Social Prescribing: Doctors Who Recommend Game Nights

Social prescribing is when a doctor refers a patient to a community activity, not just a pill. How it works, what the evidence says, and where games fit.

8 min read

In parts of the United Kingdom, a patient who visits a general practitioner feeling low, isolated, or stuck can leave with a referral not to a specialist but to a gardening club, a walking group, or a weekly board game session at the library. The practice is called social prescribing, and it has gone from a fringe idea to a formal part of the National Health Service in about a decade. The United States is starting to catch up.

This article explains what social prescribing is, what the evidence suggests about it, and why game nights keep showing up on the list of things doctors recommend. It is not medical advice. If you are struggling, see a doctor; the whole point of social prescribing is that a doctor is in the loop.

What is social prescribing?

Social prescribing is a system in which health professionals refer patients to non-medical community activities to address needs that medicine alone doesn’t reach: loneliness, low mood, inactivity, lack of purpose, the slow grind of a hard life.

In the NHS model, a GP refers a patient to a “link worker,” a trained person whose job is to sit with the patient, understand what matters to them, and connect them to local groups and activities. The link worker follows up. The activity might be a choir, a men’s shed, an exercise class, an art group, or a game club. The 2019 NHS Long Term Plan set a goal of referring at least 900,000 people to social prescribing by 2023/24, and by the King’s Fund’s account that target was passed, with more than a million people referred and about 3,600 NHS-funded link workers in post by that year.

The idea is older than the name. Doctors have told patients to get out more for as long as there have been doctors. What social prescribing adds is infrastructure: a referral pathway, a person to make the connection, and a directory of things to be referred to.

Why would a doctor prescribe a social activity?

Because the research on social connection and health has become too strong to ignore, and because a large share of GP visits are driven by problems that aren’t medical in origin.

The U.S. Surgeon General’s 2023 advisory on loneliness summarized evidence associating social isolation with higher risk of heart disease, stroke, dementia, depression, anxiety, and early death, and made mobilizing the health sector one of its six pillars for a response. Julianne Holt-Lunstad’s 2010 meta-analysis, which underpins much of the advisory, found that people with stronger social ties had about a 50 percent greater likelihood of survival over the study periods, an effect the authors described as comparable to quitting smoking and exceeding obesity.

On the clinical side, a 2015 Citizens Advice survey found that GPs in England say they spend almost a fifth of their consultation time on patients’ non-health issues, such as relationships, housing, and work. A doctor with ten minutes and a prescription pad has little to offer for loneliness. A link worker with a list of Tuesday groups does.

The Harvard Study of Adult Development adds the long view: the people most satisfied in their relationships at 50 were the healthiest at 80, a better predictor than their midlife cholesterol. If that is true, then connecting a 60-year-old to a weekly group is preventive care in a real sense.

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What does the evidence say about whether social prescribing works?

Promising, but not settled. It is important to be careful here.

Evaluations of UK social prescribing programs have generally reported improvements in patients’ self-reported wellbeing, and a report covering nine local health systems found fewer GP appointments and less urgent care use afterward, especially among frequent users; one university study, though, found no evidence of an effect on loneliness. A 2017 systematic review found that of 15 evaluations, only one was a randomized trial, most had fewer than 100 participants, all were rated at high risk of bias, and the evidence was insufficient to judge effectiveness or value for money.

So the fair summary is: the research suggests social prescribing is associated with better wellbeing and may reduce pressure on health services, and the underlying science on social connection is strong, but the rigorous trial evidence on the prescribing model itself is still being built. Expect the picture to sharpen over the next several years.

What is not in dispute is the direction. A 2023 report from the UK’s National Academy for Social Prescribing counted activity in two dozen countries, including a national institute in Canada, a pilot running in Singapore since 2019, initiatives in several Australian states, and growing interest in the United States, and the Surgeon General’s advisory called on the health sector to treat social connection as part of care.

Where do games fit into social prescribing?

Game groups show up on social prescribing directories for the same reasons they work everywhere else: low barrier, built-in activity, and a natural reason to come back.

Consider what a link worker needs from an activity.

What a referral needsWhy game groups deliver it
Easy to walk into aloneYou sit down and someone teaches you
No fitness or skill requirementAnyone can play Ticket to Ride
Recurring, same time each weekGame clubs run on fixed schedules
Gives a shy person a roleThe game tells you what to do
Works across age and backgroundA game table mixes generations by default
Low or no costLibraries and community centers host for free

Libraries in both the UK and the US run weekly board game sessions that are, in effect, informal social prescriptions. Men’s sheds, which began in Australia and have spread widely, and memory cafes for people with early cognitive change are two more settings where a simple game often serves as the shared activity. We cover the research on games and cognitive aging in what the research says about board games and dementia.

The feature that matters most is the one we keep coming back to: a game gives the gathering something to do. A person who has been isolated for two years is not ready to walk into a room and make conversation. They can walk into a room and be dealt a hand. The conversation comes later, sideways, the way it does for everyone.

What is happening with social prescribing in the United States?

Less than in the UK, but more than a few years ago.

There is no national program. But the same international report points to growing federal and state interest in the social determinants of health, including the Centers for Medicare and Medicaid Services’ Accountable Health Communities model, created in 2016 and Kaiser Permanente’s community health work, and the Surgeon General’s advisory asked the health sector to take social connection seriously. Some U.S. programs use community health workers in a role similar to the UK link worker.

What the United States mostly lacks is not the research but the directory: the local list of Tuesday things that a doctor or a patient can point to. That is a gap third places can fill. A game lounge with a weekly open night, a library with a standing game session, a church hall with a card club. The infrastructure of social prescribing is, in the end, just a map of places where people regularly come together.

That is part of why the Ludarium exists. See why every city needs a place to play for the longer argument.

What can you do without waiting for a prescription?

You don’t need a referral to act on the research.

  1. If you’re isolated, find one recurring group. A library game night, a community center, a lounge. Pick one and go three times before deciding.
  2. If you know someone who is isolated, invite them to something recurring. Not a one-time dinner. A standing game. The second invitation is the one that matters.
  3. If you run a group, make it easy to join alone. Greet newcomers, teach the game, save a seat. Think of yourself as the link worker.
  4. If you’re a clinician, know your local Tuesdays. Social prescribing begins with a doctor who can name three things within five miles.

The LEV Institute, which the Ludarium works alongside, treats regular in-person play as a social and mental health practice worth building into daily life, with or without a doctor’s note. The game is the reason. The people are the point.

FAQ

What is social prescribing?

Social prescribing is when a health professional refers a patient to a non-medical community activity, such as a walking group, choir, or game club, to address needs like loneliness or low mood. In the UK, a link worker helps make and follow up the connection.

Does social prescribing work?

Evaluations generally report improved wellbeing, though results on loneliness are mixed, and the research on social connection and health is strong. Rigorous controlled trials of the prescribing model itself are still limited, so the evidence is promising rather than settled.

Can a doctor prescribe a board game night?

In systems with social prescribing, yes, in the sense of referring a patient to a regular game group. Game clubs appear on social prescribing directories because they are easy to join alone and give newcomers something to do.

Is social prescribing available in the United States?

Not as a national program, but pilots are growing, and the Surgeon General’s 2023 advisory encouraged health systems to address social connection. Libraries and community centers already run many of the activities a prescription would point to.

Be the Tuesday on someone’s list

The Ludarium is building a place in Indianapolis that a doctor, a link worker, or a lonely neighbor could point someone toward. New articles on play and health go to subscribers first. Subscribe to the Ludarium newsletter for new pieces on togethering for a lifetime.

Sources

  • social prescribing
  • what is social prescribing
  • social prescribing examples
  • link worker
  • loneliness and health care
  • community activities for health
  • Play and health
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