Social Prescribing for Children

After last week's blog on social prescribing and green care, I received a few emails asking - Is social prescribing used for children and young people?

Since I began researching green care and care farming in 2018 I've seen very little written about social prescribing, although that is now increasing, and I've seen even less written about wellbeing and health support for children outside of much more well known forest schools or farm education.

So this week I've done some investigation to see what I can find. 

In February 2020 the Evidence Based Practice Unit at University College London, in partnership with the Anna Freud Centre, reviewed the evidence for social prescribing in children and young people. They specifically considered the evidence base for how it helped mental health and or wellbeing. They searched four databases and literature published by organisations such as Public Health England, and after their screening processes, they found no records that met their criteria.

Why didn't the search find any records? While they can't be sure, the researchers have offered their thoughts which include: social prescribing is in its infancy; it may be complicated to adapt adult social prescribing methods to meet the needs of children; parents or carers may not agree with this method of treatment; health professionals may feel the health needs of the youngsters are too serious for this method of treatment; or there maybe a lack of accessible provision for children or young people to attend in their local area.  

My own research has found that only a handful of farms and gardens in the South East of England were prepared to take children or young people. Why is this? Based on my conversations with owners and managers of such facilities I have concluded that: most organisations won't take people under 16 years old and some others won't take people under the age of 13. Many organisations perceive taking children as more difficult than adults because they fear that they will need to provide further safeguarding training for staff and develop additional or more robust child protection policies.  Some felt they didn't have sufficient staff to meet the necessary adult to child ratios and others didn't feel they had appropriately trained staff on site routinely and were worried about the health and safety implications of taking children or young people. 

Could this be contributing to the lack of local provision or underuse of the facilities that already exist?  Well, I can't be sure. There is probably a combination of factors in play, but many owners and managers of farms and gardens tell me that they have yet to be contacted by doctor's surgeries or link workers to discuss what they are able to offer in terms of social prescribing. Perhaps some medical practitioners and link workers are not aware of the green care provision in their local areas or what they could offer? Children and young people may also be reliant on parents or carers to provide transport to the farm or garden, especially in rural areas due to limited public transport. 

I'll continue to update on social prescribing as we move through 2021. 

Social Prescribing and Green Care

When you feel unwell and make an appointment with your doctor, you probably anticipate that he or she may offer medication, tests or even healthy living advice but you probably don't expect to be prescribed a weekly art class or gardening club! This is the relatively new concept of social prescribing that allows health professionals to offer non-medical services to support a patient's health and wellbeing.

In 2019 I attended a regional presentation delivered by medical practitioners and attended by local voluntary service providers. The purpose of the session was to discuss social prescribing and explain why the NHS was funding pilot projects that considered the potential benefits of personalised approaches for patient treatment plans. These projects used link workers as the conduit between doctor's surgeries, the patients and the activity providers within the community. 

For some individuals with long term health conditions, mental health issues, or those suffering from loneliness or isolation, medication is not always the most appropriate answer. Offering activities such as sports, cookery classes, lunch clubs or one of the many other types of pursuits available in the wider community could encourage individuals to meet new people and enjoy greater social contact, perhaps take up a hobby or learn a new skill. 

Green care activities such as spending time on a care farm, in a community orchard, working with a gardening group or as part of an allotment association, are all excellent options for those being offered a social prescription. Indeed, this is a fairly common approach in parts of Europe and health practitioners frequently refer clients to farms and gardens as a part of their treatment plan. Part of my Churchill Fellowship research will examine specifically how farmers in Italy, Norway and Ireland have diversified into care farming as a result of social prescribing and other commissioned services. 

Early research into the social and economic impacts of social prescribing are showing promising findings with more results being published all the time. From my own conversations with the operators of care farms and gardens, this may not have yet filtered down to those working on the ground (excuse the pun). For example, many of the owners and managers I spoke to in England, said that they found the referrals process to be very slow and that few clients were coming through the system. However, they remain optimistic that as the benefits of social prescribing become more well known, their services will be in greater demand. 

Family Growing Project Update and Supporting Parents and Children

This week I've spent three totally absorbing days on a 'Supporting Parent and Child Interaction' course. The programme was run by The Anna Freud National Centre for Children and Families and focused on developing the skills of the professionals who work with the parents of infants and younger children, using a positive model of child development and parenting, to help nurture the parent/infant bond. It was great to hear thoughts and examples from the other participants who were attending from across the UK, USA, Europe and Asia as well as from the course trainers themselves who had vast experience in the field.

As you will know, if you have been reading this blog over the last few weeks, I have been conducting a rapid research project. Subject to the findings of the research, I hope, in the New Year, to design a family growing project and the strategies and techniques described during this child and parent course, will enhance the programme aims and delivery, particularly for high risk children and their families.

My research has been considering the impact of the pandemic and lockdown on children and families and I have asked the question; 'Could a green care project offer families a chance to be together, in a quiet space outdoors, whilst learning a new practical skill or taking part in purposeful work?'

A handful of pieces of research into the impact on children of the pandemic have been conducted since the spring by organisations such as Barnardos and The Children's Society amongst others. While I'm sure its no surprise to find that many children have struggled emotionally with lockdown, you may not have anticipated that some children, such as those with social anxiety or young carers, have preferred online schooling and being at home to being in a formal classroom setting. 

For some families, spending more time together during lockdown has served to strengthen their inter-personal relationships but for vulnerable families, for whom daily life may already be a delicate balancing act of trying to keep on top of the challenges they face, perhaps due to poverty, mental health or other issues, this time may have caused significant distress. In a future blog I will share with you the experiences of green care organisations during lockdown and how this could be used to support families further.

 

Green Care, Transatlantic Workshops and Urban Growing in Canada

My Churchill Fellowship will see me travel to Italy, Ireland and Norway to explore green care and care farming in more depth. But for now, and with travel prevented by current Covid 19 restrictions,  I content myself with some virtual travel through zoom meetings, courses and emails.

In particular, I wanted to explore care farming in countries outside of Europe and you will know that over the past few weeks I have been speaking to farmers and growers in Australia, Canada and the USA. 

In September, I joined a Food for Resilience online workshop which was jointly hosted by green care organisations based in London, New York and Toronto and where we shared our Transatlantic experiences. I send a huge thank you to NYC Parks GreenThumb and Toronto Urban Growers for their warm welcome and taking the time to answer my green care questions relating to North America.

While social and therapeutic horticulture is thriving in Canada, care farming is in its infancy with only a couple of working care farms at present, Fiddlehead and Nourishing Hearts. They operate in a similar way to the European care farming model but crucially, were founded by social workers, and operate in a very child and family-focused manner and follow nature-based therapeutic and counselling approaches.

Social horticulture in Canada is not only found in the countryside, but also in towns and cities. Urban agriculture projects encourage every available space to be turned into community orchards, allotments and growing spaces for the use of the local community. As well as making friends, learning new skills, and investigating new ways of growing such as Hydroponics or Vertical Growing, these gardens and growing spaces lift the spirit as well as feeding those who attend.   

Green care projects and the Oxford Climate School

I have hopes of setting up a green care farm once my Churchill Fellowship research is completed. But while I'm waiting to travel to Europe I decided to focus on some of the other elements in my plan. My thoughts turned to any potential environmental issues and mitigations and knowing my limitations in this area I looked for some expert support.

So in early September I decided to apply for a place on the Michaelmas 2020 Oxford School of Climate Change and was delighted to be selected for the programme. The school is run by the Oxford Climate Society and offers participants an opportunity to gain an interdisciplinary foundation knowledge in eight core subjects. I look forward to my Thursday afternoon lectures and feel very fortunate to be hearing from some of the world's leading academics on climate change.

As the food cooperative producers consultation comes to an end and we begin our consumer market research I hope to apply what I'm learning from the programme in the design of the pilot food project. There will be more news on the potential food cooperative in future blogs.