Cultural Prescribing: Concepts, Evidence, Implementation, and the Contribution of Socially Engaged Art.

Cultural prescribing is an emerging approach that connects people with arts, cultural activities, heritage, and culturally meaningful places to support health and well-being. It is usually situated within social prescribing and overlaps with Arts on Prescription, museum-based programmes, creative health, community arts, and participatory arts. However, inconsistent terminology and intervention models make its scope difficult to define. This critical narrative review clarifies the concept of cultural prescribing, summarizes its proposed mechanisms and current evidence, examines implementation and ethical challenges, and considers the contribution of socially engaged art. Existing reviews indicate that referral-based arts programmes can improve psychosocial well-being and may reduce anxiety, depression, loneliness, and social isolation, but the evidence remains limited by observational designs, heterogeneous interventions, selective participation, and insufficient long-term and economic evaluation. Cultural engagement may operate through emotional regulation, aesthetic absorption, meaning-making, identity development, learning, embodiment, social connection, place attachment, and collective agency. Implementation depends on trusted relationships, accessible and sustainable cultural infrastructure, adequate support for artists and community organizations, and attention to inequalities in participation. Socially engaged art is not synonymous with cultural prescribing, because it does not necessarily begin with a clinical referral or seek health outcomes. Nevertheless, its emphasis on dialogue, collaboration, shared authorship, and social transformation can extend cultural prescribing beyond the referral of individuals to pre-existing activities. Cultural prescribing can therefore be understood as a continuum from referral to participation, co-creation, and collective transformation. A relational and community-oriented model may be particularly relevant in Japan, where libraries, local festivals, traditional practices, and informal community spaces can function as cultural health assets. Future research should evaluate not only individual symptoms but also relationships, cultural inclusion, community capacity, and structural conditions.