be examining projects in the U.S.National Organization for Arts and Health & Social Prescribing USA
These two national organizations provide organizing bases for SPA activities and advocate for increased integration of arts and health services. These groups may be instrumental in building a constituency for SPA.New Jersey Performing Arts Center, New Jersey
The New Jersey Performing Arts Center is the site of an arts and health program to, “leverage the power of the arts to encourage mental health and well-being.” The Center aims to, “find new ways to tie public performances, arts education, and community engagement to health and wellness.” Although this program is not strictly Social Prescribing for the Arts, it does reinforce SPA goals, especially in terms of closing the gap between low income communities and the performing arts.Dr. Alan Siegel, Contra Costa Regional Medical Center, California
Individual physicians are embracing SPA and carrying out practices that advance new thinking about ways people can heal through arts participation. Dr. Alan Siegel, for example, a family physician based in California, and a co-founder of Social Prescribing USA, has been instrumental in building a network of health professionals committed to social prescribing.University of Florida Center for Arts in Medicine, Florida
Academic institutions offer another path towards greater awareness and understanding of SPA in the U.S. For example, the University of Florida Center for Arts in Medicine, organized and hosted, “Creating Healthy Communities Convening” in October 2022. SPA was a topic of discussion, along with health equity and the role of the arts in health. These kinds of convenings are essential for stimulating new ideas and gaining momentum for changes in practice.
What Can We Conclude About the Future of Arts and Health for Older Adults?
"People are recognizing that it takes leaders and influencers from the community to create change. Change is truly possible for people when funding is backed with deep listening in communities that are given the tools and resources to be able to heal themselves. This change is deep, powerful, and replicable to every city."
— Vanessa Ford, Care Coordinator for CultureRx: Social Prescription and Project Manager for the Trust Transfer Project at the Community Music School of Springfield
In conclusion, social prescribing is merging an intersection between arts and health in a sustainable and accessible way for older adults. Through awareness, accessibility, partnership, and trust, this approach has a growing potential to thrive in the arts and health field across the globe and create visible pathways to wellness, especially for older adults in the U.S.
In our roundtable discussion, Swaback presented two thought-provoking questions: 1) What is going to be the prescribing model?; and 2) How can arts/culture and health sectors build an alliance with social determinants of health at the roots of social prescribing? The answers are still being researched and explored through the diverse and robust pilot programs happening globally, but as Swaback and Golden stated, the social change around this practice, “...needs to be an advocacy for us all.” This movement is not only about making non-clinical prescriptions more accessible and diverse, but also about shifting mistrust, stereotypes, and negative attitudes about healthcare among the youth and older population. Most importantly, it’s unveiling new ways for older adults to rediscover and redefine their worth and journey to wellness through sustainable and research-backed arts/cultural programs.
Share Your Thoughts and Resources on Social Prescribing for the Arts!
We invite you to respond to the following reflection questions below in an effort to continue the dialogue and research on SPA, and share additional efforts that are happening in the U.S. and beyond on The Creative Aging Resource Website. Please respond to the following questions in the comment section below and/or submit your resources via the form linked below.
What are the challenges to enfolding SPA into older adult health services – both internally and externally?
What are the challenges for integrating and implementing SPA from the perspective of local cultural organizations?
What attention would need to be paid to engendering trust in SPA across varied socio-economic and racial constituencies? This raises the issue of trust or familiarity in terms of cultural programming as well as health services.
How can we move beyond pilot projects? Can we envision some approaches to sustainable funding?
How does SPA relate to creative aging? Where is the overlap? Could we envision scaling up creative aging as a consistent vehicle for implementing SPA, or vice versa?
Lifetime Arts Says Thank You to Diantha Dow Schull
Following the publication of this issue, our dear friend and creative aging mentor, Diantha Dow Schull, will be stepping away from her current role at Lifetime Arts as the writer, researcher, and curator for The Creative Aging Resource Website and Journal. We are incredibly grateful for her contributions to Lifetime Arts’ growth and impact over the last 15 years. As a cultural organization program specialist, she has helped develop major national creative aging programs for public libraries in collaboration with Lifetime Arts. Diantha’s work underpins our success in making the case for creative aging throughout hundreds of cultural systems across the country. In her latest role, she has helped us curate over 600 resources on The Creative Aging Resource and developed seven robust and thought-provoking scholarly journals on diverse creative aging topics. While we say farewell to Diantha in this role, she will always remain a valued partner to Lifetime Arts.
Diantha is Principal and Founder of DDSchull Associates LLC, providing advisory and training services for museums, libraries, foundations and nonprofits. She has written articles and books for museum and library professionals, including, Boomers and Beyond: Reconsidering the Roles of Libraries, with Pauline Rothstein, PhD.