September 21, 2012 9:34 pm

A root to recovery

Hospitals, prisons and mental health institutions are increasingly using horticulture as therapy

Tucked away at the north end of London’s Battersea Park, a long-abandoned English rose garden is being given a new lease of life. Honeysuckle and jasmine grow alongside pomegranates and rhubarb. Groups of gardeners tend a colourful wash of flowers and plant life. After years of dilapidation, the red-bricked walls once again have something worth protecting.

The transformation has been driven by Thrive, a charity that helps people with disabilities and mental illness through gardening. Each year, the group’s Battersea project offers horticultural therapy to around 300 people in the belief that it will improve their lives. For those involved, the garden has become a classroom and refuge.

Mary (not her real name), who regularly tends the garden, has multiple personality disorder and swings between having the identity of a highly articulate woman and various young girls. In her backpack she carries a teddy bear, and a book by Stephen Fry. On the day of my visit she is taken up with studying weeds such as rosebay willowherb.

“I don’t need a hospital but I am not ready for the real world. This is a good balance and when people ask about my life I can say that I am a gardener,” says Mary, who also cares for a private garden in west London. “Gardening is grounding and you quickly feel like you’re accomplishing something.”

In the past decade a growing number of hospitals, prisons and mental health institutions around the world have adopted horticultural therapy as a supplementary treatment for a range of illnesses. In Norway, for example, people suffering from depression have the opportunity to work on farms, while mental health patients in Singapore are prescribed gardening on hospital grounds to alleviate stress.

The belief in the restorative power of plants is nothing new. For centuries Japanese gardens have inspired peace and meditation while nearly every culture has used herbs to treat illnesses. In 500BC Persians began creating fragrant gardens to please the senses and in ancient Egypt, court physicians prescribed walks in the palace gardens for the mentally ill.

“Anti-depressants are flattening and they take away one’s emotion,” says Sir Richard Thompson, president of the Royal College of Physicians in London. “Pills are very effective when they are needed [to treat depression] but gardening, surely, is a much better alternative when it works.”

Sir Richard adds that gardening, like any physical activity, helps us feel better. One hour of vigorous weeding, for example, can burn up to 200 calories and also improves co-ordination and flexibility.

The positive health impacts can be lasting, too. In 1984 Roger Ulrich, then a professor at Texas A&M University, discovered that looking at plants inspires a positive response in our bodies. After observing two groups of hospital patients, he found that patients with rooms that overlooked trees recovered faster than those who faced buildings. They also took less pain medication.

In 2007 Christopher Lowry of Bristol University also discovered that mycobacterium vaccae, a harmless bacterium in soil, may trigger the release of serotonin in the brain. And at the Norwegian University of Life Sciences, researchers observed 46 people with clinical depression and found that participants on average had significantly reduced anxiety levels after 12 weeks of gardening.

Gardens also have a sensory power that is less quantifiable: it exists in colours, sounds and fragrances. For some the real pleasure may be in working the soil, while for others it may have more to do with the idea of creating living beauty.

At the South Florida Reception Center, a state prison in Miami, James Jiler encourages incarcerated men to garden. By digging through coral rock and burying kitchen waste for compost they have managed to cultivate papaya and tamarind trees. The fruit is sold in low-income neighbourhoods as a way for inmates, many of whom are serving life sentences, to keep in touch with their communities.

Of the 2.3m people in the US prison system, around 80 per cent are sentenced for non-violent, drug-related crimes, says Jiler. Many are battling serious addiction and traumas related to mental illness.

“I often find that those who suffer from mental illness have never been given credit for anything positive,” says Jiler, who also co-directs Here’s Help, a garden project for young adults at a drug rehabilitation facility in Opa-Locka, Miami. “When they begin working with plants they’re suddenly getting good responses and soon correction officers are asking them for advice about their own gardens.”

In 1985 Jiler gave up a Wall Street career so that he could help people connect to nature. Before settling in Florida he directed the GreenHouse Project, a programme run by the Horticultural Society of New York for inmates on Rikers Island, one of the largest prison complexes in the US, which houses some 14,000 convicts.

Jiler acknowledges that gardening is not to everyone’s liking and getting people interested often calls for a creative approach.

“At first they’re inevitably thinking: ‘why is this guy talking to me about flowers?’” he says. “So I say that I’m going to teach them how to grow good pot. Some are taking notes, asking questions. I have them hooked.

“Then when a project is finished and they reflect on what the place looked like before, they suddenly realise the power of what they just did,” adds Jiler. “There is a sense of pride that goes with turning a seed into a plant and transforming barren ground into something beautiful.”

The sensory absorption that gardens provide can make them ideal backdrops for different types of therapy. This has been the case for the men and women at Freedom from Torture’s treatment centre in Finsbury Park, north London. Once a week clients, all of whom have struggled with depression and post-traumatic stress disorder since fleeing torture in their native countries, plant flowers and vegetables in the company of a psychotherapist.

“Working in the garden has transformed my life,” says a client, who prefers to remain anonymous. “For a long time I could only see pictures of brutality, but doing tasks like weeding takes your mind away and nature brings hope to you when you plant.”

After several years he is still waiting to be granted asylum to remain in the UK. If allowed to stay, he plans to take a university course in environmental science.

According to Caroline Roemmele, a psychotherapist, people communicate better after a short time working in the garden. “It puts them in a better state of mind to process their trauma,” she says. “When clients are calm and in a safe space they can begin to think about their experiences and slowly they can become integrated into their memory.”

Roemmele also points to the social aspect of horticultural therapy, which she says is especially important for those who have become isolated in their illness. “Often they work on a flower bed together and discover they have common experiences,” she says. “They help support each other both here and beyond the project.”

In spite of the proven benefits, horticultural therapy has its sceptics. In the UK, for example, the National Health Service has no official guidance on the subject. Many clinical specialists say the therapy is not effective on its own and should be supported by medication or psychotherapy and in some cases both.

“General practitioners are not that switched on about the value of gardening and we’ve got to try and convince them that it can be a cheap, worthwhile therapy for mild mental health problems,” says Sir Richard, who has worked with Thrive for 12 years.

Today the demand for mental health services is soaring throughout Europe and the US. However, an onslaught of budget cuts threatens to cripple these services on both sides of the Atlantic. In England, where one in four people currently suffer from depression, mental health spending has dropped by £150m for the first time in 10 years. The situation is equally troubling in the US: according to the National Alliance on Mental Illness, states cumulatively cut spending by $1.6bn between 2009 and 2011. Psychiatric clinics continue to close across the country.

This would seem an opportune moment to take such a cheap and demonstrably effective treatment more seriously. However, Sir Richard points out, holistic therapies such as these are the most likely casualties of budget cuts.

“A recent Thrive study showed that the majority of people, if given the chance, would [choose to] have access to a garden,” he says. “It is something that is in the English psyche and I think we should build on that.”

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The challenges: Gardens can be stressful

Gardening may provide benefits but that does not mean it is without challenges. Learning what will take to your garden is often a tortuous case of trial and error. Some soil is deficient and while all plants need sun, there is such a thing as too much of it.

flower garden

“Thinking about all I have to do in the garden can actually make my stress levels rise,” says Alison Grieve, a ceramist and gardener who lives near Bordeaux in south-west France. Grieve and her husband Claude live in a remote 18th-century farmhouse, where for the past 22 years they have turned an open field into a flower garden.

However, temperatures range from -15C to 45C, and tending to 18 flower beds is time-consuming and often exhausting. Protecting the beds before the first hard frost is a race against time and keeping plants alive in summer is constant work.

As a gardener you have to accept disappointments such as losing favourite plants and finding bulbs that have been eaten by rodents. “Gardening helps you to accept that nature is imperfect. Although not everything goes to plan, you equally get wonderful surprises.”

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Horticultural therapy programmes: From Chicago to China

US

The Bridge programme, which runs in collaboration with the Horticultural Society of New York, offers gardening opportunities to people with mental illness in the Bronx and the Upper East Side of Manhattan. www.thebridgeny.org

Urban GreenWorks, founded by James Jiler, is a non-profit organisation that oversees several garden projects for incarcerated men and women, and at-risk youth in Miami, Florida. www.urbangreenworks.org

Chicago Botanic Garden offers gardening sessions to people with mental and physical disabilities. www.chicagobotanic.org

UK

Thrive has garden projects in Berkshire, in south-east England, and at Battersea Park in London. Horticulture training is offered at the Old English Garden, which is sponsored by fragrance brand Jo Malone. The group also has a database of 900 projects throughout the UK and can connect people to projects in their area. www.thrive.org.uk

Mind is a mental health charity that runs garden projects across England and Wales. There are around 30 projects in London. www.mind.org.uk

Camden Garden Centre in London works with ex-offenders, the homeless and those recovering from substance abuse issues.www.camdengardencentre.co.uk

Asia

The Hong Kong Horticultural Therapy Centre in China helps young and elderly people with a range of disabilities and illnesses. www.hkhtcentre.com

The Institute of Mental Health in Singapore offers gardening as part of its rehabilitative programme. www.imh.com.sg

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