Seeding hope: restoring nature to restore ourselves. Nature restoration as an essential mental health intervention.

This commentary offers stories of hope and regeneration in the face of the interconnected crises we face. Those of us in the health sector have the opportunity to undo the false separation that has arisen between the care we offer ourselves and the care we offer our natural spaces. Access to a healthy environment offers myriad health benefits and has been declared a human right. Beyond this, cultivating a sense of kinship with the natural world unlocks further mental health benefits and promotes a deep sense of meaning and vitality. Widespread restoration of nature, combined with the equitable reconnection of people to these restored environments, must become one of the most important aspects of public health in this century. This paper, written from a UK perspective, describes examples where people are already weaving these strands together and offers practical suggestions for healthcare professionals who want to know how this relates to their role and their everyday practice.

Bringing nature into CAMHS inpatient services: reflections for the implementation and integration of training into practice.

Poor mental health is a global concern and is exacerbated by recent challenges concerning COVID-19 and the climate emergency, with significant consequences to individuals and to society. Increasing evidence demonstrates that nature-based approaches (NBAs) have numerous benefits to mental health services and the people they support with mental health needs. Despite these benefits, understanding how to integrate these approaches into practice is challenging. In this paper, we report our findings from a recent qualitative study with staff from a CAMHS inpatient unit who had recently undergone NatureWell Facilitator training. This is a particular approach to working with people in nature developed by The Natural Academy. Participants identified the importance of implementation of discreet, novel NBAs, as well as integrating nature into current practice, the benefits when fostering psychologically safe and therapeutic relationships with staff, and the clinical and operational factors when carrying out NBAs in these settings.

Debate: If not us, then who?

Child and Adolescent Psychiatrists have stressful jobs and huge caseloads, and are ideally placed to play an influential and meaningful role in responding to 'the biggest global health threat of the 21st Century': the eco-crisis. This article describes how a group of child and adolescent psychiatrists responded to the awareness that the impacts of the eco-crisis will increasingly undermine their daily work in the clinic. The article lists the progress this small group of committed individuals have made in raising awareness of the issues and what steps they have taken to guide and support other practitioners who want to play their part. Their future plans are set out with an invitation to join the crucial endeavour.

Wellbeing Wednesdays: nurse-led clinic for improving physical health care in a general adolescent inpatient unit.

BACKGROUND: Young people with mental illness are at high risk of physical health complications. Physical healthcare on a general adolescent inpatient unit is complex. AIM: To establish a wellbeing clinic to improve efficiency and quality of the physical healthcare offered and increase health promotion. METHODS: Plan, Do, Study, Act (PDSA) cycles were used to drive this quality-improvement project. The authors audited 12 records before establishing the clinic and 12 at three further time points (6, 18 and 30 months post-intervention) to guide changes. RESULTS: Results progressively improved over PDSA cycles. Time taken for initial investigations dropped. Compliance with medication monitoring and management of important physical health domains rose from zero in some cases to 100% in all but one area. CONCLUSIONS: Establishing a dedicated physical health clinic in this setting is feasible and leads to improved performance against local and national standards. Mental health teams need to ensure physical health is prioritised.

Climate anxiety in children and young people and their beliefs about government responses to climate change: a global survey.

BACKGROUND: Climate change has important implications for the health and futures of children and young people, yet they have little power to limit its harm, making them vulnerable to climate anxiety. This is the first large-scale investigation of climate anxiety in children and young people globally and its relationship with perceived government response. METHODS: We surveyed 10 000 children and young people (aged 16-25 years) in ten countries (Australia, Brazil, Finland, France, India, Nigeria, Philippines, Portugal, the UK, and the USA; 1000 participants per country). Invitations to complete the survey were sent via the platform Kantar between May 18 and June 7, 2021. Data were collected on participants' thoughts and feelings about climate change, and government responses to climate change. Descriptive statistics were calculated for each aspect of climate anxiety, and Pearson's correlation analysis was done to evaluate whether climate-related distress, functioning, and negative beliefs about climate change were linked to thoughts and feelings about government response. FINDINGS: Respondents across all countries were worried about climate change (59% were very or extremely worried and 84% were at least moderately worried). More than 50% reported each of the following emotions: sad, anxious, angry, powerless, helpless, and guilty. More than 45% of respondents said their feelings about climate change negatively affected their daily life and functioning, and many reported a high number of negative thoughts about climate change (eg, 75% said that they think the future is frightening and 83% said that they think people have failed to take care of the planet). Respondents rated governmental responses to climate change negatively and reported greater feelings of betrayal than of reassurance. Climate anxiety and distress were correlated with perceived inadequate government response and associated feelings of betrayal. INTERPRETATION: Climate anxiety and dissatisfaction with government responses are widespread in children and young people in countries across the world and impact their daily functioning. A perceived failure by governments to respond to the climate crisis is associated with increased distress. There is an urgent need for further research into the emotional impact of climate change on children and young people and for governments to validate their distress by taking urgent action on climate change. FUNDING: AVAAZ.

School-based interventions targeting stigma of mental illness: systematic review.

Aims and method To systematically review the published literature on the effectiveness of classroom-based interventions to tackle the stigma of mental illness in young people, and to identify any consistent elements within successful programmes. Results Seventeen studies were included in the analysis. A minority of studies reported a positive impact on stigma or knowledge outcomes at follow-up and there were considerable methodological shortcomings in the studies reviewed. These interventions varied substanitally in content and delivery. It was not possible to use this data to draw out what aspects make a successful intervention. There is currently no strong evidence to support previous conclusions that these types of intervention work for children and adolescents. Clinical implications When anti-stigma interventions for young people are rolled out in the future, it is important that the programme design and method of delivery have evidence to prove their effectiveness, and that the audience and setting are the most appropriate to target. There is a current lack of strong evidence to inform this.