Nature-based social prescribing for children across care settings: baseline findings from CONNECT

Background

Children and adolescents with psychosocial difficulties face barriers to mental health care, particularly in deprived areas. Social prescribing is a non-clinical, family-centered approach connecting children and families to community activities to improve wellbeing. It may foster psychosocial well-being and equity. The CONNECT project evaluates a nature-based social prescribing intervention.

Methods

We report baseline characteristics. Children and adolescents (6–17 years) with psychosocial difficulties were referred by professionals to a linkworker, who co-designed an 8–12-week plan prioritising nature-based activities. Caregivers completed the Strengths and Difficulties Questionnaire (SDQ; abnormal ≥17) and Parental Stress Scale (PSS), among other measures.

Results

Of 76 referred, 57 dyads completed baseline; recruitment is ongoing. Participants had mean age 11.2 years (SD 2.8), 52.6% girls; caregivers were 89.5% women, 82.5% mothers and 24.6% unemployed. Main referral reasons included anxiety, depressed mood, sedentarism/obesity and social interaction difficulties; school learning was most affected (60.5% moderate-to-severe), and 93% of difficulties had lasted over one year (SDQ impact supplement). Mean SDQ Total was 15.3 (SD 6.9), with 45.6% scoring in the abnormal (clinical) range and 10.5% in the borderline range (56.1% clinically relevant). Hyperactivity/inattention was the highest subscale (M = 5.9). Profiles differed by referral setting (71.4% in the clinical range in mental health services vs. 25.0% in primary care). Mean PSS was 30.2 (SD 7.6); SDQ correlated with parental stress (r = 0.42, p = 0.002).

Conclusions

Baseline data show a high and chronic burden of psychosocial difficulties, with over half of participants in the borderline or clinical range and school functioning most affected. Differences by referral setting highlight the need for tailored implementation and support nature-based social prescribing as a promising approach.

Key messages

• Over half of children presented clinically relevant psychosocial difficulties, highlighting unmet needs in underserved populations.

• Nature-based social prescribing may offer a feasible, community-based approach to improve child mental health and support families.