Predictors of engagement in a hub-based social prescribing programme for children and young people with mental health difficulties: a quantitative service evaluation study

Background Social prescribing (SP) has been gaining traction as a complementary pathway to traditional mental health services to support children and young people especially given long waiting times to access specialised support. The connection with community-based activities is a key part of social prescribing but is currently underexplored. We know little about whether children and young people effectively engage with prescribed community-based activities and if some groups respond more readily to the opportunity to take up activities. Aims This service evaluation aimed to examine levels and patterns of engagement of children and young people with mental health difficulties within a SP pathway, addressing two research questions: (1) What are the patterns of engagement of children and young people with mental health difficulties within a SP pathway? and (2) What factors are associated with their engagement? Method Quantitative data from 231 young people in East London were used to describe the sociodemographic characteristics of these service users, and to identify their patterns and sociodemographic and referral-linked predictors of engagement in SP activities. Due to missing data, our analysis on patterns and predictors of engagement were from 146 young people only. Results Around 30% of children and young people engaged with the community-based activities they were connected to. No statistically significant associations were found between key sociodemographic characteristics and uptake: age (t(103.86)=-1.40, p = 0.163), gender (X2(1) = 1.33; p = 0.248), ethnicity (X2(2) = 1.75, p = 0.416) and deprivation index (t(75.79)=-0.09, p = 0.932). Similarly, no statistically significant associations were found for presenting need (X2(3) = 1.29, p = 0.731) and acceptance to access Child and Adolescent Mental Health Support (CAMHS) (X2(2) = 1.18, p = 0.554). Conclusions This is the first study of its kind to focus on understanding how children and young people with mental health difficulties engage with community-based activities as part of SP pathways. Study findings expand the evidence base on the implementation of SP as an intervention pathway for children and young people with mental health difficulties. We bring attention to the low-to-moderate engagement with prescribed activities but that there is no systematic bias across sociodemographic groups and presenting reasons. Suggestions for how to improve engagement with social prescribing-linked community activities are discussed.