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Three Lenses on CultureRx: Social Prescription

Käthe Swaback, Program Officer

image of a form for a social prescription, including fields for unique ID, date, city, prescriber, and signature. A logo of the cultural organization and a photo of some one participating in that organization's program
Sample Social Prescription Form

In 2020, Mass Cultural Council launched a new initiative with a unique vision for the future of arts and public health in the Commonwealth. We imagined Massachusetts as a place where culture is understood as an essential investment in health, both for individuals and for our communities. Over the past three years, through our Social Prescription Program, 13 cultural organizations and over 35 health and wellness providers have been prescribing cultural, arts, and nature-based activities, through a wide variety of partnerships that have worked hard to demonstrate what that vision looks like in action. In September, we will celebrate the work and broaden the perspective by releasing the publication, Arts on Prescription: A Field Guide for US Communities, which looks at how the arts, culture, and nature can offer protective factors and positive health impacts for those who engage. We are also pleased to announce the next steps for social prescription in Massachusetts.

Looking Back

Social Prescription integrates arts- and culture-based experiences with conventional healthcare practices, expanding them to include additional community resources for the benefit of support, connection, inspiration, and/or well-being of individuals and their communities. The benefits of arts and culture-based activities include fostering social cohesion, reducing healing time, improving access to care, supporting mobility and movement, promoting longevity, positively addressing mental health concerns, and supporting collective action toward shared health goals.*

The CultureRx: Social Prescription Pilot was developed from 2020-2023 and became the first statewide social prescription arts and culture initiative in the United States. The Social Prescription Pilot continued through June 30, 2023.

Learnings and Successes
In the midst of the pandemic and its challenges, organizations and providers were still able to create and fill over 1,220 prescriptions from 2022-2023 and approximately 1,940 prescriptions since 2020. This past year, over 35 healthcare providers and 10 cultural programs participated. A key learning was that in order for arts prescription programs to meet the needs of communities, it requires time and sustained commitment to building trusting relationships. It is also crucial for equity and inclusion to be central at every part of the process. When health equity is centered, prescriptions to arts and culture can improve social drivers of health by increasing access to community-based services and elevating the well-being of individuals and communities.

Other learnings gleaned from the Pilot’s 2023 final reports:

  1. Expand opportunities for participation for providers and cultural organizations. Broadening the programming to adjust to the patient’s needs and widening the pipeline of referrals with actively engaged prescribers have both been integral for the expansion of ways to participate. This proved especially true when, due to internal staffing restraints, several prescribers were not able to consistently refer patients. Making this process streamlined and effective while personal, collaborative, and inclusive is a challenging balance to achieve.
  2. Barriers need to be actively and creatively addressed. Barriers for attendees often include challenges in transportation, childcare, and language access. It was repeatedly noted that transportation access is a county-wide issue, especially impacting lower-income, elderly, and residents with disabilities. For staff in cultural organizations, trainings can help to alleviate the barriers to gaining knowledge in key areas (especially cultural humility, mental health, and in communicating impact). For example, Dr. Tasha Golden’s Trauma-Informed training and training in evaluations were praised for their relevance and usefulness as cultural staff gained greater awareness of what to consider when building activities and approaches in arts and cultural programming, along with how best to assess and communicate outcomes.
  3. Prescriptions help build connections to feel seen, heard, and supported. Although some cultural organizations, patients, and providers found benefits in providing total client anonymity, other prescriptions were utilized to provide connections and support among attendees. Some prescriptions were designed to include families/caregivers and to offer opportunities where they could meet, help, expand networks and support, and share resources with the wider community.
  4. Prescriptions can be utilized effectively in both limited doses and in long term engagements. Prescriptions can have incredible impact over many years, or just a few sessions. At Community Music Center of Boston, one participant was referred for attention and focus challenges, and after a few years, was taking full hour-long lessons. Another student immediately connected with a joyful new experience by learning about Bachata and Cumbia—fostering pride in the family’s cultural identity.

photo of a young man looking at the camera while holding a violin, the neck also pointing at the camera. His chin is on the instrument and he's smiling, the bow poised in the air to begin playing
A Community Music Center of Boston student before performing at Russell Multicultural Night. Photo: Rue Sakayama.

Cultural organizations fulfilled a wide variety of prescriptions ranging from museum memberships, summer nature camp prescriptions, and “Create and Restore” Saturday sessions for young people with disabilities and their caregivers. One young artist who had been given a prescription to participate at Community Access to the Arts (CATA) shared, “After coming to CATA, I feel more relaxed, more accepted even. I am less nervous around people and I feel really supported.”

Practitioners felt the benefits as well and represented a wide range of roles including behavioral health clinicians, high school counselors, pediatricians, social workers, nurse practitioners, disability-centric services, and child-life hospital staff. For example, one social worker who was a prescriber for the Clark Art Institute wrote, “Visiting the museum also helped the students understand that art is not just ‘pictures,’ but can be seen and experienced in many forms. The students did report feeling ‘calm’ and ‘happy,’ while visiting the museum. Thank you for providing our students with this opportunity.”

Another example is hospital staff speaking about Museum of Fine Art’s (MFA) Artful Healing Program at Boston Children’s Hospital (BCH), saying, “MFA offers our patients tools to express things in ways words can’t, which is essential to the holistic care of our kids. MFA has offered lots of opportunities for relationships to be built and patients a safe space to talk.”

MFA’s Artful Healing Program was able to increase their sessions for young people from 322 in 2022 to 956 in 2023. Programs like this, that have years of success are ready to expand even further when funding can support this important investment.

Celebrating Now

cover for Arts on Prescription Field Guide - geometric shapes fill the top part of the image and a row of logos is along the bottom
Cover art for Arts on Prescription Field Guide

Next week we are excited to announce a new resource for those interested in the practice of social prescription: “Arts on Prescription: A Field Guide for US Communities.” This guide was created in partnership between Mass Cultural Council, University of Florida Center for Arts in Medicine, and Dr. Tasha Golden. Rooted in growing evidence of art’s health impacts, this guide provides a roadmap for integrating arts, culture, and nature into health and social care via “arts on prescription” programs. The Guide offers key ingredients for building successful partnerships, evaluating impacts, creating streamlined systems for making and tracking referrals, and improving and scaling programs over time. It also provides views into case studies in the US, and numerous resources for additional learning and immediate application.

“From a health equity perspective, CultureRx: Social Prescription and other arts on prescription models make sense and have tremendous potential to impact people’s well-being. This Field Guide provides evidence of this and should serve as a blueprint for program development and implementation… Arts on Prescription not only provides access to cultural experiences for marginalized groups but gives those experiences the critical importance they deserve.”

– Rodrigo Monterrey, MPA, Senior Director of DEI and Health Equity, Tufts Medicine

Looking Forward: FY24

photo of a room of seated older adults all raising their arms while participating in a movement class
CultureRx Springfield’s Let’s Get Moving with Tracey Thomas.

This year Mass Cultural Council will partner with Art Pharmacy as the next entity to not only absorb the learnings from our CultureRx: Social Prescription Initiative, but also to expand the scaling of their successful model as they co-create with communities across the Commonwealth.

We are working closely with Art Pharmacy’s team to further cross-sector partnerships and build strong relationships with providers, payors, and health systems in its expansion within Massachusetts.

Art Pharmacy currently works with healthcare payors (e.g., insurance companies or state health systems) to solve mental and behavioral health treatment shortages with arts and culture prescription initiatives, in partnership with healthcare providers. Art Pharmacy’s network currently includes hundreds of arts and cultural organizations and healthcare organizations, along with providers ranging from medical doctors to social workers in primary care, behavioral health, oncology and palliative care.

For providers and cultural organizations who wish to become involved in prescribing or in facilitating arts and cultural experiences for patients/clients, please contact Art Pharmacy.

“We are excited about a new system that would empower potential patients with autonomy and freedom to choose a cultural experience that speak to them. Anything they can do to reduce the limitations and barriers to access for participants will be great, including making it as easy as possible on our healthcare providers so as not to burden the health field.”

Community Music School of Springfield

History of the Social Prescription Pilot

Social Prescription Research & Resources

*Golden TL, Feldmeth G, Terry A, Ahmadi-Montecalvo H. Arts and Culture: A Necessary Component to Address Unmet Social Needs and Advance Individual and Community Well-Being. American Journal of Health Promotion. 2023;0(0). doi:10.1177/08901171231188191

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