Stop & Talk

Singer 0:00
Stop talk to me.

Crystal Page 0:02
Hi grant.

Grant Oliphant 0:11
Hey Crystal,

Crystal Page 0:12
how are you today?

Grant Oliphant 0:13
I am good. You know, mostly good. These are complicated times.

Crystal Page 0:17
I agree. But we're back on stop and talk, and who's our guest today?

Grant Oliphant 0:22
Well, we're gonna, we're gonna be talking in this episode with Chris Appleton, who is the founder of an entity called Arts pharmacy. And Chris is a really smart guy who comes out of the nonprofit sector, but he has been devoting himself in recent years to the idea that by using the arts, we can help people address mental health issues in a way that will stand up to the standards and scrutiny of health providers and insurance companies. And the simple ideas is just that by using the arts in in their fullest, most natural form, we're going to be able to help people feel more connected and more vibrant and more alive and maybe more connected with their own sense of purpose. So it's a it's a really exciting conversation that we're going to have with Chris

Crystal Page 1:20
Excellent. Sobasically, he's presenting the opportunity for me to get a social prescription. That's art, so I can-

Grant Oliphant 1:29
Right. He talks about a lot about this idea of social prescribing. And social prescribing is, you know, your doctor writes you a prescription for for medicine. But why can't that medicine be something that cures you or helps you in kind of a natural way, and through gathering with other people, experiencing an art form, maybe even contributing to that art form and and coming alive in a way that the arts can help people do now I want to caution at the front end, he's not suggesting that that replaces medicine as we traditionally think of it, but that it is its own kind of medicine that can add to the arsenal of tools that doctors have at their disposal.

Crystal Page 2:17
Sounds fascinating. Shall we dive in? I think we should. Let's do it. Let's do it.

Grant Oliphant 2:25
Chris Appleton, thank you so much for joining us grant. Thanks so much for having me today. It is a it is a real pleasure. This is kind of a new departure for us with bringing someone onto the program who has been not a local grantee in the community yet, although I think there are plenty of people who are who are pulling to have your work and your influence be woven through San Diego more, but somebody who's who started off your iteration with us as kind of an inspiration For our work. And, you know, we just announced a major initiative for the foundation called Healing Through nature and arts, which was in no small part inspired by arts pharmacy and the work that you have done to get people to see to look differently at the role of art, and, by extension, nature into the world of of wellness and healing. And that's what we're going to talk about today, is, is how that came to be for you. You know what your what your original interest in it was, and I'm just going to dive in, if that's okay, with some questions about that and your journey, and what it's made you realize, and insights that you've had along the way. Sound good.

Chris Appleton 3:47
It sounds great. I look forward to the conversation. Thanks for having me

Grant Oliphant 3:50
today. Yeah, likewise. Well, let's start at the at the beginning, at least, of this journey for you. You You started two nonprofits before you started arts pharmacy, maybe we should just start by explaining to people, from your perspective, what arts pharmacy is, and then we'll talk about how you got there.

Chris Appleton 4:11
Sure, art pharmacy is a social prescribing company. We're based in Atlanta, but we work nationally social prescribing. Maybe we should explain that, please do practice. You know, the practice through which healthcare providers refer their patients or clients to non clinical community supports and art pharmacy is a company that that enables that for healthcare providers, for health systems for community based organizations, all in service. And as you've mentioned of leveraging the healing power of arts, culture and creativity to improve individual and communityhealth.

Grant Oliphant 4:52
So let's talk a little bit about then. And by the way, I'm sorry that I kept pluralizing arts, but I think of it as arts, so I. But, but in your name, it's art pharmacy. Tell us a little bit about how you came to focus on that. You know, how you got the idea for social prescribing and and your journey in the nonprofit space before that that helped you get there.

Chris Appleton 5:18
I have built a career when I was in college, two friends and I started a small arts and community development organization that was a college project that became a thing, and I ended up running for about 15 years until 2019 and through that work, it was really about integrating arts and culture into civic life, community development issues related to transit and housing. Through that work was introduced to the arts and medicine field and came to discover, certainly, I had witnessed through the work and witnessed in my own life the healing power of the arts, but came to discover through the arts and medicine, Arts and Health Research field, it's just an abundance of evidence that demonstrates that arts participation, arts engagement, can improve people's health outcomes. And it was, you know, like every good social entrepreneur, odd to me that US healthcare system hadn't bought the arts, you know, at scale and so, so, you know, the asking of why to, you know, why hasn't the system adopted the arts and really embraced the arts at scale, is the, is the, you know, beginning question that led to the development of our talk.

Grant Oliphant 6:35
See, I have to ask, what was your What was your answer to that question about why they hadn't, was it, if there was an abundance of evidence, the cynic in me would say it's because you can't patent or trademark it and and also it feels soft in a field that tends to adhere to hard medicine. You know the and drugs as solutions, and the concept of healing is that what, what was the primary factor in your discovery?

Chris Appleton 7:10
You know the science is, the science is actually pretty strong so and not just soft science, hard science. We know that engaging in the arts can reduce cortisol levels can have positive impacts on heart rate and blood pressure supports the immune system, improve brain function. We know these things. The unfortunate truth in the US healthcare system is that it's not only about can it improve clinical outcomes, not only is it about, can it improve people's health, but also, does it reduce cost of total cost of care? Is it less expensive than other interventions? Does it reduce the unnecessary utilization of, you know, other other healthcare services? And that is a piece that the arts and health research field has not yet really tackled, so it's done a good job of tackling. Does this improve people's health? We always need more, but we don't have challenges convincing physicians, health plan executives, policymakers. We don't have challenges convincing that can have a positive impact on people's health where there's still needed. More evidence is on on the economic benefit, not to society, you know, I think we talk a lot about the economic benefits to the of the arts, to society, the economic impact in you know, but, but can it really deliver to the bottom line of third party payers, Centers for Medicare and Medicaid Services and private health plans.

Grant Oliphant 8:44
So that was the notion with art pharmacy, was that you would intervene at at that level and and try and get, really, get this concept built into the core system of US healthcare,

Chris Appleton 8:59
correct? That's exactly right. That's what we are. That's what we're trying to do. It's very hard work, but we're making some progress.

Grant Oliphant 9:06
How does it fly with the notion of social prescribing? How does it fly with patience? In your experience, we cannot keep up with patient demand. Seriously, say more

Chris Appleton 9:21
people are hungry for connection. People are hungry for belonging. There is a mental health crisis in America. There is a social isolation and loneliness crisis in America. There are not enough available mental health supports. You know, the time to care for somebody, especially on individual, Medicaid, Medicare plans, the time to care to get an appointment to see a therapist, it's long and there's still a lot of stigma for some communities around seeking mental health support and social prescribing is. A less stigmatized, more available, more affordable, as effective intervention, more culturally responsive, more culturally accessible. Intervention for for people who are looking for alternatives,

Grant Oliphant 10:16
beautiful. Can you share some examples of of people who you've seen this work for, are there particularly compelling stories that help you illustrate this when you're talking about it, so that it comes alive for people who are hearing about it for the first time? There's

Chris Appleton 10:37
a story that I got just yesterday, so this will be my first time telling this story, because it just happened this past weekend. Yeah, one of the places where we work is in rural Massachusetts, and we work with a health plan there that refers members to us that are Medicaid, Medicare members. They're older adults. They're also economically vulnerable that have some risk factors for social isolation and loneliness and chronic disease. An individual was referred to us, and this is an older man, and he got connected to a theater in this small town that that he lives, went to that theater performance. But as a part of going out to that performance, I think it was on Friday evening. As a part of going out that performance, Friday, Friday evening also went out to dinner and came back to us and said, I didn't know. I left my house I didn't know all these resources the cultural vibrancy of this community that I live in. So not only is this social prescription providing me direct access to these very specific activities that our pharmacy is referring the individual to, but also opening him up to awareness of the other resources and assets that are in this community.

Grant Oliphant 12:03
Love that story in an example like that, instead of being prescribed therapy, and I want to talk about therapy in a moment, but instead of being prescribed therapy, he's being prescribed art. And in your model, you know, in the old model, the therapy model, somebody pays for theoretically helps pay for the therapist, and the counseling in this model is somebody paying for the arts experience.

Chris Appleton 12:36
That's exactly right. So in our model, not only does the individual this this older adult, this man, not only does he not have to pay to attend the theater, we also provided him with companion participation, so he was able to go with a friend, and we paid the theater for that, and and we're paid by by the health plan, by a third party payer.

Grant Oliphant 13:08
That's brilliant. It's it's such a, such an important innovation, I I'm curious, as we have rolled out our program in San Diego and been talking about this and trying to build a broader base of support for this work here, one of the things that I've really been thinking a lot about is how we talk about this, versus where we started, which was the clinical treatment and therapy model. And we started with that because we walked, we were created right in the middle of this mental health crisis. And you know, the epidemic of loneliness, the epidemic of disconnection, everywhere we looked in terms of the challenges facing young people, it surfaced, and it was clear. And what we kept hearing from traditional healthcare providers was, we are overwhelmed. We can't keep up there, you know, we, you literally cannot hire enough therapists. There aren't enough people to play the roles. And then, you know, but we, we tried, we we gave it the, you know, the old college try and funded some of that, and I think good things happened as a result. You know, certainly some people got access that otherwise might not have to those traditional services. But then we started looking around at the basic evidence of what's going on in society. So if, if the utilization of therapists is on an exponential growth curve, and the crisis of mental health is on an even larger exponential growth curve. You have to, at some point ask, is that the solution to this problem and and as we've, as we've looked at this program here, we want to be respectful of because we. Think there's a place for traditional therapy in this but we also think there needs to be something else that is disruptive and preventative added to the system. How do you talk about the relationship between a solution like social prescribing and and the traditional model of therapy

Chris Appleton 15:21
We think about social prescribing a long an acuity continuum, so social prescribing can and should be a true prevention methodology. Social prescribing can and should be an early intervention for people that are perhaps sub clinical, don't yet have a diagnosis of depression disorder and anxiety disorder, but maybe don't yet need to be seeing a therapist every every week or every two weeks. And then social prescribing is also an adjunct and a complimentary support to individuals with more serious and persistent mental illness that are in the care of a behavioral health provider. So it's really across the continuum. The challenge in, you know, being social prescribing, being all of those things is, well, those are three very different populations. Those are three very different payers. Those are three very different ways of serving people. And so organizations and programs that are delivering social prescribing need to really think about where they fit in, or if they have multiple, you know, ways of doing it. To be really clear about population selection, cohort selection, what is the goal? Back to an earlier question that you had regarding, you know, what's the, you know, what's the reason that US healthcare hasn't bought it? One of the challenges in US healthcare is the lack of incentives for prevention, right? We enter into 12 month contracts with our health plans, right? Well, prevention is not really about saving money within a 12 month contract period. Prevention is about saving money further down the road. And so why should a health plan pay for something today, when maybe I'm not going to be on that health plan in 13 months, when the cost saving shows up. And so thinking about those incentive structures that exist and making sure the right parties are at the table and every everyone sort of knows what they're working towards. Are we looking to prevent or are we looking to intervene and hopefully mitigate later, more acute effects of a mental healthdisorder.

Grant Oliphant 17:48
It's such a helpful answer, and I really actually complex answer, but I think a couple of takeaways for me are, first of all, in terms of the therapy versus social prescribing quandary that I raised, what you're saying is they're on a continuum. It's not either or. It can be complimentary, both and sort of depending on which population, which which challenge you're looking at. Correct Very much so. And then the the second thing I took away from that, that answer was, and we have to look at the way the system is set up, where it disadvantages any investment in prevention. Because, yeah, there are short term contracts that get reassessed every year. We actually have different payment streams for for different populations under different circumstances. How do you navigate that when really it feels like there ought to be a part of art pharmacy that is focused on policy advocacy, and I think there is, and you as a spokesperson and leader. But how do you navigate that?

Chris Appleton 19:03
Well, we try to work in partnership with other organizations that are, you know, much more well resourced than us, and have been doing advocacy for a long time in this space. I mean, there's some great organizations, the National Social national initiative around social isolation and loneliness, the foundation for social connection is doing really great work. There's an emerging organization called Social prescribing USA that's really trying to kind of be that advocacy, that grassroots advocacy organization.

Chris Appleton 19:37
So so much of the work has to happen in partnership, and, you know, shoulder to shoulder with with others, and social prescribing may sound new, but can I think so important to acknowledge, as evidenced by the 59 grantees that you all just support. You know, made announcement that this. Work has been happening for a really, really long time. We're talking about it as though it's new, and maybe some of the way it's being framed and talked about is new, but artists have been healers since the beginning of humankind. People have been using nature to heal since the beginning of humankind. And doctors and health systems have been doing referral, community referral, for hundreds of years. It's just that those two fields, right, the arts and culture field and healthcare field were ill equipped to work with one another. So we need better infrastructure to make it easier for them to do so

Grant Oliphant 20:33
I really so appreciate you pointing that out. It was something that leapt to the fore for us as we began to talk about this that you know there's a lot of ancient wisdom on the idea of creativity being a way of remaining connected and well, and of being out in nature being a way of remaining connected and well and combating depression and isolation. So you're right. This goes way back, and I think maybe it would be helpful for our audience just to hear a little bit more about why you think it works when we talk about the gentleman, for example, in the exam, the story that you shared with me discovering the vibrancy of his downtown so he has this isolated experience where he he feels good for a moment and, and that's a that's a great thing, but how does that become a deeper experience that helps him achieve a new level of wellness in his life? You know, I we had a we had a terrific experience in launching the 59 grantees and the $5.2 million initiative that we did yesterday in healing through nature and the Arts, where I happened to be present at one of our groups as We were rolling this out, and they absolutely insisted that we all start dancing with them on stage as they were playing instruments and sort of teaching us this musical genre. Which, okay, that was scary for me, because it forced me again. But I I noticed that the level of energy in the room, say there are 25 people in the room. The level of energy in the room at the beginning was, you know, what you would expect when everybody's coming together in a strange environment, and it's a meeting, and you know, meetings are deadly, and everybody's suspicious and wondering what they're going to experience and what they're going to have to do. By the end, everybody's laughing and talking and chatting and connected. So again, that's you can see. We all see it every day. I mean, we see experiences. But why do you think this works and and why does it what does it take to have it work over a sustained period of time?

Chris Appleton 22:59
Those are two. Those two last questions are so crucial, the why does the specific activity work? And then how does, what is the longitudinal, durational benefit of it? And how do we make sure that there is that duration,

Chris Appleton 23:17
I think, to the first part of why it works is a few things we do know that there are physiological things that happen in our body when we engage in creativity, and those benefits depend on what the activity is, whether it's dance or painting or a receptive experience of listening to music. So there's there's physiological benefit. There's also a great deal of power in having shared emotional experiences with others. It helps us feel connected to one another. You don't have to be talking to them. You could be sitting shoulder to shoulder, watching the same movie, watching the same play, have different perspectives on what happened was happening, but both having an emotional experience and and therefore we're better bonded to one another. And I think that that's a really powerful component of it. Arts and culture spaces create space for social connection and dialog and belonging,

Chris Appleton 24:22
I think, to the longitudinal, sort of longer term. How does it that? How do we make it stick? Think that's really important. I think that's one of the foundational pieces of research that informed our model. It's a study by Dr Daisy Fancourt out of the University College in London. It's a longitudinal study, I think, 8500 participants, that shows that regular engagement in the arts, not every day, not every week, but a handful of times a year, is really crucial to reducing loneliness, boosting connection and belonging. And so in designing social prescribing programs, you know, grantees or other organizations out there really ought to think about it's not just one dose that we're providing people, but we ought to be providing multiple doses, and there's got to be a mechanism to connect that first dose to the second dose, and the second to the third and the third to the fourth, and tying it to people's health goals or whatever aspirations they have for themselves. And that's that, that is, you know, really needed to integrate the healing power of arts and nature into long term health gains for the participant.

Grant Oliphant 25:45
And do you buy? I mean, I know you focused on, primarily on, on art and cultural experiences. I guess really just arts experiences. Do you buy the idea that this works as well with experiences in nature as much as it does with the arts,

Chris Appleton 26:04
there's plenty of evidence to show that engaging in nature is extremely beneficial. I'll speak for myself. Some of the time that I feel best is in nature. I spend a lot of time try to spend a lot of time in nature. We do have programs that are more cultural experiences. So, you know, botanical gardens are some of our partners and and then we do have some, some nature based programming that's a part of our, a part of our, our network. One of the thing, one of the advantages that the arts have relative to nature is something to do. I think actually, with accountability. There's an art class at 2pm on Saturday at the local community arts center, and so we're able to say to the patient, you've got an appointment at 2pm on Saturday at this venue, and there's going to be someone there, there's going to be someone there to receive you as you as you show up for your appointment, like you may for a therapist or some other kind of appointment. Some of that exists in the nature programming, but other times it can be, you know, here's the directions to your local park. Here's directions to this, you know, outdoor activity, but it's going to be totally self guided and on your own. And for individuals that are struggling, that are lonely, that you know, that that accountability is a challenge for them, that you know, other barriers exist, it's many times why they're seeking out, you know, these types of resources, it may be a challenge.

Grant Oliphant 27:44
Yeah so something that is, it's a, it's a really good point point. So something that is purely self directed, maybe more of a challenge. And, yeah, nature's there all the time, or we like to think it is. So sometimes we we need to steward it better to make sure that it will continue to be but that's a subject of a different podcast. I'm curious. You know, since you mentioned accountability, I'll ask this question now, how do you think about because you have to, you're working with some of the toughest business clientele in the world, how do you talk about accountability at the level of delivering value through social prescribing? What are the metrics that you use and that you point to when you're having a conversation with somebody that goes beyond a study of efficacy in theory, but now looks at efficacy in the actual practices applied as part of their business,

Chris Appleton 28:45
we think about process measures. So can you get people to enroll and participate? Right? If we get an eligibility file of 10,000 members and health plan X, Y, Z, can we actually get people to engage and participate? So there's some process measures that we think about. Then there are the health outcomes that we measure. We get baseline data on our members. We're using things like the UCLA loneliness index, the PHQ ads, which are standard tools for measuring depression and anxiety, the WHO five, which is a well being index, we get that data at intake, and then after each dose, we're measuring the efficacy of that dose, so we're able to see changes over time and the dose response for members. So that's the second big bucket. Is, you know, what is the what is the impact on the members, mental health and well being, and then, and then the third is really around healthcare utilization. And you know, can we prevent emergency department visits where there may be opportunities to do do so? Can we strengthen the relationship between the patient and their prime. Care provider, right? We know when someone has a strong relationship with their primary care provider that they're going to engage more in preventative services. Can we reduce a total cost of care? Right? So those are the things. We measure those things with our partners. We report to our partners on those things every month, because what we are doing is in some ways novel. We talked about in how other ways it's not novel, right? But because of what we're doing is in some ways novel, and the incentive structures here are very complicated and maybe oftentimes not favorable to more preventative care being rigorous on the measurement and reporting is is necessary for you know, to make, to make the partnerships that you're speaking to

Grant Oliphant 30:51
Chris, when you when you talk about those measures and and it's, it's a terrific set of measures that you have and very clear, and I imagine you list them with ease, but I imagine they're not easy to track or inexpensive to track, as you're talking to growing, you know, cadre, I think it's still early, but a growing cadre of nonprofits and foundations here and elsewhere that are Interested in this work, what's your advice to them about measurement and how to how to prove the efficacy of the model, to

Chris Appleton 31:27
have all the four key stakeholders, the patients, the prescribing partners that the cultural the, you know, arts organizations or nature organizations, and the third party payer at the table together early on. And I think philanthropy has a really important role to play in this that, you know, it's, it's, you know, there's, of course, an exception always, but you know, the health plan is unlikely to pay for it until there's more evidence in in San Diego or imperial, Imperial County, local to that that community, and so as a result, they often don't get invited to the table to set some of those success metrics early on. Right they they're they have the data and philanthropy can play a role in being the third party payer when, while also bringing the health plan and health system to the table to to set those clear metrics that need to be measured over time. Brilliant.

Grant Oliphant 32:32
Thank you. We'll we'll heed that advice.Appreciate it.

Chris Appleton 32:39
You already are.

Grant Oliphant 32:41
Well as I said, you know, the design of our healing through art and nature was so inspired by what you've done. You know, I think I just want to keep acknowledging that, that you have been a groundbreaker. And although, although there is a lot of ancient wisdom here, and you you are kind to say, hey, the model isn't new. It is a brave thing to to take something that that seems intuitively obviously true, and was, you know, has been around for a long time, but is totally and completely ignored as part of the establishment and the practices of our modern era. So I just, I just think it deserves to be said that even though you might be diminishing the originality of it or the innovativeness of it, it's very innovative and original.

Chris Appleton 33:35
Grant, thank you for saying that. We've got a wonderful partner in Massachusetts, Eric Holmgren, who works for the mass Cultural Council, and Eric opens sort of every discussion about about social prescribing. He does this so well, I'll butcher it, but he opens every discussion. He says, The only thing simple about social prescribing is the concept of social prescribing. It sounds just as you've said, right? It sounds so simple and so easy, but actually doing it is really, really hard,

Grant Oliphant 34:04
so interesting. You know, when I want to take us back for a moment to to the broader concept of what we're trying to do through social prescribing, and I as I was listening to you a question, as I was listening to you talk about the benefits for individuals, it also struck me, huh? It is not only individuals who suffer from a crisis of loneliness in America, it's society itself. We are living through an era where there's this incredible part of partisanship, incredible divisions in society, social media algorithms that drive us to maybe see each other in the most nefarious ways possible, and people are being, in a way, driven apart from each other. And they're not experiencing naturally in the way that they might once have, being outdoors, engaging with nature, or engaging with the arts and and so yes, it hurts them as individuals, but it also produces what we're seeing in the larger society. And I wonder, do you ever think about the work you're doing as a social cure as well as a as an individual health cure, or does that feel too grandiose for for the level at which you're trying to work?

Chris Appleton 35:35
I hope we are, I hope we're making some small impact. What you're sharing makes me think of what the outgoing US Surgeon General Vivek Murthy shared just last week as his parting prescription for America was community, and spoke just to the to the issue that that that you're speaking to is it's not just this individual disconnection that we feel. It is a it is a societal disconnection. And, you know, you get the Surgeon General's parting prescription, isn't, you know, injection for a weight loss drug. It is, it's a prescription for community. And that is, that is definitely what we need more of. It

Grant Oliphant 36:29
is that actually was a pretty powerful statement, you're right, and and I well, and it's why I it's what, it's what came up for me as I was hearing you talk. Because if we are getting people to address their own wellness issues through experiences of connection with the arts and nature, then maybe we're doing a good something good for the larger society that they're a part of as well. Feels like that should be true lot harder to measure, by the way, but maybe, maybe that's something we can work on and be helpful with. I'm curious, as we've talked about these programs, Chris, is there any? Are there any particular programs that art pharmacy recommends that we should talk about as part of this.

Chris Appleton 37:21
O love this question because it's happening all over the all over the world, all over the country. People are doing great work. There are some some research centers and research labs that I think people should know about, whether it's to support that work or just to learn from it right there, they're producing research. It's a repository of wonderful information. A few that come to mind are the neuro Arts Lab at the at Johns Hopkins, Susan Magsamen co authored a book with Ivy Ross of Google last year, called your brain on art. It's really about neuro esthetics and that that that's that work coming out of Hopkins, that Susan's leading people should definitely be aware of. The University of Florida, Center for Arts and medicine I always sort of talk about is, you know, being kind of the Center of the Arts and Health universe. The work that Jill Sonke pioneered at at University of Florida is incredible. The Jamil Arts and Health Lab, which is a collaboration of NYU, the World Health Organization, community, Jamil culture runners, many other folks are part of that work. There's great work going on at UCLA. There's these multi disciplinary and transdisciplinary research labs. I think are great places for people to look and while I have been, I think some ways today, speaking to a particular lens on social prescribing, that we've got a lot of conviction, conviction about of, you know, a certain, you know, certain way that we ought to be doing it. There's no wrong way to be doing it. There's no wrong there's no wrong way to do this work

Grant Oliphant 39:04
in a way you kind of just answered the question I wanted to ask you next. But I'm gonna ask anyway, because you might have a slightly different answer, which is, who are your heroes doing out there in the world? Who are either supporting what you're doing or doing what you're doing, or adding to the to the work. I assume that the folks you just mentioned are all on that list. But who else would you name?

Chris Appleton 39:28
I'm inspired by our team every day. You know our team at art pharmacy that they are mission driven people. You know you don't do this work unless nobody's doing it because they're getting rich. Nobody's doing it because it's easy. Everyone's doing it because they care deeply about both impact, the impact that we have on individuals and granted you spoke to earlier, hopefully leaving a little something behind for us. There's two.

Grant Oliphant 40:00
Yeah, I want to bring this back to you for a moment before we we zoom back out to close out. But I, you know, you have this interesting background, and it, it didn't start off in the health space per se. You know, if I, if I have, if I have my background info on you correct you were involved in, in, in voter participation, and, you know, sort of the more generic type of interest that we would see in the social advocacy space. Does this work feel complimentary to you,

Chris Appleton 40:43
it does I, I think of, you know, there's a, there's a long answer to this question. I'll try to give that. I'll try to give a really,

Grant Oliphant 40:53
Give the best answer. Don't worry about the language, yeah.

Chris Appleton 40:58
Resources show up to different kinds of organizations differently. And I think we have a long history in the United States of philanthropic resources showing up to support the vital life giving, healing, kinds of programs that so many wonderful artists, nature, you know, arts and nature organizations, community organizations, and those resources need to be more and we need, you know, we need it more frequently. Absolutely, we have not had the industry resources show up to support the same individuals those programs that we're speaking about are supporting and and so, you know what? What, what we're doing at our pharmacy, I went back to business school a few years ago to, you know, be a little better equipped to try to bring additional resources to support individuals and communities that otherwise lacked access to these vital programs.

Grant Oliphant 42:07
That's commitment, by the way, taking yourself back to basics to to learn how to do it differently and right. Good for you. It's admirable. What would you say are your top two or three goals for art pharmacy in the in the next five years.

Chris Appleton 42:24
My number one goal in for art pharmacy over the next, not five years, but over the next three years, is is for art pharmacy to be delivering services to members in all 50 states. That is a that is a huge priority for us, and in order to accomplish that, and this is, this is the second goal, to have irrefutable evidence that that the arts deliver the outcomes that are required for all four stakeholders in in that scheme that we talked about earlier, that that social prescribing delivers the results that everybody needs.

Grant Oliphant 43:06
That's fantastic. I guess I should turn the last couple of minutes over to you to ask you, you know what you hope our listeners will will take away from this conversation. I know you're a busy guy, and taking time out of your schedule to to speak about the work is part of how you view your job, but it is also, you know, takes you away from doing that job. So what? What do you hope our listeners and viewers will will think about this conversation and learn from it. I

Chris Appleton 43:44
hope that that while I'm sure there's a huge listenership for for this podcast, it's still relatively small to whoever's watching. You know, Prime Time Prime Time news, or

Grant Oliphant 43:57
I can promise you it is.

Chris Appleton 44:00
And if you're listening to this podcast, you're doing the right thing, not by listening this podcast, though, yes, you're doing the right thing this podcast, but if you're do if you're listening to this podcast, have faith in the work that you're doing and that the organizations and people that you're working with are doing. You don't end up in doing this kind of work for the wrong reasons. So, so that is, that is one thing I hope people know. You know, sometimes it can be hard to sustain the energy that is required to do this longitudinal work, this generational work, right? Like we're trying to bring into an existence, new ideas, new models, new ways of paying for things, and that is really, really hard work to do, and so just know you're doing the right work. The second thing that I hope people hear is that there are a lot of other. People that want to do it with you, invite them to your tables. Show up to their tables, maybe another. And this has been, this has been a lesson for me as a, you know, career nonprofit executive turned you know, social entrepreneur founder, is that the private sector isn't waiting. The private sector is acting much more quickly than than the nonprofit sector and the social sector. And it may be counterintuitive, but, but if you got a good idea that just might work, do it? Go for it. Be mindful. Be considerate, be thoughtful. Ask the right questions, but take action. Don't be afraid to take action.

Grant Oliphant 45:48
I love both of those bits of advice, and I was going to ask you if you have any parting thoughts for the 59 organizations in San Diego that are part of our healing through initiative. And what I just heard you say was understand that it may be hard, but you're doing the right work, and if you have a good idea, act on it, and don't stand on ceremony or wait for permission, but get going. Anything you'd like to add to the folks in San Diego, just

Chris Appleton 46:18
that we hope to be out there with you sometime soon,

Grant Oliphant 46:23
Chris, I just want to say what a pleasure this conversation was. I I can see why you're making headway in this in this work, you bring a lot of passion and a lot of knowledge to it. I appreciate what you're trying to do. And I really do believe that what you're doing is an antidote to what ails us at a lot of levels, just as I believe that the 59 organizations here in San Diego and everybody else who maybe isn't part of this program, but is thinking about doing this work, or is engaged in it somehow else, in a in another way, really tapping into the desire that people have for creativity and flow and and to bring things into the world and to be connected with each other and awe and wonder, just saying the words makes us feel good. So why would engaging in it? Not so. I just want to say thank you very much for the doing the podcast, obviously, more importantly for doing the work and being a leader nationally on something that I think we really need to be paying attention to.

Chris Appleton 47:33
Well grant that's really kind to say, especially coming from you with just the incredible career and impact that you have had nationally, means a lot to me. So thank you.

Grant Oliphant 47:42
Thank you. All right, we'll be talking more. Thanks, Chris, thank you.

Crystal Page 47:52
Okay, that was an very interesting interview.

Grant Oliphant 47:55
There was a lot there, and you know, we are, I at least am sitting with a few thoughts about this, which is that, you know, in between when we spoke with Chris and now, when you and I are talking about this, a lot has happened on the science front. And I just want to say at the front end that investments in science of all kinds matter hugely, and the more we invest, the more we learn about what works and doesn't work and and what the work that Chris is doing is a as a fruit of a lot of that research, where we're learning about different ways of approaching really thorny challenges for our society. That's one thought I'm sitting with. Another thought I'm sitting with is that in in the work we've been doing with with Youth Mental Health and with mental health generally, and community wellness, part of what we're seeing is that the the model that depends on on therapy and treating people after the fact has such is so limited in terms of the capacity of society to provide those services at scale and to actually help address the underlying causes. And what's exciting about Chris's work is that it does point away to how we can start investing in a culture and a community that builds mental health and and people who are better off simply because we're connected with new and different ideas in each other.

Crystal Page 49:33
Yeah, and to build on that, I think it's not just that he's built it out. We know we live in an economic model that has health insurance companies, no matter how people feel about them, but he's built out a model that's starting to work with health insurance groups, that makes it easier for nonprofits to engage these tiny little nonprofits who are offering a service or a chance to go to the theater. And he's building out an economic model that works for our current systems.

Grant Oliphant 49:34
I think. This is so key, and thanks for for going there, because what he is proving through his model is that there is economic value to this for health care systems and for health insurance companies. And you know, that's the way our health care system gets paid for. So it has to be paid attention to. And he is demonstrating that if you connect people with arts opportunities, it will actually help them in terms of managing health care costs. And obviously, Insurance insurance payments coming from that. So wouldn't it be better to invest in these preventive activities at the front end and save money and potentially save lives? Yeah,

Crystal Page 50:50
so it's good for the economy. It's good for you know, whether you have Alzheimer's or the story he shared about the gentleman getting back out into community and realizing there was more. And it seems like there's the physical benefits, right? You're getting engaged. Your mind is working more, but then there's the benefit of it feels like working through issues in real time, right? We're engaging with folks at dinner, talking to folks, or even the example you shared about going out to via international Right, right?

Grant Oliphant 51:20
Yeah, you know, I think it probably isn't a mystery about how this works, right? There have been studies, though, that have documented that it works, and we know a fair bit about the science of it now that experiencing arts, activities and events, and also, as we're discovering through our own programs on nature as well, that nature can have the same impact that it helps increase the neuroplasticity of the brain, it helps increase the sense of connection we have with awe and Wonder and something divine in the universe with each other. It gives us a deep appreciation of what community is about. Makes us feel connected to that. It has all these immense payoffs that on the surface, maybe we take for granted. And I, and I think we, we should pause for a moment and think about the society we're living in and why all of that is so valuable. You know, most of us these days, I myself included, spend a disproportionate amount of our time staring at this little screen. And we're, we're scrolling all the time on, you know, through through story after story that tells us about how awful other people are and makes us feel not like we're in community. It's such a lie to call that community, it makes it feel like we're disconnected from the rest of the world. And, I mean, talk about a paranoia machine, and, and, and what comes out through the arts is you get challenged with new ideas. You have a moment to think about them. You get to process that. You get to do it in community with others. It's just a wholly different and restorative experience. So I, you know, when I think about it, seems so obvious, and yet we struggle with the idea that that is somehow curative. Of Of course, it's curative.

Crystal Page 53:22
And to go further, to build on what you just said. So we know San Diego is a strong arts and culture economic market, right? We have so much talent here, whether it's poets, theater and like you said, we also have the outdoor resources, right? I've participated in in plays that have been out at uh, Mission trails or something like that, right? So it's, why wouldn't we take

Grant Oliphant 53:43
a very popular hiking destination,

Crystal Page 53:45
which we love as a new grantee. But you know, there's all these resources that are here that they're given. We don't have to build anything else. They're already here. So why not take advantage of that in a time where, you know, sometimes healthcare is hard to get, and don't get me wrong, those of us who have therapists, we love it, we need it, but there's also this element of supporting one another that now we're being told also just makes good economic sense. So why wouldn't we invest in this? Well,

Grant Oliphant 54:12
and you just, you just said some many things that were important. But one is, this is not an either or, you know, in terms of the clinical model versus a preventive model rooted in art or rooting rooted in nature. It is taking advantage of both, but acknowledging that there is this powerful resource available to us all, and it is in this community. It's widely available because of the arts assets that you talked about, and the natural assets that exist in abundance in this area. You know, it's fascinating for us as a foundation, because we're, you know, our areas of work are arts and culture, which many of the folks who are, who are listening to this podcast are. Watching it are involved with medical research, which is about finding new ways of treating and addressing illness and and then healthcare itself, and how we treat people once they're once they're finding that they need to be treated. And I think it is just such an eye opener, in a way that it maybe shouldn't be to realize that these other resources that exist in abundance around us can be helpful in improving the overall picture of human health and community well being. It's a wonderful gift, actually. So what Chris is, I think what, what Chris was really pointing to, is how to put a structure around all of that and and make it something that we are willing, in this society of ours to add value to and, or to ascribe value to and and to compensate people for taking advantage of it.

Crystal Page 55:58
Yeah, that that feels right. And I think whether we approach it from a scarcity mindset or an abundance mindset, right? Scarcity, we know that sometimes healthcare systems are stretched thin. Sometimes it's hard to get resources. So if you want to look at it from that angle, these are additional resources to build upon. From an abundance mindset, it's like we feel so much better. So there's there's the hard science and facts that point to this as an important thing. But then, as we know, because you just spoke at Creative Mornings, to tie things together, right? Like, yeah, there's like, a bunch of artists, hundreds of artists, that do all kinds of different things in our communities, whether it's like our CO producer Adam, who has a bubble gum machine that has poetry in it, right, all these things add up to our well being and our our feeling good, but being able to go forward, I think, and contribute more. And so I think the more we can get legislators to take this seriously, the more we can help healthcare system see it's possible that builds the San Diego that I want to live in, you know well,

Grant Oliphant 56:58
and I, you know, I think what you're what you're pointing to there, as is, is a really important point for us, maybe, to end on, which is that it it's not just a recent phenomenon that the way we've been talking to each other as a culture has been really negative about what the future looks like. So everything is dystopian and everything is scary, and doom is lurking around every corner, and you know, yeah, okay, because it often feels that way in modern life, because things are are sometimes feeling so out of control. But we have to, have to have to tell stories of connection and possibility. It is the only antidote to that that will work in the end and and it's not just artists and culture bearers who can carry that message, as it turns out, it's healthcare providers and it's medical researchers. It's certainly people who are working with young people like many of our grantees. Are I? It is I, you know, I think the, I think the responsibility we all have right now is to lean into what that looks like and to build that world, because no one's going to build it for us.

Crystal Page 58:20
Agreed, and I think in the meantime, I'd encourage all of our staff and talkers, that's your new name, to do is start to practice this. Right? I had gone on a work trip last year where I had a chance to watercolor. So I doodle almost every other night. Someone, I think our vice president, said a program told us, Hey, here's some research that shows if you doodle, even if it's bad doodles, it may extend your life 10 years. I'm like, I'm all in. So I have all my little doodles, my avocados and stuff, and I'm sure you're writing poems all the time, right?

Grant Oliphant 58:53
I am a lot good. Yeah? So by the way, I want to commend you on your your choice of outfits for today.

Crystal Page 59:00
I love your outfit too,

Grant Oliphant 59:04
All right. Well, it's pleasure doing this with you as always. Thank you for for being a fellow traveler on these important issues.

Crystal Page 59:11
Thank you Grant and thank you stop and talkers, take care.

Grant Oliphant 59:20
This is a production of the Prebys Foundation,

Crystal Page 59:24
hosted by Grant Oliphant

Grant Oliphant 59:26
Co-hosted by Crystal Page

Crystal Page 59:29
Co-produced by Crystal page and Adam Greenfield,

Grant Oliphant 59:33
engineered by Adam Greenfield,

Crystal Page 59:36
production coordination by Tess Karesky,

Grant Oliphant 59:39
video production by Edgar oniveros Medina,

Crystal Page 59:43
special thanks to the Prebys Foundation team.

Grant Oliphant 59:46
The stop and talk theme song was created by San Diego's Mr. Lyrical groove.

Crystal Page 59:52
D ownload episodes at your favorite pod catcher, or visit us at prebysfdn.org.