My profile

Biography

I’m an interdisciplinary researcher trained in social science (BSc, Sociology; MA, Social Anthropology of Science, Technology and Medicine), humanities (PhD, History of Medicine) and health services research (MRC post-doctoral training fellow; MSc, Health Services Research). I work across public health, mental health and environmental research, with a focus on testing and evaluating real-world solutions to complex problems.

My research looks at how mental and physical health can be improved through better services, community-based support, and green or sustainable interventions. I’m especially interested in the links between climate, nature, health inequalities and mental health. I work closely with people with lived experience, community groups, the NHS and policymakers to co-design and evaluate interventions that can make a difference to people’s lives.

I use mixed methods, and lead studies ranging from randomised controlled trials and evidence synthesis to qualitative process evaluations. 

Before joining Manchester Met, I was Professor of Environment and Mental Health at the University of York, where I led the Mental Health and Addiction Research Group. I spent many years at the University of Manchester, starting out as a postgraduate student and PhD researcher at the Centre for the History of Science, Technology & Medicine under the late John Pickstone. He instilled in me a lasting appreciation for the plurality of knowledge - that the practice of science, the creation of knowledge, is always shaped by its social and political contexts and purposes. This philosophy of science motivated me to engage in work with an applied focus, and to retrain in health research, beginning at the Christie Hospital, and then on to the School of Nursing, Midwifery and Social Work and the Centre for Primary Care, where I was fortunate to be mentored by a brilliant group of clinical academics and health service researchers.

I’m Deputy Chair for the NIHR Team Science programme and a Senior Fellow of the Higher Education Academy. 

I am scientific advisor for Sow the City - a Manchester based social enterprise committed to greening urban spaces to create healthier places to live.

Interests and expertise

I have over 20 years’ experience of working in applied health research. Much of my work has focused on evaluating therapeutic interventions to integrate mental and physical health care in people with mental health problems and multiple long-term conditions. This has involved working with primary and secondary care mental health services in the NHS across England to test the effectiveness and cost-effectiveness of psychosocial interventions in populations with mental and long-term physical health problems. 

I continue to make major methodological contributions to applied health services research, specialising in mixed-methods process evaluations to understand how interventions are delivered and experienced, to better inform scale-up in real-world settings. 

Over the past decade my work has become far more interdisciplinary and shifted focus to understand how services, communities and environments can better support people living with complex mental and physical health needs, including those facing disadvantage and vulnerabilities.

I’m particularly interested in how nature-based and place-based interventions, such as green social prescribing, can improve mental health while delivering wider environmental co-benefits. I am also interested in developing work that addresses how the NHS and community care systems can adapt to climate change driven weather events such as floods and heat waves, and contribute to the UK’s net zero goals. 

I am committed to working across disciplines to connect public health, clinical practice, and environmental science, using methods that bridge co-design, lived experience and inclusion, and experimental evaluation. 

Impact

Green social prescribing: evidence for scalable, community-based care

As part of NHS England and Defra’s national green social prescribing “test and learn” programme, I co-led the first longitudinal and quantitative evaluation of nature-based prescribing across Humber and North Yorkshire. Working in partnership with Hey Smile, Humber and North Yorkshire Health and Care Partnership, and the Humber Teaching NHS Foundation Trust, we used a cohort design to measure changes in mental health and wellbeing among participants referred to nature-based interventions via social prescribing.

Our analysis reported in Health & Social Care in the Community showed significant improvements in wellbeing and reductions in anxiety and depression symptoms, particularly among those engaged in horticulture and care farming activities lasting 9–12 weeks. The size of the treatment effects are equivalent and in some cases larger than those observed for psychological therapy in primary care. These findings offer some of the strongest UK-based evidence to date on the effectiveness of green social prescribing as a community-based intervention for mental health. The study has contributed to the national case for investing in green social prescribing and lends supports to the wider ambitions of the 10 Year Health Plan for England to focus on prevention, community-based support, and sustainable models of care in the context of rising mental health need.

Advancing collaborative care for depression and long-term conditions

Over the past decade, my research has helped shape understanding of how collaborative care can be used to improve outcomes for people living with depression, including those with multiple long-term conditions. This work began with a landmark qualitative study, Talking About Depression, which identified barriers to mental health care among people with long-term physical health problems and was awarded the RCGP Research Paper of the Year for Mental Health in 2012.

Building on these insights, I led the COINCIDE trial, one of the largest trials of collaborative care for people with depression and multimorbidity in the UK. COINCIDE not only tested the effectiveness of an integrated care model for people with long term conditions but also the effectiveness of a model that could potentially be delivered at scale in health services such as the NHS. It showed that integrated mental health care, provided jointly by psychological wellbeing practitioners and practice nurses, improved mental health and self-management skills in people with depression and heart disease and/or diabetes. The companion process evaluation was awarded RCGP Research Paper of the Year for Mental Health in 2016, and showed that collaborative care can reduce stigma and boost team confidence in managing depression, but that care needed to remain patient-centred to allow space for managing mental health.

I have contributed to a series of systematic reviews and meta-analyses, including a study-level meta-regression and two individual patient data (IPD) meta-analyses in JAMA Psychiatry (2016, 2025), which collectively unpacked the active components of collaborative care and challenged assumptions about its applicability across different patient groups. One key finding was that the effectiveness of collaborative care does not depend on the presence or type of physical health condition, illustrating its flexibility and broad utility across populations.

This body of work has shaped NICE guideline development for depression in adults, and provided a robust evidence base for commissioners and policy-makers working globally. This research shows that collaborative care is not only scalable but can deliver meaningful, cost-effective change in primary care.

Shaping the policy debate on climate change and mental health

My work at the intersection of climate change and mental health is beginning to influence national policy discussions. A key example is our widely cited systematic review of the mental health impacts of flooding (IJERPH, 2020), which informed the Centre for Mental Health’s position statement on the climate emergency and mental health. I also chaired a Festival of Ideas event in 2023 hosted by the Centre for Mental Health, bringing together experts, activists, and community voices to explore how climate change, especially extreme weather events, can impact people’s mental health, especially those living in marginalised and disadvantaged communities.

This work is part of my ongoing commitment to evidencing the health and environmental benefits of sustainable and net zero mental health care. 

Projects

Co-PI for the Forest School Intervention for Children’s Health (FINCH) study.

Co-led with Dr Hannah Armitt, FINCH is funded by NIHR Public Health Research and delivered in partnership with Humber Teaching NHS Foundation Trust. It aims to produce new knowledge about the feasibility of running a definitive Forest School trial with Key Stage 2 children aged between 7-11, inclusive of children with Special Educational Needs and Disability (SEND). The study seeks to better understand whether Forest School is acceptable to both children and school professionals.

Co-investigator for CO-produced Nature-based Intervention Feasibility for children with ADHD Study (CONIFAS-2)

Funded by NIHR Research for Patient Benefit, this study builds on the co-design of a family centric nature-based intervention for children with ADHD, to test the feasibility and acceptability of delivering the CONIFAS intervention in NHS Children’s NHS Neurodiversity Services. 

Co-investigator for Experience-based Investigation and Co-design of Psychosis Centred Integrated Care Services for Ethnically Diverse People with Multimorbidity (Co-PICS)

Funded by NIHR aims to improve the care of diverse people living with psychosis and at least two physical long-term conditions by first learning about their experiences and then co-designing clinical and training resources based on their experiences to support greater integration of care and services. I am leading the process evaluation to evaluate how the co-design solutions are implemented in practice. We are drawing on Normalisation Process Theory to frame understandings about take-up and integration of these solutions in everyday settings. 

Co-I for Green Spaces for Stroke Units

Funded by the Stroke Association this study explores how hospital-based green spaces can support recovery and well-being for people after stroke. Using case studies across three hospitals, we will observe how patients, visitors, and staff use outdoor areas and gather their views through interviews. The findings will identify what makes green spaces beneficial and lead to recommendations for designing and using these spaces in stroke care and beyond, contributing to Greener NHS ambitions.

WARM: Whole-system Adaptation for Resilient Mental Health

Funded by NIHR and co-led by Prof Tim Doran at the University of York, WARM is a 10-month development award as part of the NIHR’s climate change and health programme with a focus on adapting health and social care systems during severe weather events. We’re conducting exploratory and consultative work across Greater Manchester and York and North Yorkshire to identify how climate change shocks impact mental health service and system delivery and to develop a programme of work to address these system level challenges.

Recently completed projects

Co-investigator for Developing and evaluating a diabetes self-management education intervention for people with severe mental illness: The DIAMONDS programme

Funded by NIHR Programme Grants for Applied Research DIAMONDS co-produced a self-management intervention to support people with serious mental illness and diabetes to better manage their diabetes. The programme aimed to improve control of diabetes as well as supporting mental health. The intervention was tested in a large nationwide randomised controlled trial.

I led workstreams for systematically reviewing the determinants of self-management in people with long-term conditions and severe mental illness and testing the feasibility of the intervention in the context of secondary care mental health NHS Trusts in England. I also led the process evaluation for the randomised controlled trial.

Co-PI for DIAMONDS URDU

Co-led by Jennifer Brown and funded by NIHR Programme Development Grants, DIAMONDS URDU aimed to understand the barriers to participation in mental health research among people from Urdu language speaking members of South Asian communities. Working in partnership with community groups and partnering NHS Trusts we ran focus group based evaluations of the drivers and barriers to research participation in this group, along with reviewing the broader literature about what can support people from South Asian communities to take part in mental health research.

Teaching

Supervision

I have supervised seven PhD students to completion and continue to support PGRs to undertake doctoral research that addresses policy, methodological, and applied questions across health, environmental and care contexts.

Current PhD students

2021-current, Jen Brown, part funded by Mentally Fit York, “Continuous glucose monitoring in people with type 2 diabetes and severe mental illness” (co-supervisors: Prof Najma Siddiqi and Prof Ramzi Ajjan)

2021-current, Wajeeha Raza, NIHR Yorkshire Humber ARC and EEPRU studentship, “Developing an evaluation framework to measure the health economic benefits of green space interventions for health” (co-supervisor with Prof Laura Bojke and Prof Piran White)

2022-current, Nikki Patterson, Leverhulme Centre for Anthropocene and Biodiversity, “Linking biodiversity, nature connectedness and health over the lifecourse” (co-supervisors: Prof Piran White, Dr Sarah Blower, Dr Teresa Kittler)

2024-current, Pengfei Wang, Chinese Scholarship Council, “Urban-living environments and mental health” (Thesis advisory panel member) 

Research outputs

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