A key principle of sustainable healthcare delivery is prevention. In the mental health space, the preventive health benefits of fruit and vegetable consumption are acknowledged and supported by research.1 However, when it comes to children and adolescents, increasing uptake of healthy behaviours can be challenging.
Being involved in the process of growing food in an outside space improves behaviour, increases consumption of healthy food 2 and has been shown to improve mood and self-esteem, reduce anxiety and improve attention span.3
A place to grow and play
To facilitate the uptake of healthy behaviours in children and adolescents, the project team established a vegetable garden and outdoor play area at Ellimatta House, a mental health service in Port Macquarie. The service provides care for patients up to the age of 17 experiencing mental illness and distress. The existing indoor areas at the site are currently geared to adolescents and are not always appropriate for younger clients. The introduction of an outdoor area will allow children to play in a familiar environment and interact within a less intimidating space while they are engaged with clinicians. The gardening area provides a hands-on project to promote a shared goal between the clinician and client as they build rapport and work towards a therapeutic relationship.4
The project team planned and prioritised the best use of the space and engaged a landscape designer. The garden and play equipment were made from recycled and upcycled local timbers and supplies purchased from local businesses. The building phase took approximately three weeks, with weekend working bees with numerous volunteers. Once built, the space was introduced to the broader clinical team and explained how it may be used.
Positive engagement with young people
Staff and clients have reported that this project successfully engages young people, builds rapport between the client and the healthcare worker, and addresses barriers that exist in more formal clinical settings. A survey across 10 community health staff showed positive engagement with the grow and play space, with all participants reporting enhancements in their care delivery.
The initiative used sustainable materials sourced locally and continues to improve sustainability by composting organic materials from staff and diverting these from landfill. This project has garnered interest from other parties across NSW and throughout Australia who see the potential for scalability and enhanced client experience. While it will look different in each area, the principles of a sustainably built space to promote outdoor activities for child and adolescent mental health services could be adopted by other similar projects.
References
- Huang, P., O'Keeffe, M., Elia, C., Karamanos, A., Goff, L. M., Maynard, M., Cruickshank, J. K., & Harding, S. (2019). Fruit and vegetable consumption and mental health across adolescence: evidence from a diverse urban British cohort study. The international journal of behavioral nutrition and physical activity, 16(1), 19. https://doi.org/10.1186/s12966-019-0780-y
- Ruiz, L. D., Zuelch, M. L., Dimitratos, S. M., & Scherr, R. E. (2019). Adolescent Obesity: Diet Quality, Psychosocial Health, and Cardiometabolic Risk Factors. Nutrients, 12(1), 43. https://doi.org/10.3390/nu12010043
- Tillmann, S., Tobin, D., Avison, W., & Gilliland, J. (2018). Mental health benefits of interactions with nature in children and teenagers: a systematic review. Journal of epidemiology and community health, 72(10), 958–966. https://doi.org/10.1136/jech-2018-210436
- Jacob, J., Stankovic, M., Spuerck, I., & Shokraneh, F. (2022). Goal setting with young people for anxiety and depression: What works for whom in therapeutic relationships? A literature review and insight analysis. BMC psychology, 10(1), 171. https://doi.org/10.1186/s40359-022-00879-5
