
British Doctors May Soon Prescribe Art, Music, Dance, Singing Lessons - pseudolus
https://www.smithsonianmag.com/smart-news/british-doctors-may-soon-prescribe-art-music-dance-singing-lessons-180970750/
======
notus
People may be dismissive of this but this is one of the best things that most
people who suffer from mental health issues can do. Every therapist I've seen
over the years has constantly pushed me to exercise and/or maintain a
consistent hobby. I was historically very dismissive of this idea and my
thinking was that my problems were unique (even romanticizing that idea
somewhat when I was younger). As I got older I just felt more alienated,
disconnected, and crazy. Certain medications helped but it was difficult to
stay on them. It wasn't until I was able to get into a workout routine and be
consistent with it for a while that I started to feel mentally "normal" again
or at least I stopped thinking that I was crazy and everyone else wasn't. The
thing that motivated me into this was pretty much terror and panic. I was
convinced I was losing it and everywhere I'd go the walls would close in and I
would freak out (pretty bad agoraphobia). Hopefully someone who is struggling
with mental health issues reads this and decides to make a change now instead
of waiting until it gets worse.

I know all of this sounds like some "wow thanks i'm cured" content and no it
will not cure you of your afflictions, but it takes the edge off of them so
you can actually focus on and confront your issues rather than barely holding
on.

~~~
natalyarostova
>(even romanticizing that idea somewhat when I was younger

Hah, me too. Nothing kills that romantic feeling of individualistic poetic
suffering like realizing your problems are actually because you are just a
glorified biological robot not getting sufficient exercise and nutrients.

~~~
dorchadas
I can third that. Though I think we also need to include the _social_ aspect
into it as well. Exercise and nutrients are needed, but I do think social
interaction is also needed. In fact, I've almost made it a point to _never_
turn down any invite simply because it generally makes me feel better, even
when I'm not in a depression period.

------
vorpalhex
My initial skepticism based on the title was overcome by reading the actual
article. Basically, it's no good to sit around in a bed popping pills and
wasting away. To that end, the UK is allowing GPs to more strongly encourage
patients to get out and be active with things like free tickets.

This isn't a terribly new idea, though it's still a very good one.

~~~
dehrmann
The best part is if it doesn't work, the side effects are negligible if not
beneficial.

------
red_admiral
Context: in the UK, healthcare is nationalised and seeing the doctor is free;
for a prescription you pay only a small, fixed charge (and even that's free if
you're under 16, over 60 or disabled).

So if your child has a cough and you get some Calpol from a pharmacist, you
pay the regular price, if you can convince your GP (or pharmacist, where
supported under the "minor ailments scheme") to prescribe you the same thing,
you get it for free. This is one reason why every winter the National Health
Service runs campaigns telling people "do you really need to see your doctor?"
and poor people in particular go "yes we do". I don't blame them.

(Google "UK Calpol for free" if you want to read up more on this.)

~~~
vkou
> This is one reason why every winter the National Health Service runs
> campaigns telling people "do you really need to see your doctor?" and poor
> people in particular go "yes we do".

The other reason (At least in the US and Canada) for why poor/'poor' people go
and see their doctor when they have a cold, is because their boss expects a
doctor's note for a sick-with-the-cold day.

Such campaigns are as much targeted at the patient, as it is at their
employers. Doctors don't want to deal with non-serious seasonal infections,
and they don't want patients seeking a doctor's note to get their other
patients sick.

~~~
red_admiral
Been there, done that.

Phoned up work to tell them I was on the first day of a bad cold and needed a
day off. They say no problem but you MUST get a doctor's note. So I phone the
GP and they tell me they can see me in 2 weeks' time, I go along as ordered -
the cold's completely better by then of course - and ask for a note to say
that I had a cold 2 weeks ago, which I duly get and hand in to my employer.
Everyone's happy, free at the point of service etc.

~~~
DanBC
Your GP was allowed to charge you for that letter, and if you were inside the
self-certification time your employer must pay the charge.

~~~
philliphaydon
Which country does this apply to?

~~~
DanBC
England. Sorry, I should have said. I don't know what happens in Wales or
Scotland or NI.

------
ScottAS
Encouragement is not a bad idea, and there’s nothing stopping doctors from
doing that today.

But the idea of “prescribing” an activity that is meant to be intrinsically
motivated seems misguided.

It reminds me of those kids growing up who’s parents forced them to do every
extra-curricular activity. They ended up -hating- everything they were made to
do. And from my anecdotal evidence, kind of miserable.

Creative activities require a real intrinsic desire to participate in them in
order to be joyful. Forcing them spoils them, and can make the participant
feel even more down on themselves (I’m practicing, why don’t I like it?).

I think the better alternative is for the dr to flesh out what things the
person really wants to do already, and continuously encourage them to go for
it.

Maybe what I’m missing is that by making it a prescription, medical insurance
will cover it? I guess that would be pretty great, as long as the person has
an intrinsic desire to do the thing.

~~~
acct1771
Parents do it all the time.

Nobody wakes up wanting to play the oboe.

~~~
Angostura
Oddly enough, my daughter did. No idea why at all.

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pcurve
Our northern neighbor is doing it too. I hope it catches on in the U.S.

"A similar campaign launched in Canada earlier this month, Brendan Kelly
reports for the Montreal Gazette. Beginning on November 1, every member of the
Montreal-based medical association Médecins francophones du Canada (MdFC)
gained the option of handing out 50 prescriptions allowing patients and a
limited number of friends, family and caregivers to tour Quebec’s Montreal
Museum of Fine Arts for free. Normally, admission costs up to $23 Canadian
dollars (roughly $18 USD). As MdFC vice president Hélène Boyer tells Kelly,
the initiative builds on research suggesting museum visits raise serotonin
levels to offer a quick mood-boost."

------
honkycat
I used to suffer from SEVERE depression in High School / College / Throughout
my 20s. I am also diagnosed bipolar.

It's amazing how much of my problems could be traced back to lack of sleep,
lack of exercise, smoking too much dope, and drinking too much.

The human body was made to be constantly strained and working out. Working out
is a requirement of successful aging. [0][1][2][3]

It sounds like that condescending claptrap you hear over and over again, but
hey: Maybe we are being condescending for a reason. Maybe you need
condescended to. Maybe we are sick of telling you that you need to get enough
sleep and work out to feel better. Even if it does not get you to 100%, it's a
start.

0: [https://www.nytimes.com/2018/10/31/well/move/being-fit-
may-b...](https://www.nytimes.com/2018/10/31/well/move/being-fit-may-be-as-
good-for-you-as-not-smoking.html) 1:
[https://www.nytimes.com/2018/06/06/well/weight-training-
may-...](https://www.nytimes.com/2018/06/06/well/weight-training-may-help-to-
ease-or-prevent-depression.html) 2:
[https://well.blogs.nytimes.com/2011/11/09/aging-well-
through...](https://well.blogs.nytimes.com/2011/11/09/aging-well-through-
exercise/) 3: [https://www.nytimes.com/2017/11/15/well/move/to-maintain-
mus...](https://www.nytimes.com/2017/11/15/well/move/to-maintain-muscle-and-
lose-fat-as-you-age-add-weights.html)

~~~
jat850
By "used to", it sounds as though you have navigated to a better place in
life, and that is great. When you look back, do you think that it is possible
that some of the bad sleep/lack of exercise/smoking too much dope/drinking too
much could have been owed to depression, instead of the cause of it?

I might be misreading your wording, but to my interpretation you're
attributing depression being caused by those things. I am only asking for
clarification because I have experienced some of those things, but also
depressive feelings, and I'm wondering - introspectively, and by asking you,
trying to learn from others - if it's easy to identify causes, and then learn
to address those causes.

(edit: wording was pretty awful)

~~~
honkycat
> ... could have been owed to depression, instead of the cause of it?

It's a viscous cycle, absolutely. For me it was DEFINITELY lack of sleep as
one of the primary instigators of my depressive episodes. Lack of sleep was
both a symptom and a cause of my depression. But, I know this: Getting more
sleep and living well would have solved a LOT of my problems. LACK OF SLEEP
was the thing to conquer, not this vague ennui I was dragging around like
Christ on the cross.

I went to school at night and worked 40 hours a week through college. I would
stay up late so I could have SOME AMOUNT of free time that was not occupied by
work or school. This would lead me to getting really behind on my sleep,
leading to poor performance at work and at school, and on and on. Graduating
and finally going to bed at a decent time is what REALLY helped me get on the
right track.

The research is very clear here: Sleep is absolutely an essential part of your
life, and you forgo it at your own peril. I know it's "cool" in the hacker
world to stay up super late and work on code all night, but in my personal
experience: The code they write at 2am will have to be rewritten by your
college who got enough sleep that night. And going into work worthless the
next day is not an equal trade-off.

~~~
jat850
Thank you for your response, and candor. It certainly gives me a better
understanding and new things to consider.

------
maxxxxx
Makes sense to me. In Germany you sometimes can get a few weeks at a spa
("Kur") to recharge your batteries. We often forget that in order to be
healthy we need something to feed our souls and for most of us that work
doesn't do this.

------
androidgirl
It's crazy how far behind the US is on mental healthcare.

I have been battling depression for a long while now. My insurance can only
get me to see an in network therapist four times every year!!! I can only see
a psychiatrist once every six months.

This is with paying an already ludicrous sum each month for healthcare. I feel
like I'm burning money, the most pressing healthcare issue I have, I cannot
get help for.

Regardless, I have been working really hard on improving alone.

~~~
dorchadas
I think there's two issues contributing to this in the US. The first is,
obviously, as you mentioned, health care costs and insurance. But I think the
bigger issue is stigma. Everyone talks about how it should be acceptable to go
get mental healthcare, but it still isn't. A lot of it has to do with the
culture of individuality and consumerism that has been forced down Americans
throats since birth. I think it's especially bad for men (and I am _not_
saying it's not bad for women, but I can only comment on my male perspective),
as there's the thought that we _should_ be able to hide our emotions and do it
alone; that we should be able to overcome everything through sheer willpower.
Basically, the Protestant mentality is driving us all insane. Sadly, I don't
really know of any good way to go about changing social norms in this regard.

~~~
philliphaydon
There is a bigger issue in the US than health care cost and stigma. And that’s
the kickbacks Doctors get for prescribing drugs to begin with. America has the
single largest prescription drug problem in the world.

------
zepto
Because humans need creativity and self expression in order to be healthy, and
not just a job?

~~~
PavlovsCat
> _Suppose that humans happen to be so constructed that they desire the
> opportunity for freely undertaken productive work. Suppose that they want to
> be free from the meddling of technocrats and commissars, bankers and
> tycoons, mad bombers who engage in psychological tests of will with peasants
> defending their homes, behavioral scientists who can 't tell a pigeon from a
> poet, or anyone else who tries to wish freedom and dignity out of existence
> or beat them into oblivion._

\-- Noam Chomsky

------
kolektiv
So, as a UK resident, I'm torn here. On the one hand, many people would
absolutely benefit from these things. It is appalling in our society how many
people suffer from something as ostensibly simple as severe loneliness, which
can cause significant mental and physical health problems. So yes, this sounds
great.

On the flip side... Mental health treatment in the UK is currently
dramatically under-funded and under-resourced. Waiting lists are stretched
beyond belief, and obtaining treatment is almost impossible for certain
conditions. (First hand experience - one fairly significant mental health
condition, but - ah! Only one! We only have enough resources to even try and
help people with two conditions - co-morbidity. Come back when you're worse!)
So two things - how much of this will in reality be pushed in an effort to
avoid prescribing more serious therapies that people genuinely need (but the
system can't manage), and how much of this would actually be available? It's
all very well telling someone with little to no means through ill health to go
and take up dance, or learn an instrument, but is that really on offer? Will
that really be funded and available in areas where currently there's an 18
month waiting list to see a simple counsellor?

(I thought I should pre-empt a possible reaction of "well, that's what you get
with socialist/communist/etc. medicine - <death panels> etc." \- there's no
inherent reason for this other than poor management, under-funding and
structural incompetence. It is definitely possible for the NHS to work well
again, but right now, the fact that it doesn't is more political than
theoretical. It would be like me pointing to the current shutdown in the US as
evidence that governments aren't possible.)

------
cik
In Canada, our doctors already do this - there's a social prescription that's
taken root the last year or thereabouts.

[https://www.thestar.com/life/health_wellness/opinion/2018/03...](https://www.thestar.com/life/health_wellness/opinion/2018/03/18/doctors-
are-starting-to-give-patients-social-perscriptions.html)

------
arethuza
A BBC article on the same subject:

[https://www.bbc.co.uk/news/entertainment-
arts-46111595](https://www.bbc.co.uk/news/entertainment-arts-46111595)

I'm sure it initially _sounds_ silly - but if it is shown to be clinically
effective then I'm all for it.

~~~
pseudolus
It does indeed sound silly but given what we know about the real and
measurable effects of placebos - why not art?

~~~
arethuza
Indeed, I'm sure ideas like washing your hands and drinking clean water also
sounded silly at some point.

[NB In the middle of reading a history of the Crimean war and you realise how
many aspects of basic hygiene were completely ignored as recently as the mid
19th century].

------
DanBC
It's weird that they're suggesting this may soon start: social prescribing
isn't new, even in the UK.

Recent announcements are that it is to become more available.

[https://www.england.nhs.uk/personalisedcare/social-
prescribi...](https://www.england.nhs.uk/personalisedcare/social-prescribing/)

The big announcement, and something that most commentary is missing, is that
this an effort to increase personalisation, and personalisation is a big part
of the integration (joining up social care and NHS care) agenda which is being
pushed by the current secretary of state.

------
gaius
What of those who already “self-medicate” with these things - will they be
subsided too or go on paying full price? What’s sauce for the goose is sauce
for the gander after all.

~~~
Angostura
The UK Arts Council does indeed already subsidise such medication

------
cityzen
A little off topic but interesting reading if you want to understand more
about how mental health is covered under health insurance:

[https://www.apa.org/helpcenter/parity-
guide.aspx](https://www.apa.org/helpcenter/parity-guide.aspx)

