Only About a Third of Young People Take Up Social Prescribing Activities, Evaluation Finds

Children and young people referred to a hub-based social prescribing programme in East London connected with the community activities they were offered only around 30 percent of the time, according to a quantitative service evaluation published in BMC Public Health. The study, led by Mariana Willmersdorf Steffen with Francois van Loggerenberg, Paul Heritage and Jennifer Y. F. Lau, is described by its authors as the first of its kind to focus specifically on how young people with mental health difficulties engage with the community-based side of social prescribing, the component the researchers say remains underexplored even as the approach gains traction as a complement to traditional mental health services.

Social prescribing has attracted growing interest as a complementary pathway for children and young people, particularly given long waiting times to access specialised mental health support. The model works by connecting people to non-clinical, community-based activities, but the research team set out to answer two basic questions that had not been systematically addressed for this age group: what patterns of engagement actually look like within a social prescribing pathway, and which factors are associated with whether young people take up the activities they are connected to. To do this, the evaluation drew on quantitative service data from 231 young people in East London who had been referred into the programme, using the records to describe the sociodemographic characteristics of service users and to identify patterns of engagement as well as sociodemographic and referral-linked predictors of uptake.

Because of missing data, the analyses of engagement patterns and predictors were based on a smaller subset of 146 young people, a limitation the authors acknowledge in the study. Within that analysed sample, roughly 30 percent of children and young people engaged with the community-based activities to which they had been connected, a level the researchers characterise as low-to-moderate engagement. The evaluation then tested whether a range of characteristics predicted who took part, comparing engagement across age, gender, ethnicity, deprivation index, presenting need and whether the young person had been accepted to access Child and Adolescent Mental Health Services, known as CAMHS.

The statistical results were strikingly uniform in one respect: none of the tested factors showed a statistically significant association with engagement. Age showed no significant link (t(103.86) = -1.40, p = 0.163), nor did gender (X2(1) = 1.33, p = 0.248), ethnicity (X2(2) = 1.75, p = 0.416) or the deprivation index (t(75.79) = -0.09, p = 0.932). Presenting need, the reason a young person was referred, was likewise unrelated to uptake (X2(3) = 1.29, p = 0.731), and so was acceptance to access CAMHS support (X2(2) = 1.18, p = 0.554). In practical terms, this means the evaluation found no systematic bias in who engaged with prescribed activities across sociodemographic groups or presenting reasons: boys and girls, younger and older participants, and young people from different ethnic and socioeconomic backgrounds took up activities at broadly comparable rates within the data.

The authors argue that these findings expand the evidence base on implementing social prescribing as an intervention pathway for children and young people with mental health difficulties. The absence of sociodemographic differences in uptake suggests that the opportunity to connect with community activities was not disproportionately reaching, or being taken up by, any particular group among those referred. At the same time, the overall engagement level of around 30 percent brings into focus the gap between being connected to an activity and actually participating in it, which the researchers highlight as a key implementation challenge for the model.

The study is careful about what it can and cannot show. As a quantitative service evaluation rather than a controlled trial, it describes engagement within one programme and identifies associations in routine service data; it does not test whether social prescribing improves mental health outcomes, and the reduction of the analysed sample from 231 to 146 young people because of missing data means the engagement estimates and predictor tests rest on the records of roughly two-thirds of the service users. The authors also note that the connection with community-based activities, although a key part of social prescribing, is currently underexplored in the literature, which is why they frame the work as a first step in understanding uptake for this age group rather than a definitive test of the pathway.

What the evaluation does establish is a benchmark for a programme serving young people with mental health difficulties in East London: engagement with prescribed community activities occurs at low-to-moderate levels, and that engagement is not patterned by age, gender, ethnicity, deprivation, presenting need or CAMHS acceptance status. The researchers bring attention to this engagement gap and discuss suggestions for how uptake of social prescribing-linked community activities might be improved, positioning the study as an early contribution to the implementation evidence for a model increasingly being considered for children and young people who face long waits for specialised support.

Subject of Research: Predictors of engagement in a hub-based social prescribing programme for children and young people with mental health difficulties

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

Article References: Steffen, M. W., van Loggerenberg, F., Heritage, P., & Lau, J. Y. F. (2026). Predictors of engagement in a hub-based social prescribing programme for children and young people with mental health difficulties: a quantitative service evaluation study. BMC Public Health. https://doi.org/10.1186/s12889-026-29973-8

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29973-8

Keywords: Predictors, engagement, hub-based, social, prescribing, programme, children, young, people, mental, health, difficulties