# ‘Obviously, you can’t outright ask’: what are the barriers and facilitators to discussion of spiritual health within social prescribing? A study using semi-structured interviews

## TL;DR

This study explores how social prescribers discuss spiritual health with patients and identifies barriers and facilitators to these conversations.

## Contribution

The study provides new insights into social prescribers' attitudes and practices regarding spiritual health discussions.

## Key findings

- Social prescribers often use faith-based organizations for non-spiritual support.
- Barriers include fear of sensitive topics and lack of confidence in discussing spiritual health.
- Training and cultural change are needed to better integrate spiritual health into care.

## Abstract

Social prescribing aims to provide holistic care to patients and meet needs that expand beyond the biomedical model. Holistic care includes spiritual health. However, the understanding of social prescribers’ attitudes towards discussing spiritual health with their patients is limited. This study aimed to understand how spiritual health currently fits into social prescribing and explore barriers and facilitators to incorporating spiritual health within social prescribing practice.

Twelve social prescribers were interviewed online, using semi-structured interviews. These interviews were an hour long and covered aspects of spiritual health within social prescribing, as well as barriers and facilitators to the discussion of spiritual health within social prescribing. Thematic analysis was used to analyse the interviews by three researchers.

Currently, social prescribers use community faith-based organisations mainly for non-spiritual holistic support, especially around practical items. They identified an overlap and limited differentiation between spiritual health and mental health. When a patient discloses spiritual health needs, social prescribers felt they were open to helping patients access help.

Barriers and facilitators to the discussion of spiritual health included: viewing religion as a sensitive topic and a subsequent fear of ‘deep conversations’; concern about harm or offence to vulnerable patients; social prescribers’ comfort and confidence with the topic being part of their role, as well as discordance/concordance with patient beliefs.

Social prescribers appeared very open to the topic of spiritual health; however many felt more confident with non-traditional-Western spiritual activities such as yoga or meditation, and using community faith-based organisations for non-spiritual support. Bespoke training for those in primary care could address barriers to the inclusion of spiritual health in primary care, but a systemic cultural approach is needed.

The online version contains supplementary material available at 10.1186/s12875-025-03060-0.