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Welcome everybody to this breakout session about championing change. My name is Ben Whisker. My background is a mental health occupational therapist and I am the mental health lead and allied health professions lead at the Center for sustainable healthcare. My co chair today is Emma o'neill. Um Emma is a palliative care doctor in Yorkshire and in her spare time, she is a visiting lecturer in Planetary Health that leads medical school. And you may have seen Emma's presentation about planetary health and sustainable healthcare curriculum in the education breakout room earlier today. So very pleased to have our four presenters today. Um Maya Lindsey will be discussing being an Echo artist in residence and Rory Gibson will be talking about how they used Climate week to strengthen the community of practice across the north of Scotland, Eleanor Cook will be discussing the Climate Health School Card initiative and Ruth Coffee is going to be talking about bringing nature into psychiatric practice and how they've evaluated a Nature Based training course for psychiatrists. So the the first half of the session will be the presentations and then we will have the rest of the time being Q and A at the end. And so I would like to start by welcoming uh excuse me, I would like to start by welcoming Maya Lindley who is a first year BSC global sustainable development student at the University of Warwick. And prior to this, she worked as an eco activist in residents with black poor teaching hospitals, NHS Foundation Trust and she's here to talk to us about being an echo activist in residence. Thank you. Thank you. I will just share my slides. Now. Can everyone see that? Is that okay? So, um first, well, hi, thank you so much for letting me be here today. I'm really looking forward to hearing everyone else's presentations and I just like to tell you a little bit about the project and I worked on last year. Um So I'm originally from Blackpool, but I'm talking to you today from Warwick and sort of in between my, a level exams and starting university. I got to work as sort of a self employed eco activists and residents with Blackpool teaching hospitals, acting as my host organization. So to begin with, I'd like to explain how I found out about this opportunity in the first place because it's a little bit sort of unconventional and it is quite unique. So it finally, I found out about the job advertisement through the Boingboing social media, which I was following because I was a member of a Black Full Climate Co research group, another Boingboing project where myself and other young people had the chance to be on a co research team for a phd student focusing on climate change and young people's mental health. So the activists and residents project is created by Boingboing. So for anyone who doesn't know, and this is a foundation which aims to promote resilience, research and practice to improve the community. And my main contacts were in Blackpool, which at times my local area. So the project for me involved pairing myself with a host organization so that I could carry out an activist project of my choosing. And and so yeah, here are the basic steps. Instead of an interview, I proposed the project that I wanted to undertake, which I decided would be improving the underrepresentation of young people in environmental discussion's and and also to improve the networking between different groups within the community. And I decided that the best way to achieve these goals would be to create, to echo guides informed by discussion's between local young people. And also my hope organization, hospitals, green champions, the green champion roles at the time were very new. And I basically volunteer roles taken on by Blackpool, teaching hospital staff to the green ambassadors within the workplace. So I facilitated two rounds of discussion's. The first was a conversation between myself and each of the young people. And then the second was a conversation where the young people were paired with green champions to talk about ideas for the Echo guides. And then following this, I took their ideas and wrote and distributed the guides through social media and sort of the relevant websites from the organizations that taken part. So the first guide um which hopefully I can show it to you now or some excerpts from um was aimed towards the green champions to help them win in their new roles, to provide some guidance and some advice. And here are some sample pages and I know the writing might be a little bit small, but I can always share the links later on if people want to have a look in more detail. Some of the pages included inspiring messages from the young people, things that they wanted to say to the green champions and the impact of their positive actions, a sort of a motivator and the expectations of their role, sort of what they were getting into the impact they could have and how it can help the hospital and the area. The second guide um was a little bit more general. So it had some slightly different pages on it. This was for members of the public in the Blackpool area who want to make more eco conscious lifestyle choices. And as you can hear some of the pages included activities that they could do within their daily lives guides, the local recycling systems, because obviously, this can sometimes be a little bit confusing and again, some messages from the young people to help inspire them and motivate them to make more sustainable choices. And then there was some cross over within the guides. So some things that we included within both were advised on mitigating climate anxiety tips on how to spot and avoid greenwashing. So sort of false eco friendly marketing resources that myself, the green champions and the young people thought might be useful as well as some gel information about the project and who was involved in creating it. And these guides themselves are publicly available to view absolutely free of charge. And whilst they are aimed initially people in the Black Pool area. So some of the information is quite specific, most of it is relevant to people outside of the traffic and can very much be generalized. So in terms of the project, that was what I did and it was a really rewarding experience. I'm very glad to have been able to involve the community in creating something for them. And it's also very nice to be able to work within healthcare, which isn't necessarily something I expected as an eco activist, but definitely demonstrates that sustainability underpins or should underpin every sector of society. And then sort of my other main reflections so that people seem to really, really enjoy being given the platform in which they could voice their really thoughts on climate and environmental issues in connection with the local communities, which is something I very much related to as a young person involved in this field. And in that sense, it is my hope that the people involved in the project felt as though they gained something from it. In addition to providing a meaningful contribution to the sustainable efforts of the local hospital in the wider area. And in a broader sense, the project is something that I hugely support because it's been carried out with other young people and different host organisations. I think it's an amazing initiative that really helped me branch out and gained some incredible experience. Um not only showing that young people are gradually being taken more seriously within such discussion's, but also genuinely has built up my skills on a more personal level in a way that I think has already helped me within my studies. Um So for example, I was working within what was a technically self employed role. Um So it involved a high degree of sort of self motivation and organization that also came with a lot of freedom just as the project is intended to be having the chance to sort of fully decide what the role would entail is obviously quite unique and it's not something that you hear about very often. So I am very grateful to have stumbled upon that role at the right time just before I started uni and and finally being able to take on so many aspects of the project from sort of facilitating the discussion's to reaching out to organizations such as street life, a local charity for homeless young people and active Blackpool, which promotes active lifestyles to even designing the physical look of the guides. It really expanded my impression of what any activists could be. And so going forward, I definitely think I have a more open minded perception of how eco activism works both within healthcare and the wider community. So I would really recommend to everyone to explore how sustainability can fit into places that might not spring to mind automatically when you think of eco activism. And that's something I really hope that we've shared with the young people. I also want to reiterate the importance of networking and including young people in a really meaningful manner with an environmental discussion's more so than just a tick box exercise because as I hope the guides demonstrate this can be a really productive way to work. And that's really all I have to say. Um I do have some links with some information about the guides and access to the guides. Um I can always put those into the chat function if that's helpful. Um But yeah, that's it for me. Thank you very much. Terribly sorry. Um Yeah, so again, thank you. My, I had, I've never heard of an eco activists and residents before and really inspiring job title and great to hear about all the inspiring work that you did. Uh Well, we're saving up the questions for the end. So if you have any questions? Maya, please put them in the chat. And um, yeah, thank you again. I will now like to welcome Rory Gibson, uh a junior doctor, working as a medical education fellow at the Highland Education Center in the Nature. And Rory is going to be talking about how they used Climate week to strengthen a community of practice across the north of Scotland. Uh Over to Rory. Thank you, Ben. Although I appear to be having an issue with my slide deck. Oh, there we go. Can you see my slides? Yes, we, but now they've disappeared again. Sorry, I'm not quite sure what's happening when that. There we go. Okay. I won't jinx it but they're up. Okay. So, hello, everybody. Uh Sorry for that. My name is Rory Gibson and I am a junior doctor working as a medical education fellow at the Highland Medical Education Center based at Rate More Hospital in Inverness Scotland. And I'm delighted to have been asked to talk to you today on behalf of a collaborative team between N H S Highland and the University of Aberdeen about some work we did earlier this year at North with a presentation entitled Climate Week using a national sustainability campaign to strengthen a community of practice across the north of Scotland. So, what was it? And how did it all come about? Well, you don't need me to tell you that the relationship between healthcare and our natural environment is of growing interest and within medical education, we are of course also see an increasing enthusiasm for including sustainability within healthcare curricula. For example, within Inverness, we now have University of Aberdeen, undergraduate medical students learning about health care sustainability within their professionalism blocks and Scott Gen students undertaking sustainability focused quality improvement projects. However, at Inverness, we wanted to try to go that little bit further. So Climate Week is a Scottish government led campaign that has taken place annually since 2016, which intends to raise awareness of the global climate emergency and encourage climate Axion across the country. At at, at N H S Highland. We recognize this as an opportunity to raise awareness of the intersection between healthcare and the planet within our own setting by organizing our very own Climate Week in conjunction with the national campaign and to maximize impact across the north of Scotland. We decided to collaborate with our colleagues at the University of Aberdeen and N H S Grampian. The aims of this project, we're threefold to raise awareness of the climate emergency and its role as a health crisis amongst healthcare staff and students provide education on the principles of sustainability and it's intersection with the delivery of healthcare and finally to inspire change in clinical practice and inclusion of sustainability within Q I projects. So what did we do? In essence, we hosted a week long series of events available to all healthcare staff and students within N H S Highland. Our colleagues in Grampian also ran a parallel series of events and these were livestreamed where possible between regions to make the events as accessible as possible. These events varied significantly in order to attract a wide audience and it included the likes of a program of well being events such as morning walks, mindfulness, yoga, bike skill classes. Additionally, a film screening of the award winning French documentary demand. We also hosted daily climate cafes at various sites throughout the hospital complex in collaboration with local third sector organizations where people could either intentionally attend or join as passes by to discuss any aspect of health and the climate that concerned them. And then finally, there were more traditional events including speaker events from clinicians, members of estate members of the center of sustainable healthcare. And finally, students were also given the opportunity to present on projects relating to sustainability that they had been involved in. This meant that the topics covered. We're also quite broad including social prescribing sustainability within quality improvement, preventative medicine and low carbon therapies and many more. So, how did we do well for the pilot event? I'd say pretty good. Over 60 healthcare professionals and students of various disciplines attended events, these included medicine, nursing, and dentistry and many of those had limited previous awareness of health care, sustainability related issues. Feedback. Following the event was generally very positive with people saying it scored 9.7 out of 10. Um and feedback also suggested um an increased confidence in talking about the planetary crisis and a willingness to engage in climate Axion. And there have been multiple ripple effects since. So students and healthcare professionals are undertaking new quality improvement projects with sustainability embedded at their core, further collaboration between boards and further climate weeks has already taken place and teaching on health care sustainability has become further embedded in local undergraduate and postgraduate training. What have we learned from this experience? And what's next? Ultimately, what this has shown is that using a national campaign to launch a series of local events has enabled positive engagement across staff and student groups, promoting collaboration, connection. And it has facilitated the development of a community of practice to further drive awareness of cyst pain ability within healthcare. Hopefully, it has also shown that anyone has the potential to either piggyback sustainability campaign like Climate Week or it can inspire others to host their very own climate week of events, regardless of whether or not there is a other campaign occurring. We feel what we have also learned is the importance of diversifying both both the message and delivery. For example, using the likes of yoga session and embedding a discussion about social prescribing and preventative medicine and how this thinks in with health care. Sustainability really allows us to try reach that wide audience. And as for what's next, well, we obviously would like to repeat the success of this climate we can try to reach even further than we did on this occasion. How can we do this? Well, I think incorporating a multi professional approach to organization is key for me as a medic, I think I can get quite used to talk into just other medics on the topic. But obviously to see any realistic and necessary change, it is going to require an M D T effort. Therefore, seeing what willingness is there is in other disciplines to organize these type of events is crucial. And then finally broaden in that community of practice even further, we've already shown about what the benefit can be from two different sites, collaborating on such a project. But how about 34 or even going nationwide? Thank you very much for listening to me talk today on our work. I'd be very happy to answer any questions you may have at the end. But if you'd like to get in touch about organ, your very own climate week, then you can send me an email address that's been provided and I can pop it in the chat as well. Thank you so much. Thank you, Rory. I Yeah, it's really great to hear how you've made the most of the potential climate week and the ripple effects going out from that. I hope this inspires others to do similar work in the health care communities and reach out across there M D T s and beyond. And again, any questions Ferrari, please put them in the chat and we will come back to them at the end. So now I would like to introduce Eleanor Cook who is a C T three in Psychiatry. Um Eleanor does have Amelia's name and Eleanor and Amelia submitted the abstract together but is Eleanor and under is from Camden Islington NHS Foundation Trust and it's going to be talking about the Climate Health and Scorecard initiative. And so over to you Eleanor, thank you, also showed the slides, but I'll come back on. Um So hopefully, uh husband said my name's Eleanor and I've worked with Amelia on this uh called the Climate and Health School Card Initiative. Uh huh. So I will just tell you a bit about hopefully the slopes will be okay um quickly through the background, what the aim of the projects our strategy was um what we found in our pilot and what we're up to now and do next. So just a bit of background um are both uh psychiatry trainees in London, but we actually met at a protest, a climate change just back in 2019 at that time time of other mental health professional interested in climate, good sight declares. And we decided that we were paying for the Royal colleges psychiatrist divest from fossil fuels. So we did that quite successfully. My divested the next year and then from then we would get every health organization best and while we're at it, how can we get them to do like a whole myriad of things um in order to the climate crisis. So that's a bit about the background. Um So the goal of the initiative quite simply encourage health organizations to take admit and ecological emergency. And our strategy was to develop a questionnaire and to serve a health organizations uh using a kind of structured framework of achieve ambitious climate actions. We decided we would score these answers and questionnaires um to kind of the organization's a baseline from which they could them as um and also to try and a bit too competitive uh types of organizations. The thing we wanted to do was to encourage best practice by share ing case, positive climate Axion and but bust developed the question in conjunction with experts in climate and health, there were four different areas or domains. So they positions education, training, divestment and advocacy. Second, um in regards to score ing we with the scoring other questions according to the S I had add on mitigating the climate and ecological emergency. So I just had those with four domains. Um So internal operations, what organizations are doing within their own organization to minimize uh their carbon emissions? Who did those on transport? Did they have a good look? Teething? They've transferred, discourage like flight, they were food policies, waste policies. Did they use that renewable energy? Um That's the kind of thing we had and, and entire in education and training, we looked at whether organized had embedded into the exam curricular, whether they were in conferences and webinars and subject with the inability and whether they were also thinking about educating in the public subject uh in the finance section, our main thing was took out the organization, taking their money, uh fossil fuel investments and we defend their endowment funds and their pensioned funds. Um But the finest domain we looked at with advocacy, consider that organizations have uh can be like quite powerful by the stage. So uh organization declared a climate and ecological emergency, whether they were members of the UK Health Alliance, climate change and whether they kind of the political level um and effect laws. So we did our pilot and we published it uh last year in the health. Our main results are kind of summarize slide. Um So we, we had, we invited 28 organizes in total of which 11 kind of uh stated. Uh We scored them and published the results and the, the pediatricians did really well, but we tried to keep it very positive. Um uh Yeah, we were really itched. Um And we're very thankful for anyone one participated regardless of how well they did. Um So I ran the pilot and we looked at back to that. We got some nice feedback, for example, on the left here reports, it very useful for our strategic objectives and hopefully what uh school is going to be used as a time, complete the change. So the multitude of actions into manageable portions. Um so that we also, we're enough in the BMJ, but the alliance will work with the UK, have to learn some climate. Um So now we're repeating the project this year. Um We've invited more than four 40 organizations. We can a lot. I and I didn't did it accordingly. I don't that all out. We're currently um collecting responses and we've also developed a new website added to publish the results. Yeah. Um And that's it really. So, thank you so much for listening. I'm pleased you get in contact if, if you've got any questions or thoughts will get involved about email address and you can call us on Twitter and that's our website. Dress. Okay. Thank you. Okay. That's, that's great. Thank you, Elena. Um, brilliant work on the scorecard. I've been part of meetings where the climate health school card has been discussed by professional bodies and it's highlighted some really important areas for professional bodies to consider. It's really good to hear more about it and really keen to see how it develops in the future and hopefully more and more organizations will get involved with signing up to it. Um So again, any questions for Eleanor, please put them in the chat, lots of, you know, lots of positive comments for speaking so far. Thank you. And we now move on to a point presentation. We're going for uh urination. So I'd like to welcome Ruth Coffee, a medical student from Brighton and Sussex Medical School. Um He's going to be talking about the circle of life rediscovery, which is a nature based training organization that has developed a two day nature based training psychiatrists. Uh It's of course in conjunction with Royal College psychiatrist. So, uh over to your roof. Hello, just show this. Hi. Um, so my name is Ruth. Um, and I'm a medical student at Brighton Sussex Medical School. And today I'd like to talk to you about bringing nature into psychiatric practice. And specifically, my research looked at this two day course for psychiatrists which trained them in nature based techniques to be able to use with their patients'. This is a very important area at the moment for two key reasons, one that we're living amongst very high rates of mental health conditions at the moment and this has a big impact on quality of life but also on uh economic impact. And secondly, is that we're obviously living amongst this climate emergency. And it's really important that we act now to try and minimize the impacts of this. And one of the ways we need to consider things that we need to consider is the links between the healthcare and planetary health. So in terms of background, we know that time spent in nature is really good for you. And one theory by Wilson in 1980 for called the biophilia theory came up with this idea that there's something innate about nature and humans have this automatic deep rooted need to connect to nature. And this has been supported by numerous studies and one by white at our 2019 uh proposed that 120 minutes was the sweet spot for the amount of time spent in nature per week to improve overall well being. And more specifically, we now have reasonable evidence that nature based interventions. So that is interventions and therapy's conducted in nature or using nature um can be good for all manner of mental illness is as diverse as depression and anxiety to psychosis and PTSD. And we also know that there's a relationship between poor planetary health and poor mental health. And that climate change is impacting directly and indirectly on people's mental health. With one study of 10,016 to 25 year olds reporting that up to 84% of them said that they felt moderately to extremely anxious about climate change. And this is where the term uh echo anxiety has come from. It's therefore really important that healthcare, healthcare recognizes its responsibility to try and mitigate the impacts of climate change and adapt their practice to be as sustainable as possible. And the course that I looked into did exactly this. So it was a two day course, the first of its kind and it was run by Circle of Life rediscovery, which is this community organization organization based in Sussex um in conjunction with the Royal College of Psychiatrists, and it was designed specifically for psychiatrists to give them the knowledge and the skills so that they'd be able to use nature in their own clinical practice. And it combined both an immersive experience. So they did uh would would build fire building and cooking um with the theoretical background to Nature Connection and uh neuro neuroscience and green social prescribing. And so my research aimed to explore the potential benefits of Nature Based training for psychiatrists to their clinical practice. And it consisted of two elements. One was creating this pre and post course questionnaire that can be used in future to assess whether the courses meeting its aims to give participants confidence to use nature and practice. And the second which I'll focus on more here is a qualitative evaluation of the course of this first course. So just briefly, the questionnaire I designed uh from a brief literature review and from reformulating previous providers questions and we came up with these five areas. Um and this is now being piloted for another Nature Based training course for psychiatrists. In terms of the course evaluation, this was done through semi structured interviews which were conducted 6 to 12 weeks after the course. So that participants had had the chance to implement anything that they've learned in their practice. And the box on the right of the screen shows the four domains that we uh interviewed about five participants of the 12 attendees of the course took part and we analyzed it through thematic analysis and that showed this. So this is a thematic map. And the big green circles are the four themes that we came up with. And I don't have much time to go into them here. But broadly, the first theme was Nature Awareness. And the fact that there's inadequate awareness publicly and professionally within psychiatry about the importance of nature mental health and that we need to escalate this. The second theme was that connection to others and to nature is very important for mental health. Whoops. The third theme was that uh interweaving nature into clinical work. And in this participants really reported this dichotomy between the wonderful course experience in the woods and real life, clinical practice and the fact that these don't necessarily add up at the moment. And it's therefore difficult for participants to integrate nature into their current clinical environments. And the last theme was embracing that the natural world and primal instincts. And that really was that participants uh embrace this holistic perspective of humans as part of the larger natural world and that this is important for planetary health. But also that planetary health and human health are links. So over all the results showed that all the participants believe that nature is very valuable in mental health and that there is something innately important about connecting to nature. And that's something that in our Western society and are disconnected lifestyles we slightly lose sight of. And that can be to the detriment of our mental health. The participants also stressed the need for the synergistic relationship between nature and humans for the sake of the planet. But then also for the sake of human health and the idea that nature and nature based interventions can promote sustainable practice. All the participants felt that the course benefited their own mental health and this has been reinforced in studies such as this one where it's found that practitioners using Nature Based Interventions with their patient's also experienced benefits. Although the participants did think that they used and thought about nature more in practice sense. Of course, most of this was within an advisory capacity rather than actively integrating this. And they felt that the course needed a greater focus on practical ways to implement nature. The main limitation of this research was that the sample was very select. So all participants were cam psychiatrist. So there weren't any adult psychiatrist who took part and also all of them had a background interest in nature or or sustainability. But overall, the research is very useful for circle of life rediscovery. We hope to be able to refine their future courses so that uh future participants can feel more confident using Nature Based interventions and practice. So overall, whilst nature and Nature Based interventions are not the solution to all mental illness, they can promote mental well being across the general population and formulate part of a healthy lifestyle and for some people, they will present the option of uh psychiatric treatment. And we hope that this the success of small initiatives like this circle of life called rediscovery course may drive the development of a larger network of Nature Based training across the UK so that all uh participle patient's can experience and benefit from this. And in conclusion, we know that nature based interventions can be beneficial for staff, for patient's and for the planet. And so therefore, it's important that we consider this going forward. Thank you and thank you to doctor Lisa page because she helped supervise my project. That's brilliant. Thank you, Ruth. It's always good to be reminded the evidence base around engaging with nature how sports, positive mental well being one of the initiatives I lied on the central chamber. Healthcare is green walking and mental health recovery, which we know has benefits not just for the service users who go on green walking groups, but also for staff running those green walking groups. And yeah, really interested to see the themes that came out of your research and I'd like to find out more about those. So thank you to all of our presenters. We now move into Q and A section. Um So thank you to those of you that have put questions in the chat and if anybody has any other questions is that me um So Maya um 1st 1st presenter, first question to you. Um Just interested initially. Are you um as part of your current course, it's global sustainable development. Are you exploring sustainability and healthcare settings as part of that as well? And I haven't so much of this year. Actually, a module I've chosen to take in my second year is health and sustainable development. So I'm assuming that will have quite a bit of crossover. So I'm really looking forward to that one. That's great. Thank you. And Henry Lee, you got a question that, you know, would you like to come off of mute and ask that question, Fryer. Hi, Maya. I was wondering about excellent talk, by the way, really, really impressed by your presentation skills. Um I know plenty of people who are the same age as me, which is a lot older than you who can't present as well as you can. Um I wanted to know what your supervision was like because you emphasize that it was a self employed roll. And I was wondering whether you got any supervision from the trust or from an external organization. Yeah. So first of all, thank you very much. Um and I had sort of one main contact with in the hospital and then a main contact within been going foundation. And um I was already actually quite earlier with Henry Pollack, who was my main contact with Boingboing because we worked together um on the co research project and then within the hospital, um I kind of spoke to Dr Heather Cat the most, but they were both very helpful in sort of showing me like who I could talk to. What resources were my disposable me, a contact with people that I needed to be in touch with. Um But what was really lovely is it was they very much allowed the process to be led by me. So they would ask me questions about what I wanted to do, how I wanted things to run. But they were very much there for support when I needed it. So it was great, great. Thank you. Um So I suppose it's the question for everyone um With my talking about being an echo activist and resident other ways in which you've thought of yourselves as an eco activist in the workplace or in um where ways you think you've had to be an eco activist in the work that you've done. So, any of our other presenters? Do you something? Um I guess, I think eco activism is a really any action that everyone take on the climate in my view, activism. So I guess, yeah, from my point of view, the Cloud initiative is a listen um in a way background is you met her protest with uh yeah, kind of sit in the activism idea is to encourage. So, um Yeah, that's, well, I'd say any like small idea. Um any Axion that you take in your own life or with your colleagues or at your workplace or in the wider community. Um I think is the correct. Um Yeah, so I'm excited. Yeah, I certainly agree with that in the sense that within our roles within medical education, in terms of even trying to include a tutorial, for example, on health care sustainability that students can opt for. I, I feel like that even comes under the realms of eco activism to an extent because it is kind of that small debt that will hopefully lead to further integration of health care sustainability within a broader curriculum. So even just kind of trying to include that trying to negotiate that with people at higher levels to have those tutorials. That's at least getting them to think about that broader message that you're trying to deliver. So I think even if it's yet small steps, I think that that certainly is considered eco activism within, within the workplace. Thank you. Um Ruth. Do you have anything to add to that? We have a question for you in the chat as well? Sure, I don't have anything to add to that. Really ask questions. Okay. So it is, would you like to come off mute and ask a question or I can do that for you if you're not able to think? So this has us in the chat. Ruth. How do you think psychiatrists can practically use? Okay. That's fine. Don't hurt on mute. I'll continue. Um How do you think psychiatrists can practically use nature based interventions and should psychiatrist themselves delivering these or would it be more worthwhile improving, funding for therapists such as occupational therapists to carry this out? Hi. I think that's a really good point. I think uh both, I think that um for example, some of the participants who did it, one of the participants was taking patient's on walks when she did her consultations. So I think things like being able to practice outside, seem to be able to be really helpful. Um And I know that there are lots of barriers to that and sometimes practically there isn't the space and time to be able to do that. But even doing consultations outside, if there are gardens and things like that would be, would be very helpful. Um And even things like nature views and making and bringing patient's awareness to, to images outside and things I think that can be useful. But I think also that yes, probably funding for therapists like O T s or physios so they could practice their work outside more would also be very good. Thank you Ruth. And I'll just speak to that briefly as well. I'm going to put the link in the chat. So the Central Stable Healthcare, we have the Green Walking Mental Health Recovery Initiative. And when we published the Green Walking Guide a couple of years ago, it was endorsed by Royal College psychiatrist, Royal College of Occupational Therapists, Royal College of Nursing. And we are looking for funding for national rollout of Green walking across acute inpatient settings and other mental health services as well. Um And there was another question for you, Ruth from Catherine King who said is the nature course only in the South or are there any northern links? Yes. So uh my mind, this cool of life rediscovery is only in this Sussex uh location. But I know it is something they're trying to, I think they're working with the Royal College of uh psychiatrist cause ideally, they do want to be able to roll it out a wider level. Um But there's, yeah, but at the moment, it's only in Sussex. Thank you. Um So any other questions, please keep me coming in the chat, Jenny Jenny Goerdeler. Have a question for Rory. Would you like to ask that? Yeah. Thanks, Ben. Can you hear me? Okay. Yep, you're fine. I'm just wondering to what extent to involve the non clinical teams um in your project. So during that Climate Week and how much collaboration do you get between the two groups? Thank you so much, Jeni. Um So given it was the first time, this was actually quite a grassroots idea. I would say the development of this program of, of Climate Week. It was very much just it kind of originated from a discussion that I had with my colleague Adelaide who's who's popped up on camera. And our colleagues said, so it was just three of us who together discussed the potential of organizing this Climate Week program that then kind of began to evolve, evolve, evolve, evolve. And it very much kind of stayed within the medical education department and didn't really extend into that sort of managerial of the of the wider health board. Um that said, given kind of the work we did often relied and that's kind of going through the communication departments of the, of the wider health board to try to reach out to staff. We kind of have that involvement with it, but because it was like I say, the first time and, and, and grassroots in origin, we didn't necessarily have that endorsement from the kind of managerial aspect of the wide health board going forward though. I feel like it would be great and necessary to get that. And I think that we would be looking to kind of discuss future events with them so that we can get, yeah, well, they're endorsement their involvement just so that we can keep it as broad as possible, reach as many people as possible. Um And so that it can show that the health board is taking it seriously as a, you know, or the wider health board is taking it seriously as a, as a subject. Um So, yeah, like I say, the general communications, we have, you know, with the communication department and directly with any kind of speakers that we wanted. So we contacted members of the states who are particularly progressive with kind of sustainability related projects who, who got involved. Um But yeah, I think, I think going forward, there's a, there's a much bigger role for including, you know, the likes of the, of the, of the wider health board managerial team. I don't know if you have anything to add to that. Adelaide. It's just to say, I think, can you hear me? Okay. Yeah, a lot of the reasoning for that was also as for probably alluded to, um, it was kind of just the three of us and I think that discussion we had was only maybe three or four weeks prior to Climate week. And because we were trying to do it on those fixed dates, there wasn't a lot of time to um involve lots of other people and make something very big. We just have to be as efficient as possible, which did involve kind of organizing it amongst ourselves. But I think as what we said, the future, um that would be very sensible. And again, that was probably part of the, the difficulty we had in getting lots of people involved who didn't come from a medical school or medical background. We had tried to reach out to because where we're based there is, you know, the nursing school and dental school and lots of other departments all around us. Um, the University of Highlands and Islands are just next door. But I think because of the kind of time limit to get something off the ground, it was quite hard to build up those links with them to attract lots of people who weren't medical students or doctors. Um So yeah, I think it was mostly a kind of a logistical kind of reasoning for that. Thank you. Yeah. Really great point. Thank you. Thank you. Thank you for the question, Jenny. And yes, and I we we have a comment in the chat from Roslyn custody, um saying yes, I think for myself as Nico active at work in role in Durban, South Africa because of the many initiatives an issue I raise. Um Rosin, were you able to come off it and say anything about that? Maybe you could have an international healthcare eco activists perspective. So Rosalynn mentions discussing what it means to leave the tap running and necessarily, for example, in the water scarce country. And though that is a consideration we don't have here. Um So yeah, obviously, lots of global issues that are going to be much more troublesome as climate change progresses. And thank you, Lisa uh for your response to Kathryn's question in the chat. Um As far as you know, circle of life as first organization to offer this train of psychiatrists, but there are other courses based in West of England, such as Bristol for healthcare professionals who want to take their practice outdoors. Thank you for that. Um, I'm thinking if I put my email address in the chat, I'm involved with the networks at the Central Stable Healthcare and we do have a green space for health network. We have monthly Green Walking mental health care recovery, sorry, green Walking mental health recovery meetings. So, if anybody would like to get involved with any of that or any other networks, do you get in touch? And um is there anyone else who would like to come off mute and ask any questions or pop anything else in the chat? And I will then? Okay. Uh Are you going to uh well, I was question, am I allowed to ask a question as coach? So I was going to ask a question to ruth if that's okay. Is there any evidence around how the quality of the natural environment affect the mental health outcomes? And I guess what I'm thinking is things like um if it's a true natural environment. So there's been a bit of research around uh soundscapes implantations uh compared to natural forests. Um And I'm wondering if there's any evidence around around that? Really? Yes, it's a good point. Um I know that they're definitely has been studies into different types of exposures to nature. And I know that there has been studies that have shown even things such as having pictures of natural landscapes on the wall is beneficial. So I know that there are uh there are benefits are a whole schedule of different types. I can't say I really know how much evidence there is to what degree different things are helpful. Uh I'd have to look into that, to be honest. I think there is evidence for that. Thank you. Cool. Thank you. Um So question for Eleanor Lyme interested in how you decided on the waiting of the points for the different areas in the school card. And also what feedback you've had from professional bodies that may have influenced or changed the next iteration of the school card? Yeah, thank you. So, yeah, the scoring often. So there's a question it was to do. Um Essentially, there's nothing else that we're aware kits says there's not really a gold standard that from. So essentially, we, we did it as a working group. We basically, so can you hear me? OK, we scored the questions which we thought would have more impact more highly. So for example, advocacy, we scored quite highly because we need organizations to kind of campaign at political level circle, national government, a national government level really to try and influence um level change. Um And then we also like, we're quite a few points, for example, for David, it's quite um an impact whole thing. Um But what we did was when we put the schools down, we thought it was appropriate, we then small off and we got an expert, expert in the feel sick. Brew and feedback. Uh, we have to do a couple of things in this just about. So, yeah, but it's, now it's not like a, uh, it wasn't easy. Um, so the second part of the question will be a list. I was pretty direct. Yeah. How the professional bodies, nephew, we have influenced your next situation of the Yeah. So it was really did quite thoroughly. You back some of it was a kind of uh I mean, there was some feedback that it was quite a lengthy question and there was a lot of bait whether like so we did like short and simple part of it, but then to make sure it was quite inclusive, a good framework from which all the Malaysians could work and therefore we didn't shorten it that much, but we didn't, but we appreciate, you know, this is quite lengthy. Yeah, we added in after feedback, for example, in the finance section, um things on banking. So which bank that organising with? Because uh invest well may invest in fossil fuels and stuff. I did that. Uh And then ensure uh um three questions to make it clear and simple, simpler in response to feedback as well. Um Yeah, injured quite a lot. Um Hopefully now. Um but I'm kind of the kind of the scope. It's great. Really, yeah, really good bit of work you've been doing that. So thank you for, thank you for that. Um So you got a couple of minutes left and, yeah, I'd just like to return Rory Adelaide. But also anyone else who's on the call from my back already talked about how you've taken a national campaign and focused on what you can do locally. But then thinking how that local, yeah, it's sort of like making the most potential of what you're able to do locally, how that could then spread out that nationally and be done more around the country. I suppose it's thinking what support or systems do you think might need to be in place in order for that roll out to happen? Yeah, that's a, that's a really good question because I guess the concept of Climate Week is because it's Scottish government doesn't necessarily mean that it needs to be implemented by any kind of public sector organization or, or private sector. I think it's just a campaign to encourage organizations to take part in climate Axion. Um So I guess it was honest to try to find a way of doing that and to try expand it. Um, I guess what systems would need to be in place. That's a, that's quite a difficult one because if you're going to expand it in the network, the way that we were thinking there's a lot of a lot of different organizations or institutions that I would love to get involved. You know, we started kind of between two sites Inverness and Aberdeen, but there's potential to spread amongst other Scottish cities, universities all different to try to coordinate and make a program that we can all attend. Um But there needs to be, I guess that level of collaboration between those institutions which might not necessarily be in place that would allow such such thing. Um So I guess it's, it's kind of focusing on that, that ethos of collaboration, which is so key to kind of healthcare or sustainability as, as a whole, it relies on people working together. Um So I guess that's the main system that we need is just these institutions to be willing to work with each other on such a topic and maybe not be so protective about resources or programs which can get in the way of, of medical education. Sometimes I um but I'll just hand over to ablate to see if she has anything to add to that. I don't really have much to add, I think um I guess the other challenge with that from our perspective is the lack of continuity within our roles as well. Um So if you wanted to roll something like that out on a larger scale and spread it around between different areas, I think it's certainly in our department, we tend to change as stuff we change over annually. So um this was something that just kind of came out of three of us who happened to all be interested who were in the same room as each other, I think. We're just said, do you want to do this? And we just did it, but that I think was a lot of happenstance, whereas, you know, we have departments where people have a fixed role for a long time that they can work on these projects over a longer period of time and they have those connections and they know how to kind of link with other areas that, that would be much, much easier. Um Because I think for us in our position, you know, you spend four months just working out what your job is and who the people in the other areas you might want to speak to our. Um And then by then you're almost moving on from your job. So I think that's another kind of challenge. Uh Well, thank you. Thank you very much. And yeah, it's a great reminder if you never know where those little conversations are going to take you. So just need, we need to keep having those conversations. We've mentioned it working a bit. I'm just going to put a link in the chat for networks and sustainable healthcare. Um And I will, yeah, just say thank you to all the presenters. Thank you for everyone who's contributed to discussion at the end. Lots of inspiring work, lots of food for thought and go well, everyone.