Branching Out: Tackling mental health inequalities in schools with community artscapers

卫生、社会保健和教育部门的专业人员越来越关注需要心理健康支助的儿童人数的增加，以及随后对心理健康服务的需求的增加。Covid-19大流行加剧了这种情况，据估计，可能有多达150万人因此需要增加或新的心理健康支持。关于Covid-19对儿童心理健康影响的研究发现，经常户外活动与更好的心理健康有关；支持之前的大量研究表明，与大自然的接触可能对健康有实质性的好处。尽管如此，孩子们花在户外的时间越来越少，这导致了社会对儿童与自然环境失去联系的担忧。一种新颖的方法是通过户外艺术，有证据表明，艺术可以帮助身体、认知、社会和情感的发展，以及改善心理健康和社会包容。因此，本研究将探讨如何利用社区志愿者（称为社区艺术家）在小学更广泛地实施由艺术家领导的基于自然的项目“生态能力”。决策者认识到需要创造适当的环境和背景来支持儿童的心理健康，以减少对心理健康服务干预的日益增长的需求；学校和教育机构已被确定为在提供这种支持方面发挥关键作用，但它们获得的资源却很少。目前的Eco-Capabilities项目探索如何通过与学校户外空间的艺术家合作来支持小学生的福祉。研究结果表明，与大自然中的艺术家合作对儿童的心理健康和福祉有积极影响，特别是那些有不良心理健康风险因素的儿童。“拓展”项目建立在这项工作的基础上，并将调查更广泛地扩展和实施生态能力项目的可行性。为了增加项目的可扩展性，将招募和培训社区艺术家来执行活动方案，从而增加至关重要的能力，并使项目能够在国家一级的学校中开发。这项研究将采用参与式方法，与来自学校、艺术组织、儿童心理健康慈善机构的利益相关者以及地方当局和NHS信托基金的代表合作；我们将共同制定一项实施计划，合作从当地社区招募志愿者，成为社区艺术家。这将通过两个并行的工作流程来实现：第一个将涉及对艺术组织的全国调查，以确定学校内外儿童的当前实践，以及未来参与该计划的兴趣。第二个工作流程包括三个阶段：首先，我们将与目前参与生态能力计划的艺术家和学校工作人员进行访谈和焦点小组讨论，以调查计划实施的挑战和障碍。其次，德尔菲技术（一项调查）将与全国以学校为基础的心理健康和福祉专家合作，利用社区艺术量表制定国家实施计划。最后，该计划将在不平等地区各种情况下的学校进行试点，以测试交付模式和实施计划的可行性和可接受性，并由更广泛的利益攸关方进行评估，包括来自支持儿童健康的更广泛卫生系统的代表。根据研究结果，将建立三个工具包，以支持可持续利益相关者群体的发展和大规模实施以学校为基础的自然艺术实践。

Professionals across health, social care and education sectors are increasingly concerned by the growing number of children requiring support for their mental health, and the subsequent increase in demand for mental health services. This has been exacerbated by the Covid-19 pandemic and it is estimated that there could be as many as 1.5 million requiring added or new support with their mental health as a result. Studies of the impact of Covid-19 on children's mental health have found that regular time outdoors is associated with better mental health; supporting a wealth of previous research suggesting that substantial benefits for wellbeing may be derived from contact with nature. Despite this, children are spending less time outdoors, leading to societal concern about children's loss of connection with the natural environment. A novel way to approach this is through art in outdoor places, with evidence suggesting that the arts can aid physical, cognitive, social, and emotional development, as well as improving mental health and social inclusion. Therefore, this research will examine how an established artist-led nature-based project, 'Eco-Capabilities', can be implemented more widely in primary schools using community-based volunteers (described as Community Artscapers). Amongst policy makers there is recognition of the need for creating the right environment and context to support children's mental health to reduce the growing need for interventions from mental health services; schools and education settings have been identified as having a key role in providing such support, yet they receive few resources to do so. The current Eco-Capabilities project explores how the wellbeing of primary school children can be supported through working with artists in outdoor spaces in school. Findings demonstrate that working with artists in nature has a positive impact on the mental health and wellbeing of children, particularly those with risk factors of adverse mental health. 'Branching Out' builds on this work and will investigate the feasibility of expanding and implementing the Eco-Capabilities project more widely. To increase scalability of the project, Community Artscapers will be recruited and trained to deliver the programme of activity, thus adding vital capacity and enabling projects to be developed in schools at a national level. This research will use a participatory approach, working with stakeholders from schools, arts organisations, children's mental health charities, and representatives from local authorities and NHS Trusts; together, we will co-produce an implementation plan for working in partnership to recruit volunteers from local communities to become Community Artscapers. This will be achieved through two concurrent workstreams: The first will involve a national survey of arts organisations to identify current practice with children both in and outside school contexts, and interest in future involvement in the programme. The second workstream consists of three phases: firstly, we will use interviews and a focus group with artists and school staff currently involved in the Eco-capabilities programme to investigate challenges and barriers to implementation of the programme. Secondly, the Delphi Technique (a survey) will engage with school-based mental health and wellbeing experts nationally, to enable the development of a national implementation plan using Community Artscapers. Finally, this plan will be piloted with schools across a range of contexts in areas of inequality to test feasibility and acceptability of the delivery model and implementation plan with evaluation by a wider group of stakeholders, including representatives from the wider health system supporting children's health. From the research findings three toolkits will be built to support development of sustainable stakeholder groups and implementation of school-based, artistic practice in nature at scale.