• A Charles Sturt University research team found significant achievements by a youth mental health service program in northern NSW that works with young people
• Most participants of the Human Nature program reported improved wellbeing, enhanced life satisfaction and sustained engagement
• The research report provides key findings and policy recommendations to support the expansion of innovative, non-clinical mental health services

A Charles Sturt University research team’s evaluation of a nature-based, trauma-informed mental health service’s program operating in Northern NSW has demonstrated its effectiveness to improve wellbeing among adolescents aged 14 to 18 years.

The Charles Sturt Rural Health Research Institute (RHRI) research team was led by Deputy Director and Professor of Rural Health Research (Mental Health and Addictions) Julaine Allan.

She said research on youth mental health is limited and the Australian Government has developed the National Children’s Mental Health and Wellbeing Strategy to improve our understanding of the topic.

As an example of the potential scale of the issue, the Australian Institute of Health and Welfare (AIHW) estimates that 20 per cent of 11 to 17 year-olds and 15 per cent of 18 to 24 year-olds experience high or very high levels of psychological distress.

Professor Allan said the Human Nature charity based in Lismore NSW delivers person-centred mental health support services to young people with moderate intensity support needs in non-clinical settings.

“The effectiveness of the Human Nature program had not been examined previously and we used its routine data to evaluate the program over a two-year period,” she said.

“We found the Human Nature program offers a scalable, evidence-based solution to fill a critical gap in youth mental health care.

“Its success underscores the need for policy innovation that embraces non-traditional, inclusive, and therapeutic environments because investing in such models can transform outcomes for young people who are currently underserved by existing systems.”

Professor Allan and RHRI colleagues Dr Nicole Snowdon, Dr Mamun Huda (SRM) and Dr Hazel Dalton have presented the final report titled Bridging the ‘missing middle’ in youth mental health: evidence from the Human Nature Program to the organisation.

The key research findings are:

• Improved Wellbeing: Participants showed significant improvements in symptom distress, interpersonal relationships, social role functioning and overall wellbeing.
• Enhanced Life Satisfaction: Across seven domains of the My Mind Star scale, participants reported substantial gains, particularly in self-esteem, time use and educational engagement.
• Inclusive Reach: The program effectively engaged vulnerable populations, including Aboriginal and Torres Strait Islander youth (27 per cent), LGBTQIA+ (11 per cent), and those from socioeconomically disadvantaged communities (42 per cent).
• Sustained Engagement: Most participants attended an average of 26 sessions, with 65 per cent remaining engaged throughout the program  

Professor Allan explained that young people with moderate mental health support needs ─ often referred to as the ‘missing middle’ ─ face significant barriers to accessing appropriate care in Australia.

“What is important to understand is that Human Nature offers an alternative to formal institutions that typically provide healthcare, and funding bodies need to know what works for young people to ensure suitable services are provided,” Professor Allan said.

The Human Nature research report notes policy implications:

1. Expand nature-based mental health services: Support the integration of nature-focused interventions into mainstream youth mental health services and fund pilot programs in other regions to replicate Human Nature’s model.
2. Address the ‘missing middle’: Allocate targeted funding for services that cater to young people with moderate support needs and develop flexible service models that operate outside traditional clinical settings.
3. Support trauma-informed, person-centred care: Promote training for mental health professionals in trauma-informed and youth-centred approaches and encourage service designs that prioritise autonomy, safety, and cultural responsiveness.
4. Invest in long-term, free access programs: Ensure programs are free at the point of access to reduce financial barriers and provide sustained funding to support long-term engagement and continuity of care.

Its recommendations include:

• Federal and state governments should include nature-based interventions in youth mental health strategies.
• Primary Health Networks (PHNs) should commission services that reflect Human Nature’s approach.
• Educational institutions should partner with community-based programs to support students with moderate mental health needs.
• Research bodies should fund longitudinal studies to assess the long-term impact and scalability of nature-based models.