The Social Prescribing Model
Prescribe community activities instead of just pills to treat depression
Social prescribing is an approach to treating depression and anxiety that emerged from the Bromley-by-Bow Centre in East London, pioneered by Dr. Sam Everington. Instead of simply prescribing medication when a patient presents with depression, the doctor connects them with group activities in the community: gardening clubs, art classes, cooking groups, or volunteer projects. The prescription is social connection and meaningful activity, not a pill.
The model works because it addresses two of Hari's core disconnections simultaneously: disconnection from other people and disconnection from the natural world or meaningful activity. When Lisa Cunningham, a depressed mental health nurse, was prescribed a community gardening group, she found that getting her hands in the soil alongside others who understood her pain was more therapeutic than any medication she had tried. The group studied for horticulture certifications together, building both competence and community.
The evidence supports this approach. Research by Brett Ford and colleagues found that people who pursue happiness through social and community connection achieve it, while those who pursue it individually do not. Social prescribing turns this finding into a practical delivery mechanism within existing healthcare systems.
- An antidepressant is anything that lifts despair, not just a chemical compound
- Healing happens in community, not in isolation
- Meaningful activity and social bonds address root causes that medication cannot reach
- The doctor's role includes connecting patients to their community, not just managing symptoms
- People need to be helped over the initial threshold of re-engaging when they are deeply withdrawn
- Acknowledge the IsolationRecognize that your depression may be significantly driven by disconnection from other people. Loneliness causes cortisol levels to spike as much as experiencing a physical attack. Accepting this is not weakness but a biological reality is the first step.
- Find a Structured Group ActivityLook for community gardening projects, volunteering organizations, group classes, or clubs that involve working alongside others toward a shared goal. The activity matters less than the combination of social contact and meaningful engagement.
- Cross the Initial ThresholdThe hardest part is showing up the first time when you are deeply depressed. Enlist a friend, family member, or healthcare provider to help you get through the door. Lisa Cunningham described being terrified to leave her front door but found that once she was helped over that initial barrier, her desire to reconnect surged.
- Build Mutual SupportAs you attend regularly, begin sharing your experiences with others in the group. When Lisa's fellow group member said 'I realized you are the same as me,' it was transformative. The recognition that your struggles are shared dissolves shame and builds genuine bonds.
- Expand and DeepenOnce the initial group becomes comfortable, consider taking on more responsibility within it, pursuing certifications together, or branching out into additional community involvement. The goal is to rebuild a web of meaningful human connections.
Lisa was a mental health nurse who became so depressed she could not leave her house for months. Traditional treatment was not working. Through the Bromley-by-Bow Centre, she was prescribed a community gardening group. Despite her terror at leaving her door, she began attending and found that working in the soil alongside others who understood suffering reconnected her to both people and nature simultaneously. The group studied for horticulture certifications together.
Dr. Sam Everington built the Bromley-by-Bow Centre in one of London's poorest neighborhoods after recognizing that his patients' depression stemmed from social problems that pills could not solve. He began prescribing community gardening groups and other activities, and found dramatic improvements. The approach has since been adopted across the UK National Health Service.