Background Therapeutic Horticulture (TH) is a nature-based method which includes a range of green activities such as gardening to promote wellbeing It is believed that TH provides a personcentred approach that can reduce social isolation for people with mental health problems.

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Globally, there is increased recognition of a higher prevalence of physical ill health and mortality in individuals with mental health problems. A review of the literature highlighted the need to address deterioration in physical health of those with mental health problems through better recognition and management on the part of mental health nurses. However, mental health nurses have been found to lack confidence and be unsure of their role within this area. The aim of the project was to develop pre-registration mental health students' confidence to be able to recognise and manage physical health deterioration through the use of high fidelity human patient simulation, the development of contextualised clinical scenarios and additional theory around the A to E mnemonic structured assessment. The project involved 95 third year mental health student nurses, using a self-rating pre and post intervention questionnaire to measure their perceived confidence levels and to evaluate the effectiveness of the learning intervention. Findings demonstrate improved overall confidence levels in recognising and managing physical health deterioration in human patient simulators displaying mental health problems.

Purpose The purpose of this paper is to qualitatively evaluate the impact of therapeutic horticulture (TH) on social integration for people who have mental health problems. Design/methodology/approach A qualitative grounded theory approach captured the perceptions about TH from people with mental health problems. Data were collected using semi-structured focus group and interviews from a purposive sample (n=7) and were analysed using a constant comparative approach. Findings Four key themes emerged from the analysis: “a space to grow”, “seeing the person”, “learning about each other through nature” and “connecting to nature and others”. The findings suggest that TH enabled participants to integrate socially, engage with nature and develop confidence. Research limitations/implications TH is a potential approach that can help combat social isolation. The findings from this research have implications for people working towards supporting people who are socially excluded. However, this was a pilot study with a small sample size of seven people with mental health problems, whilst four key themes emerged, the saturation of concepts rather than the sample size were saturated to provide an emic perspective of the phenomena. Practical implications TH provides a person centred approach that enables people with mental health problems to re-engage and connect with their fellow human beings. Using TH could help improve the public health and well-being of local communities through re-connecting people to the environment and reduce social isolation. Social implications TH embody the principles of empowerment, person centeredness and can support people with mental health problems to integrate socially. Originality/value There is limited evidence about the influence that TH have on mental health and social integration. The use of TH is an area that is gathering evidence and this small study highlights the perceived potential benefits of this approach.

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