Nature-Based Approaches in Child & Adolescent Mental Health a qualitative study of staff experiences

Introduction

There is a growing evidence base that spending time with or in nature can be beneficial, perhaps essential for health and wellbeing. Many different mechanisms may mediate change including parasympathetic and immunological response, attention restoration, sensory integration, increased physical activity and exposure to daylight.  Nature-based approaches (NBA) within mental health care can increase nature contact and utilise pathways to increase nature connectedness to improve outcomes for patients. Although traditionally NBA have been more the domain of social prescribing, a local project to embed NBA in a Child and Adolescent Mental Health Service (CAMHS) in the UK provided an opportunity to understand staff experiences of implementation and outcomes. 

Methods

CAMHS Practitioners from one NHS Trust in the South of England were invited to take part in interviews on the use of nature-based approaches in their work. Semi-structured interviews were carried out online, transcribed and analysed inductively using thematic analysis.

Results

14 people participated in the interviews.  The analysis covered: how organisational culture affected NBA take up and influenced how risk was perceived and managed; the practical implications of implementing NBAs; and NBA benefitted staff and patients in different ways and led to increased staff satisfaction.

Discussion

The findings show that whilst CAMHS staff are interested in and motivated to use Nature-Based Approaches in their work, there remain some challenges to making this happen in practice.  Understanding of the evidence of NBAs was variable, and previous experience and utilisation of nature in practice were important factors in staff confidence to use NBA.  Further research needs to consider how organisational culture is an important factor in NBA implementation.