Healthy Young Minds: co-producing a nature-based intervention with rural High School students to promote mental well-being and reduce anxiety

一项早期干预计划将与农村高中学生共同制定，通过与自然和当地绿色空间的接触，促进心理健康，增强适应能力，减少焦虑。许多年轻人的心理健康状况不佳，特别是在2019冠状病毒病大流行之后，这在国家和全球都构成了重大的健康挑战。对气候变化、考试、身体形象和网络欺凌等问题的担忧加剧了人们的焦虑程度。Smith等人（2017）和Gilmour等人（2022）提到了越来越多的儿童和青少年心理健康服务（CAMHS）的转诊和漫长的等待时间。与自然接触与心理健康之间的联系在成年人（Mughal等人，2022年）和公共卫生中提到的益处（Masterton等人，2020年）中得到了广泛的证明，但对于青少年是否以及如果是这样，青少年如何接触自然以获得心理健康益处知之甚少，特别是在农村地区。由于地理位置偏僻、缺乏公共交通、宽带连接不良和难以获得服务，农村青年面临更多不利条件，这对心理健康产生了影响。《看我》（2018）发现，只有26%的年轻受访者会告诉别人，如果他们因为害怕被评判和不被认真对待而难以应对心理健康问题。对于那些在小社区寻求帮助的人来说，害怕被污名化是一个更大的阻碍，因为一些农村高中的学生人数不到300人，匿名是极其困难的。研究（Thompson, Lejac 2021; Allwood 2021）表明，对于那些经历额外支持需求、照顾责任、边缘化（例如LGBT+）和贫困的年轻人来说，这些困难更加复杂，而这些往往隐藏在农村地区。根据研究证据和专业精神卫生专业知识，联合制作方法增加了年轻人参与制定可获得、适当和可接受的干预措施以促进高中生心理健康的机会。合拍片将年轻人的生活体验与专业投入联系起来，加强干预设计。这一建议是基于布拉德利、埃利斯和泰勒对一群农村高中生进行的“建设自然资本”研究（创意基金）的发现。它介绍了二年级（S2）的学生研究绿色空间如何支持心理健康，并探索了他们如何在一个地区使用当地的绿色空间，在这个地区，年轻人的心理健康被高地社区规划伙伴关系“高地成果改善计划”和当地组织（如心理健康慈善机构Ewen’s Room）确定为优先事项。本研究的目的是：与农村高中生、同伴支持者和研究人员共同制定一种预防性的、基于自然的干预措施，以减轻青少年早期心理健康问题的焦虑，建立弹性，促进心理健康。确定、突出和解决农村高中学生的心理健康问题，并审查未来农村服务提供的挑战和优先事项。对合作制作活动进行研究和评估，以增加有关实践的知识，评估与年轻人共同设计的影响，并测试其在干预设计中的有效性。制定一个干预框架，在后续试点中进行试验，以测试可行性、衡量潜在影响、审查可扩展性并进行成本效益分析。

An early intervention programme will be co-produced with rural High School students to promote mental well-being, increase resilience and reduce anxiety through engagement with nature and local greenspaces. Poor mental health is experienced by many young people, particularly following the COVID-19 pandemic, and poses a significant health challenge, nationally and globally. Levels of anxiety are increasing, fuelled by fears about issues like climate change, examinations, body image and cyberbullying. Smith et al (2017) and Gilmour et al (2022) refer to the growing number of referrals to Child and Adolescent Mental Health Services (CAMHS) and long waiting times. The link between engagement with nature and mental well-being is widely evidenced in adults (Mughal et all 2022) and the benefits referenced in Public Health (Masterton et al, 2020) but less is known about if and, if so, how young adolescents access nature for mental health benefits, particularly in rural areas. Rural young people experience additional disadvantages, which have an impact on mental health, due to geographical isolation, lack of public transport, poor Broadband connectivity and poor access to services. See Me (2018) found only 26% of young respondents would tell someone if they were finding it difficult to cope with mental health because of fear of being judged and not taken seriously. Fear of stigma is an even greater disincentive for those seeking help in small communities where some rural High Schools have fewer than 300 pupils and anonymity is extremely difficult to achieve. Studies (Thompson, Lejac 2021; Allwood 2021) show these difficulties are compounded for young people experiencing additional support needs, caring responsibilities, marginalisation (e.g. LGBT+) and deprivation, which is often hidden in rural areas.Informed by research evidence and professional mental health expertise, the co-production approach increases the chances that young people will engage with developing an accessible, appropriate and acceptable intervention to promote mental well-being among High School students. Co-production connects young people's lived experience with professional input to strengthen intervention design. This proposal is based on findings from the 'Building Natural Capital' study (Ideas Fund) by Bradley, Ellis and Taylor with a group of rural High School students. It introduced second year (S2) students to research about how greenspaces can support mental wellbeing and explored how they used local greenspace in a region where young people's mental health had been identified as a priority by the Highland Community Planning Partnership 'Highland Outcomes Improvement Plan' and local organisations such as mental health charity, Ewen's Room.This study's objectives are:To co-produce a preventative, nature-based intervention with rural High School students, peer supporters and researchers to alleviate anxiety, build resilience and promote mental well-being in early adolescence when mental health problems often arise.To identify, highlight and address rural High School students' mental health issues as well as examine challenges and priorities for future rural service delivery.To undertake research and evaluation of the co-production activity to add knowledge about the practice, to assess the impacts of co-designing with young people and to test its efficacy in intervention design.To develop an intervention framework to be trialled in a follow-on pilot which will test feasibility, gauge potential impact, examine scalability and undertake a cost-benefit analysis.