Sustainable Communities: Nature Work and Mental Health

1. Sustainable Communities?
Nature Work and Mental Health
Hester Parr
Department of Geography
University of Dundee

2. Sustainable Communities? Nature Work and Mental Health
Hester Parr, University of Dundee
Contents
Page
Introduction and acknowledgements 2
Executive summary 3-5
Full Report
Section 1:
Aims and objectives of research 6
Methods 7
Case study project profiles and visuals 9
Section 2
Literature and policy review 16
Section 3
Research Findings 24
Accessing garden projects 24
Gardening as a therapeutic activity 27
Gardening as a social activity 31
Gardening as a physical experience 35
Achieving social and community integration through urban nature work 37
Gardening as work and work training 42
Difficulties with garden work 46
Section 4
Conclusion 49
Visioning sustainable public mental health 53
Section 5
Reference list 55
1

3. Sustainable Communities?
Nature Work and Mental Health
Introduction
This report documents the findings from an Economic and Social Research Council (ESRC)
funded research project (RES-000-27-0043) on mental health, nature and social inclusion. It
draws on small-scale qualitative research conducted during 2004 with a range of organisations
in the UK, but predominantly in Scotland, that facilitate gardening work by people with
severe and enduring mental health problems. The executive summary highlights the main
findings from the project as well as highlights recommendations for policy and good practice.
Acknowledgements
This research was made possible by a grant awarded by the ESRC and I wish to thank them
for their support.
I would like to thank the participating projects for their time. In particular, I would like to
thank the staff and volunteers of each project for sharing their thoughts and giving their
generous assistance.
January 2005.
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4. Executive Summary
Study and methods
5 Garden projects across the UK were accessed in order to understand the role of
community garden work in assisting people with severe and enduring mental health
problems to achieve social inclusion and stability. 40 taped in-depth interviews with
garden workers were carried out: 20 volunteers (people with mental health problems)
and 20 paid support staff. 18 non-taped interviews were also carried out with
volunteers. Ethnographic observations over a period of 6 months were carried out in 2
garden projects (averaging at 2 days per week over the period).
Summary of Findings
Access to garden projects
• The gender and ethnic constitution of garden projects are dominated by white
British males
• Access to garden projects is dependent on adequate knowledge and awareness
amongst other mental health service providers
Gardening as a therapeutic activity
• Gardens, gardening and nature are generally experienced as therapeutic by
volunteers and staff
• The therapeutic effects include a variety of positive emotions and behaviours
• Volunteers experience the therapeutic effects of gardens in both active and passive
ways
Gardening as a social activity
• Gardening activities involve a range of social opportunities for isolated volunteers
• Garden work can involve senses of shifting social roles for volunteers
• Staff and client relationships can benefit from joint garden work
Gardening as a physical experience
• Garden work helps raise levels of physical activity amongst a sedentary group
• Different physicals skills and strengths may be developed
• Physical activity can help in the management of symptoms of ill health
• Healthy eating levels may be increased
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5. Achieving integration through urban nature work
• The location and layout of garden projects affects the opportunities for community
contact and integration
• Local communities integrate with garden projects in a range of practical ways
• Volunteers can feel increased senses of belonging as a result of garden work
Gardening as work and work training
• Most garden projects offer horticultural training and qualifications are highly
valued amongst volunteers
• There are perceived barriers to volunteers moving on from garden project work,
particularly into mainstream employment
• There are few ‘next step’ opportunities for trained volunteers
Difficulties with garden work
• Gardening work is physically and socially demanding for staff and volunteers
• UK garden projects are limited in their activity by weather and need to diverse
into other areas
• Resourcing, staffing and funding levels are a constant problem in terms of
adequate support, expertise and equipment.
Conclusions
• Garden work helps people with mental health problems achieve social inclusion
and stability
• Garden work seems to be most effective in terms of widening opportunities for
social inclusion and social networking when garden space is located in or near to
residential areas
• Contact with both nature and people facilitate stabilising effects
• People with mental health problems feel a range of primarily positive emotions
when engaged in garden work
• Participating in garden work brings opportunities to rework stereotypical
constructions of ‘the mental patient’ through active citizenship in local
communities
4

6. Recommendations
• Gardening and mental health projects need to create better access routes for
women and ethnic minorities, especially in Scotland
• Horticultural therapy and social and therapeutic horticulture need a higher profile
with social and health care services at a national level
• National level good-practice guidelines need to be developed and co-ordinated
across all types of gardening projects
• Local authorities could develop innovative approaches to social inclusion and
social care by linking these to urban environmental regeneration
• Visioning the future opportunities for ‘next step’ employment for people with
mental health problems and other groups could be tied into a re-invigorated ‘green
social economy’
5

7. Section 1
Aims and objectives of research
Academic context
This work is part of a larger funded research programme [ESRC RES-000-27-0043] about
mental health and social inclusion and concerns how people with mental health problems
experience social stability through participating in different kinds of spaces. The spaces under
investigation are categorised as natural, artistic and technological. What this means in practice
is that the research programme looks at examples of innovative community programmes and
projects that facilitate the participation of people with mental health problems in (i) gardening
activities, (ii) art and performance work and (iii) the use of the internet for social support. The
research programme is primarily academic in orientation and designed to facilitate the writing
of a book about mental health and social space by Dr Hester Parr of the University of Dundee.
However, the research conducted as part of this programme also has implications for users of
service, practitioners and policy makers. As such the results are being made available in easily
accessible formats in terms of printed reports, a web-site with further information and data
(http://www.dundee.ac.uk/geography/inclusion/) and a short video film (distributed by the
National Programme for Mental Health and Well-Being in Scotland)1.
Objectives
This study set out to investigate the relationship between community gardening
activities and people with severe and enduring mental health problems in terms of the
following overall questions and in the context of the voluntary sector projects that
organised this activity:
• How does working with nature help to achieve social inclusion and stability for
vulnerable groups?
• How are unstable identities positively changed through physical interactions with
land?
• What do people with enduring mental health problems feel about garden work?
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8. • Are there ways in which garden work might be best facilitated amongst this group?
• What are the key outcomes of garden work for this group?
• Are there any wider implications for public mental health?
This research was also directed primarily by academic questions about human selves
and identities in everyday social life and spaces, although the more user and policy
friendly findings are reported here.
Methods
A pilot study had taken place in March 2000 in the Ecoworks garden project in
Nottingham whereby staff and volunteers2 had been interviewed about the advantages
and disadvantages of garden work for people with severe and enduring mental health
problems (Parr, 2000). The findings from this project (Parr, 2000) were used as a basis
for designing and researching the current research programme on community
gardening for and by people with mental health problems. Ethical permission from
The Tayside Committee on Medical Research Ethics (and permission from the local
health authorities in which the participating garden projects were based) was attained
in January 2004 for the new research, itself facilitated by funding from the ESRC.
New research work took place between April 2004 and November 2004 involving 5
garden projects across the UK and sited in Glasgow, Edinburgh, Perth, Nottingham
and London (project profiles are below). In each project paid staff and volunteers were
interviewed about their role in the garden, their gardening experiences and feelings
about the work in which they participated. Semi-structured interview schedules were
used in each project that covered a variety of relevant key themes such as:
• History of garden project attendance
• Expectations of garden projects
1
The film will be finished in June 2005. Details from the author.
2
In many voluntary sector projects, people with mental health problems are termed ‘users’ or
‘clients’. In many garden work projects for this group, however, other labels are used such as
‘volunteers’ or ‘workers’ or ‘staff’. For the projects accessed as part of this research, this was
because it was felt that such terms avoided stigmatising those involved in garden work. This
report will adopt the term ‘volunteer’ when referring to people with mental health problems,
and ‘staff’ when referring to those workers who are paid to support gardeners with mental
health problems. It is recognised that non-hierarchical ways of working means that some
projects do not differentiate between gardeners in this way.
7

9. • Outcomes of garden work
• Reflections on therapeutic aspects of garden work
• Reflections on the social and practical skills gained as a result of garden work
• Experiences of work and training for work
• Managing and funding gardening and gardeners
• Future prospects and visions
Interviews were between 30 minutes and 1.5 hours long, were mostly taped and
carried out on-site in the garden projects. The taped interviews were then transcribed
and analysed for key themes using a basic coding framework through the NVIVO
software data management package. In all, 40 taped interviews were carried out with
staff and volunteers across the 5 garden projects. This included 20 taped interviews
with volunteers and 20 interviews with staff (with a wide range of roles and
connections to the projects concerned). A further 18 shorter non-taped interviews with
volunteers took place in the context of ethnographic (participant observation) work
over the course of the research period at several projects (but mostly focused on
Ecoworks, Nottingham and The Coach House Trust, Glasgow). Taped interviews with
volunteers included 18 with males and 2 with females and informal non-taped
interviews included 2 with females. In terms of staff, 10 females and 10 males
participated in interviews. All participants in this research project except one were
white British in terms of ethnic background.
Ethnographic research
Ethnographic research is otherwise known as participant observation, whereby the
researcher participates in the activities and social worlds under study and then records
observations and reflections in a research diary. This is then used to triangulate and
verify claims made by interviewees in verbal disclosures. The ethnographic work in
this project was concentrated in two sites over a period of 6 months. Recorded
observations are not re-presented as data in this report, but serve to contextualise some
of the more general comments on how garden projects operate and their
characteristics.
Please note that all quotations from volunteers and staff in the report are anonymised
or attributed to pseudonyms.
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10. Brief Garden Project Profiles
The ESRC research programme looked at 5 gardening projects for people with severe
and enduring mental health problems in 2004. 2 were sited in England and 3 were
sited in Scotland. Although there are considerable differences between each project in
terms of location, range of activities, client base, size and funding, for the purposes of
this report, common themes will be drawn out which apply to all. Academic and
conceptual implications of the research are reported in more depth elsewhere in Parr
(forthcoming, 2005).
Broad types/categories of garden space
• Allotments in residential areas
• Allotments on ‘wild’ common land/allotment site
• Removed garden spaces (walled gardens)
• Community gardens (predominantly used for project work, but with public access)
• Community gardening, landscaping and recycling projects
Ecoworks, Nottingham
Location: Inner city, St Anns, Nottingham
Type: Allotment (on ‘wild common land/allotment site’)
Annual Income: (2003-4) Approximately £55,000
Major Funders: County and City Social Services; NOF Healthy Living Centre; The
Community Fund; The Scarman Trust; Esme Fairbairn Foundation and other
charitable sources.
Service users: 6 (current) – 30 [varied numbers of volunteers and staffing over 10
year period]. Predominately white British client base, 90% male clients [previously
other ethnic minority groups have been involved].
Staff currently employed: 3 part time posts
Remit: to provide gardening opportunities for disadvantaged people, including those
with mental health difficulties, and to promote integration between different people
and groups through garden work.
9

11. The Coach House Trust, Glasgow
Location: Residential area, West End, Glasgow (with multiple sites across North
West and South Glasgow)
Type: Community gardening and recycling project/community garden
Projected Annual Turnover 2004: £800,000
Main funders: Scottish Executive Strategic Waste Fund Not For Profit Sector;
Greater Glasgow Health Board; Social Work Department, Glasgow City council; New
Opportunities Fund; ERDF (European Regional Development Fund); other charitable
trusts.
Service users: 60 [98% male, 99% white British].
Volunteers: 19
Staff employees: 30
Remit: To counter social exclusion amongst a range of groups (those who are
unemployed and those with learning difficulties, drug and alcohol addiction and
mental health difficulties) through participation in a range of activities and training for
work opportunities.
The Walled Garden, Perth
Location: grounds of Murray Royal Hospital, Perth.
Type: Removed walled garden
Budget: (est/approx): £140, 000
Main Funders: Social Services; NHS Health Department.
Service users: 35 [80% male, 20% female, 100% White British]
Staff employees: 5
Remit: To provide a supportive horticultural work environment for those with mental
health problems.
10

12. Redhall Gardens, Edinburgh
Location: residential/conservation area, South Edinburgh
Type: Removed walled garden
Budget: (est/approx) £138,000
Main funders: Social Work Department, City of Edinburgh and NHS Lothian.
Service users: 36 [60% male, 30% female, 5% ethnic minority representation]
Staff employees: 5 full time, 1 part-time
Remit: To provide a supportive horticultural work environment for those with mental
health problems.
St Mary’s Garden, Hackney, London.
Location: Inner city/residential/warehouse district, Hackney
Type: Community garden
Budget: (est/approx) £110,000
Main funders: Thrive; The Learning Trust, Hackney; Social Services (Learning
Disability Service and Community Mental Health Teams; Neighbourhood Renewal
Fund; New Deal for Communities, varied charitable trusts.
Service users: 30 (Male 62% Female 38%, 63% from black and ethnic minority
groups]
2 full time staff, 2 part time staff
Remit: To provide therapeutic horticultural and work training opportunities for those
with mental health problems, learning disability, HIV and young offenders. To also
provide a community garden for the local community with a resident key holder
scheme.
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13. Different gardening project spaces
12

14. 13

15. 14

16. 15

17. Section 2
Context for the study: A brief literature and policy review
Nature and health
There is a multi-disciplinary and international literature base that has long evaluated
the varied connections between nature and health. Writing and research from
environmental psychology, nursing, ecopsychology, planning, wilderness therapy,
therapeutic horticulture, human ecology and human geography have all contributed to
a rich, if diverse, evidence base about perceived beneficial connections between a
range of nature-spaces and a range of aspects of human well-being (Kaplan et al,
1990; Kaplan, 1995; Maller et al, 2002; Morris, 2003; Sempik et al, 2003; Gesler,
1993; Gesler and Kearns, 2002). From early environmental psychology studies which
famously highlight the benefits of nearby nature for post-operative hospital patients
(Ulrich, 1983) to more recent work on the positive mental health implications of
woodland play for children (Bingley and Milligan, 2004), to the reported benefits of
gardening for refugees and survivors of torture (Lindon and Grut, 2002), health-nature
relationships are deemed important across many disciplines and international contexts
in terms of building human well-being and social and psychological capital. Although
it is impossible to do full justice to this literature base here, some common themes
emerge from research work that has looked at nature-health relations and these serve
to connect individual human health with local community and global community
health issues. There is hence a dominant message from this literature that nature can be
generically understood a resource for human health on several different scales and in
connection with a range of issues. The following list summarises just some of the ‘big
picture’ themes that traverse the nature-health literature in terms of perceived key
benefits:
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18. Table 1: Nature use/relations and individual/community health benefits
• Restorative properties for general human mental and physical health and well-
being
• Therapeutic properties for a range of groups with different mental health and
physical health needs
• Building social capital and strong/er communities through collective uses of nature
• Environmental impacts and eco-sensitive awareness raising
• Global and local sustainability issues
• Food security and alleviating poverty
These benefits are potentially accessed through a range of different kinds of activities
and relations in different kinds of nature spaces:
Table 2: Diverse nature spaces
• Parks
• Urban nature spaces
• Forests and woodlands
• Farm and agricultural land
• Community gardens
• Allotments
• Private gardens
• Wilderness areas
• Seascapes and watery landscapes
• Institutional natures (in hospitals, workplaces, schools, prisons, clinics etc)
The benefits of cultivating, living near, using, being and playing in nature in its
varied forms, but particularly in urban spaces of population concentration, is fuelling
research efforts to better understand the beneficial outcomes summarised above.
Recent EU initiatives, for example, are attempting to harness the research capacity that
exists to link nature spaces and human health (COST E39, 2004-2008). Current
funding strategies include facilitating collaborative engagements between different
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19. academics and practitioners in order to collate the evidence base relating to health and
nature across Europe (see also ‘policy context’ below). There are also a wide range of
NGOs who contribute to our understanding of the practical capacities of nature spaces
in terms of the broad benefits to individual and community health.
Gardening, horticulture and health
One very specific aspect of the relationship between nature and health has formed the
basic context for this study. Gardening and horticulture3 has received considerable
attention in recent debates over the health-giving capacities of nature (Francis et al,
1994; Relf, 1992; Cooper Marcus et al, 1999; Simpson et al 1998, Sempik et al,
2003).
While the health implications of gardening and horticulture are thought to be
relevant for the general population as well as specific groups (such as the elderly,
children, people who are ill, offend, have dementia, learning difficulties or physical
disabilities), it is those with mental health issues who are privileged here. Indeed, the
known relationship between domesticated nature (gardens, landscaped park land, farm
land) and health can be argued to have specific roots in institutional health care for
people with mental health problems. Gardens and gardening were recognised as a
therapeutic medium for institutionalised populations since the late 1700s both in the
UK and the US where the benefits of field labour for asylum patients were noted by
contemporary psychiatrists of that period (Davis 1998; Paterson, 1997; Digby, 1985;
Philo, 2004, Parr 2005). In the 20th century, and building on asylum practices in the
19th century, occupational and rehabilitation practitioners of various persuasions have
extensively adopted what has been termed either ‘horticultural therapy’ or
‘therapeutic horticulture’ in relation to a range of vulnerable groups and settings
(Goodban and Goodban, 1990ab; Kaplan, 1995; Nehring and Hill, 1995; Seller et al,
1999; Simpson and Strauss, 1998). These terms respectively refer to the use of plants
and garden work to meet clinically defined goals (a treatment strategy), and more
generally, the well-being that may develop from gardening in both active or passive
ways:
3
‘Horticulture’ refers to the practice of cultivating plants, while ‘gardening’ can more
generally refer to other activities such as weeding, landscaping, creating beds for plants,
harvesting and so on.
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20. ‘Horticultural therapy is the use of plants by a trained professional as a
medium through which certain clinically defined goals may be met’
‘Therapeutic horticulture is the process by which individuals may
develop well-being using plants and horticulture. This is achieved by
active or passive involvement’ (Growth Point, 1999, p 4, cited in Sempik,
2003, p3)
In order to depict the current place of garden work in the UK’s community welfare
infrastructure, Sempik et al (2003) settle on the term ‘social and therapeutic
horticulture’. This term is used to indicate that horticultural activity with
disadvantaged groups is not often strictly clinically orientated, but rather is aimed at
providing opportunities to ‘improve the well-being of the individual in a more
generalised way’ (ibid, p4). The commonalities across different disciplines and
studies in terms of a convincing, but largely unacknowledged, evidence base for the
health-promoting dimensions to horticulture and gardening are summarised below and
can be seen to crystallise around the benefits of gardening in terms of individual and
collective health and social improvements:
Table 3: Some reported benefits of garden work amongst vulnerable groups
(after Sempik et al, 2003 and Morris 2003)
• Improved self-esteem and self confidence
• Development of work and social skills
• Development of independence
• Opportunities for emotional expression and reflection
• Enhanced spiritual and sensory awareness
• Useful employment
• Increased physical activity and exercise
• Consumption of healthy food in sociable ways
• Improved opportunities for social cohesion and behavioural improvements
• Accessing to opportunities for social inclusion
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21. Despite the positive messages from most research on horticulture and health, caution
must be also exerted in terms of thinking through how and under what circumstances
such benefits are achieved for particular participants. For example, many institutional
gardens may not provide the same opportunities for social cohesion and healthy eating
as a community based garden. Community gardening projects are also often
predominantly male spaces, as this research indicates, and there maybe multiple
access issues concerning different natural spaces (see below and Kurtz, 2001). Any
benefits must therefore also be understood alongside the local conditions and
circumstances through which garden work happens, as well as considering what
national guidelines might help to ensure the above outcomes for all (see concluding
comments).
One of the key points of interest for practitioners and policy makers is how
gardening and horticultural work facilitates social inclusion for vulnerable or
excluded groupings. In arguing how this work often involves key components of
‘social inclusion’, Sempik et al (2003) suggest that collective gardening, enacted
through community social welfare projects, enables gardeners with mental health and
other difficulties to participate in processes of
i) Consumption [buying/consuming the goods that other people
buy/consume]
ii) Production [engagement in socially valuable activity]
iii) Social interaction [the building of social networks and identity]
iv) Political engagement [self-determination and empowerment]
These elements are argued to be key dimensions of social inclusion (after Burchardt et
al, 2002 and cited in Sempik et al, 2003, p37) and processes from which people with
severe and enduring mental health problems (for example) may have been distanced
through institutionalisation. In this view, engagements with domesticated nature and
gardening are powerfully associated with current social policy goals, those being the
integration and normalisation of previously excluded people in everyday society.
Political and community contexts
Mental health and mental health care have been recently linked with major
policy initiatives in the UK connected with ‘social inclusion’. Both the EU and the UK
20

22. can be seen to be pursuing a raft of policies connected to this concept. In current
political discourse the buzzword of ‘social inclusion’ is associated with access to
employment, good housing and health, education and participation in a wide variety of
social and economic arenas (Scottish Office, 1999; Scottish Executive, 2003a), while
conversely ‘social exclusion’ is associated with unemployment, poor housing, ill-
health, crime and lack of community participation (Social Exclusion Unit, 2001). In
terms of mental health it is clear that policy makers link ‘social inclusion’,
‘participation’ and the ‘improvement of clinical outcomes’ (Sainsbury Centre for
Mental Health (SCMH), 2002, p2; National Service Framework, 1999), and so
promote links between inclusion outcomes and mental well-being. For both ensuring
and maintaining mental well-being amongst the general population, then, and specific
improvements in terms of people who have experienced illness, opportunities for
community participation, education and inclusion are thought to be key dimensions to
success.
In the UK more generally there is a current political emphasis on active
participatory citizenship, facilitated by multifarious funded partnerships between the
state and communities (Fyfe and Milligan, 2003). This coincides with health care
policies that have sought to relocate the everyday lives of people with severe and
enduring mental health problems within community settings in order to end isolating
and stigmatising institutionalised care (Scottish Executive, 2003b). Simultaneously,
the drive to counter exclusionary processes and positions that many people in living in
poverty and disadvantaged communities find themselves located within has been
politically important (Social Exclusion Unit, 2001, 2004). The role of nature in this
broad political context is complicated, but has in various ways provided a platform
upon and through which politicians, communities, organisations and individuals have
claimed rights, sought participation, attained resources and articulated global and
‘traditional’ local community values in the search for an improved society. Combined,
the influences cited above are all driving factors as to why nature generally, and
horticulture for those with mental health problems specifically, is currently of interest
in UK communities and voluntary sector organisations.
There are also now significant national forums for the promotion of inclusive
nature spaces (for example, Thrive, The Sensory Trust, The Federation of City Farms,
Greenspace and Greenspace (Scotland)) and which can be understood to be broadly
attempting to facilitate new links between citizenship, well-being and nature.
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23. Community gardens are increasingly popular in UK cities and are open spaces
managed and operated by members of the local community for a variety of purposes
(Holland, 2004) including vegetable growing, recreation, training, education and
health promotion. Ideally community gardens exist to maintain or facilitate senses of
community in particular places and the aims of community participation and
empowerment is what (potentially) links the community garden idea with horticulture
for mental health. However, despite the growth in community gardens, and some
examples of integrated community work, most gardening work undertaken by people
with mental health problems occurs in special project spaces, which can hence
potentially limit the claimed advantages for social inclusion. Nonetheless, there is
some evidence of a greening of social policy and a greening of the voluntary and
community sector, a development surely framed by wider national and global politics
of environmentalism and sustainability. Such a national UK political context can be
argued to be conducive to the more widespread development and funding of
horticultural and community gardening work by people with mental health problems.
In Scotland The National Programme to Improve the Mental Health and Well
Being of the Scottish Population (and Action Plan 2003-6) reportedly flows from the
Scottish Executive's commitments to social justice and health improvement.
Demonstrating an interest to exploring innovative means to build community well-
being (Scottish Executive, 2003c) as well as dismantling stigma about mental health
issues, the role of diverse nature spaces are arguably under-explored as a means
through which social inclusion and participation might be achieved. However, given
the stated commitments to ‘joined up’ thinking and action across mental health
promotion, prevention and treatment sectors (Henderson, 2004), there are possibilities
for the natural urban environment to be an imaginative focal point for action relating
to public mental health. In disadvantaged communities with poor social housing stock,
for example, the development of community garden work and accessible natural
spaces (by people with mental health problems amongst others) could assist in
building public mental health by facilitating safe participatory spaces of everyday
community life.
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24. Table 4: Political contexts for new nature-health relations
• Community mental health care
• Political interest in improving public mental health
• European and UK focus on social exclusion
• Scottish focus on social inclusion and mental well-being
• Growth of environmental pressure groups
• Global, national and local environmental politics
In summary, there are multiple global, national and local contexts for the current
development of community garden work and the adoption of urban natural spaces as
an innovative means of achieving and maintaining health amongst both general and
specific population groups.
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25. Section 3
Research Findings
Accessing garden projects
There is no one route to participating in gardening and mental health projects and
volunteers were variously referred by CPNs, GPs, social workers and from in-patient
care. Informal access can also occur with self and social network referral being
commonly cited as pathways to gardening. Once referred applicants are usually
interviewed for their suitability for horticultural work and formal funding is applied
for. On the whole, most schemes sought clients or volunteers who were relatively
mentally stable and physically mobile, although some (varied) provision was made in
all schemes for wheelchair access. The diagnostic categories and labels applied to the
garden workers who contributed to this study are not recorded in detail, but ranged
from schizophrenia to bi-polar and to depressive and anxious conditions.
‘Well I actually heard about the Coach House when it was just beginning to start
up. I had a friend that stayed near here that knew about it and she showed me it. But
also my young sister helped arranged the funding for this when it was Belmont
Gardens, before it became the Coach House’
Mel, Volunteer4
‘My GP had mentioned it just in passing and so … I had no preconceived ideas’
Halley, Volunteer
Most volunteers report having few expectations at the point of project access,
beyond wanting to change isolated social positions, although some are at a point of
wanting to develop skills and participate in training after months or more usually
years of mental health care. However, many volunteers talked about the fear they felt
at entering a gardening project and the challenge of beginning work in an
environment of which they had little knowledge or expertise. What is valued at the
point of access is a supportive and clearly structured introduction to gardening tasks.
Working in peer teams where there are a range of abilities and levels of expertise is
4
Please note that all quotations from volunteers and staff in the report are anonymised or
attributed to pseudonyms.
24

26. also valued at initial access points. Women volunteers (few as they are) discuss the
challenge of entering male dominated work spaces and the importance of ensuring
women friendly spaces as well as the flexibility of working alone in gardens.
‘I was referred by my CPN who thought it would help, but when I came here I had
never been near a garden in my life and I didn’t know anyone and I didn’t like it’
Kim, Volunteer
‘Basically I was looking for it as a permanent job, something I could do and develop
in and utilise my skills and learn new ones’
Bill, Volunteer
Staff report how important it is to have good relationships with a range for
service providers in order to raise the profile of gardening and horticulture as viable
community activities for people with mental health problems. Some projects,
however, face major difficulties in maintaining consistent referral patterns for several
reasons:
• the perception of gardening as a ‘luxury’ service in already stretched
mainstream service budgets
• a lack of awareness amongst primary care providers (such as GPs) and the
difficulties of accessing them to raise awareness
• the unstable nature of funding sources in the voluntary sector resulting in
fluctuating staff numbers with knock on effects in terms of referrals.
In terms gender imbalance issues, garden project staff often locate the problem
at the point of referral with service providers outside the project perceiving gardening
and outdoor work as predominantly male activities and thus targeting those clients.
For long-established projects with a predominately male client base, few specific
strategies are employed to widen access to women. Only one project in the study had
specific women-friendly access routes and women-only garden spaces and activities.
‘When the project first started there was a lot of heavy work involved and so it tended
to be men who came and now if you speak to women who come and see round the
place, you can see that they are intimidated by the amount of men, particularly when
there’s young men for example. It is difficult. The ethnic mix is the same – we only
have 1 black person and 1 Asian person’
Staff
25

27. ‘We mail shot all the GPs in the borough … it’s about 60 … and then followed up
with phone calls with GPs or practice managers or whoever we could talk to … and
we got a positive response … but not a single GP has referred anyone to us’
Staff
In terms of ethnic minority participation in garden projects there are different
factors that may contribute to gardening projects being predominantly white spaces,
including a general lack of integrative mental health service provision across different
ethnic groups (which may influence referral patterns) and differing culturally based
gardening practices and experiences of cultivation amongst particular ethnic groups.
In respect to the latter point, however, some sectors of ethnic minority groups place
particular cultural importance on cultivation (such as some older Black Caribbean
men) and so shared gardening and allotment work could act as an important resource
in addressing ethnic ghettos in mental health care. Similarly, refugees and asylum
seekers often arrive in the UK from land-based economies and may benefit from
mental health services that are focused on cultivation. Ecoworks in Nottingham is one
project from this study that had active involvement with a group of asylum seekers
before their deportation in 2003. St Mary’s in London is a project that attracts the
attention of multiple ethnic groups in the locality and who also use the space as a
community garden. Natural space arguably therefore holds the potential to act as a
bridge to hard-to-reach groups who may have complex mental health needs.
Key summary points
• Access to garden projects is dependent on knowledge and awareness amongst
other mental health service providers
• Volunteers are often fearful at point-of-entry to garden projects if they lack
horticultural experience
• The gender and ethnic constitution of garden projects is dominated by white
British males
• Women-friendly access routes to project garden spaces are few
• Gardening as a focus for culturally sensitive mental health service delivery for
ethnicity minority groups is under-explored
26

28. Gardening as a therapeutic activity
Volunteers come to gardening projects with a range of experience of natural and
cultivational spaces, but with most having some exposure to these in association with
their mental health care. For some, this can mean an ambivalent relationship with
nature work, and something they associate with difficult times of their lives, or
services that did not suit them or gave them little choice. For others, who have little
experience, the work involved and the knowledge it requires can seem daunting.
Although there may be latent beliefs about health giving capacities of nature that may
underlie their initial decisions to access garden projects, few volunteers were
conscious of this affecting their access routes. It is common for volunteers to discuss
how they gradually came to experience nature and nature work (gardening and
horticulture) as therapeutic only after some time with the projects concerned.
Of the 38 volunteers interviewed as part of this study, 90% of them discussed
what might be summarised as broad ‘therapeutic effects’ of garden work. These
effects can be summarised as follows (using vocabulary by volunteers):
Terms used by volunteers to explain the therapeutic effects of garden work
• Therapeutic
• Calming
• Grounding
• Occupying
• Distracting
• Focusing
• Healing
A large majority of the volunteers discussed how general interactions with the natural
world and gardening activity in particular had helped them recover from mental health
problems, or at least helped to maintain their health status. Ethnographic observations
carried out as part of this study confirms that garden work sometimes helped to calm
erratic behaviour and provided a focus for negative energy and anger in difficult
times.
27

29. ‘When you feel angry you just dig furiously, I associate gardening with getting anger
out of the system more than anything else … it’s about getting rid of energy into the
soil somehow. There is something about releasing anger into the soil’
Josh, Volunteer,
‘Between leaving the house and walking up here you feel different, you’re glad you
came. As soon as you come up here it does have an effect on you … a positive effect …
of leaving behind stuff … it helps to break the rhythm of stress’
Mandy, Volunteer
There are two dominant ways in which nature and garden work are deemed beneficial
for volunteers:
• as a passive sensory environmental experience that prompts positive reactions
and
• as a medium for action (physical, social, psychological) through which the
volunteer creatively works for their own health.
In other words, volunteers both held or developed beliefs about nature and gardens as
inherently healthy (automatically benefiting them) and as a medium for creative
healthy action (non-automatic health benefits).
Particularly important in terms of the therapeutic benefit of the garden projects
was horticulture itself, ie the cultivation of plants. This may be both because the
practice of plant growing is in itself experienced as therapeutically beneficial, and
also because plant growing features heavily in staff explanations of the benefits of
garden projects, and volunteers are influenced by these discourses. For example, plant
growing was discussed by many volunteers as:
• Involving care and concern beyond the self
• Helping to ground confused thinking
• Involving positive emotions such as hope, pride and love
28

30. ‘You have to focus on the plant, you have to go with that and it helps you, it just helps
to ground you’
John, Volunteer
‘If you plant something it’s dependent on you, you have to slow your thoughts down to
the speed of the plant and what’s happening to it. It fixes you … it’s quite a
responsibility to care for the garden’
Kyle, Volunteer
Plants and plant growing are also often used as metaphors by both staff and volunteers
to discuss social and psychological difficulties. While this is a recognised feature of
horticultural therapy, many project staff do not claim to be practising such a formal
programmatic approach to garden work with mental health services users. Rather,
garden staff (often who are not trained mental health specialists) refer to the ‘natural’
healing capacity of gardens and garden work that they merely facilitate in a
generalised way.
‘… there’s lots of little magical spaces that people have here, where you just
wander around and it just fills you up really and I suppose it’s allowing nature to
heal you really ...’
Colin, Volunteer
‘The garden and gardening is healing really. It’s about the earth, it grounds you
when you are totally disorientated by the world around you’
Peta, Volunteer
Staff in garden projects unsurprisingly held strong beliefs about the
inherent healing qualities of nature, as well as the social and educational
capacities of natural spaces for skills training (see below). Garden staff, therefore,
play an important role in terms of how gardens and gardening are experienced as
therapeutic by volunteers. Garden staff and garden projects differ in terms of their
emphasis on structured work programmes, the amount of therapeutic talk using
plant metaphors, their discussion of the natural healing power of nature and this
all influences the experience of gardening for volunteers.
In general, where volunteers had relative freedom to develop areas of the
garden, or had responsibility for their own part of a plot for growing, they were
more likely to discuss at length the therapeutic effects of nature and gardening.
Where volunteers were more used to general landscaping and gardening in teams
29

31. or with close supervision, they were more likely to discuss at length the beneficial
social effects of gardening with others, rather than the therapeutic capacities of
nature per se.
‘I think that gardening is therapeutic for a lot of people… ill or not, disabled or not …
it is basically using gardening whether it is self administered therapy or with the help
of someone else to affect positive changes in lives’
Staff
‘We are organic and we are encouraging life to come in. That’s an interesting
thought really, actually encouraging life into the site is the same as the life in the
people as well … it’s about allowing people to express their energy, in the way that
they want to’
Staff
‘I think particularly if you’re suffering like I’ve done with severe depressive episodes,
it’s hard to think beyond surviving in the minute. You’re just wanting to get through
the next minute almost or next few seconds. To actually look at a piece of ground and
think, ‘that’s what it is like now, and then in 3 weeks time this will be like this, and
then in 3 weeks time it will be like this, and then in 3 months time it will be like this’.
You’ve actually started to create a future with the bit of earth that’s in front of you,
and for yourself, which is something you don’t have’
Andrew, Volunteer
Finally, garden space itself is seen as importantly bound up with the
therapeutic experience of nature. Project gardens and allotments were primarily seen
by volunteers as variously:
• Safe spaces
• Creative spaces
• Tranquil spaces
• Spaces of retreat
• Social spaces
• Community spaces
The geography of garden spaces was also important with zoned gardens being the
most successful in creating accessible space suitable for use by people in different
psychological and physical states.
30

32. ‘I like the patterns on the worms, the patterns, they look like floaters in your eyes the
worms. I like the noise of the bees buzzing outside, I like the sound of the wildlife
outside, aye’.
Callum, Volunteer
Key summary points
• Gardens, gardening and nature are generally experienced as therapeutic by
volunteers and staff
• The therapeutic effects include a variety of positive emotions and behaviours
• Volunteers experience the therapeutic effects of gardens in both active and passive
ways
• Plant cultivation is particularly important in discourses of healing
• Garden staff are also positive about the healing potential of gardens and garden
work and their beliefs and practices can influence volunteers
Gardening as a social activity
While most collective activities in community mental health services involve
opportunities for socialising (and garden work is no different here); there may be
particular aspects to the social activities that constitute this work that are worth
noting:
Social dimensions of community garden work
• Peer network opportunities
• Neighbourhood social contact opportunities
• Staff and client social contact
• Team working opportunities
• Food and social eating events
• Role shifting
To pick up on just a few of the above list, the seasonal rhythms of garden work
means that work is differently paced throughout the year with a variety of tasks. This
not only tends to keep volunteers interested, as well as allowing for both able and less
able workers, it also lends itself to the creation of social opportunities based around
garden work. In summer times, and at times of harvest, when produce is plentiful,
31

33. most garden projects have social events both for workers and for wider
neighbourhood users (see below). The social significance of groups of people eating
produce grown by volunteers is particularly meaningful, and contributes to feelings of
pride and satisfaction, as well as providing a focus for conversation.
‘When I took manic depression and was classed as ill and hospitalised, I lost all my
friends and even most of my family. They cut me off and I wasn’t included in anything
anymore. So I’ve been having to try and start again at the Coach House. Not
necessarily at the Coach House, but at that level. The Coach House now has basically
replaced all the ones that I’ve lost’
Kevin, Volunteer
In terms of staff and client contact, garden work provides (some) opportunities
for collaborative engagement, rather than just top-down support and/or instruction
from the staff to the client. Volunteers also felt that their own service providers saw
them differently as a result of their garden work, as well as being able to (eventually)
provide semi-expert horticultural support to paid garden staff. In some projects the
atmosphere of collaborative equality established through garden work translates to a
‘work place’ atmosphere, whereby staff and volunteers often celebrate the end of a
working day or week with a visit to the local pub.
Some other aspects of garden work also allow volunteers opportunities to see
themselves in rather different social roles, moving from positions of dependence to
becoming more independent and embodying a status of ‘responsible worker’. Such a
move is discussed as being facilitated (for example) by the use of power tools like
saws and lawn-movers. Volunteers discuss the importance being trusted to use such
equipment, as for people with severe and enduring mental health problems, ‘trust’ is a
particularly meaningful relation.
‘The guy again with the fuchsias … is quite knowledgeable and he in the past has
taken a great deal of the responsibility of the garden himself, he could partly run this
place himself as could a few others’
Staff
‘Many of the decisions on what’s planted and how it’s planted is done jointly within
the garden team’
Staff
‘I can feel that I can be trusted with a lawnmower’
Jack, Volunteer
32

34. ‘They (the CPNs) see me differently, they see me more settled ... getting on with my
life and being motivated ..’
Tim, Volunteer
Team working is also a feature of many garden projects, especially where
there is not space to allow individual gardening plots. Team working was especially
helpful to new project members as it enabled peer instruction and support to take
place. Volunteers also felt that team work enabled friendships to be more easily
established. For volunteers who were established members of garden projects, the
peer support and instruction helped them to achieve senses of self-worth and job
satisfaction, as their roles shifted from ‘just’ ‘patient’ to ‘garden worker’.
‘If I’m feeling depressed, it’s nice to go out and work in the team along with the
support staff … I feel that I’m in a safe environment, in amongst a safe crowd, there’s
nobody sort of looking or talking or doing anything, and I’m working along with a lot
of other people, volunteers and staff and whatever that are in the same boat’
Mick, Volunteer
‘I’m quicker and I’ve got experience, but you’ve got to allow for others, you’ve got to
work together and some people are faster, some people are slower …. Sometimes I
help them out, perhaps they’re having difficulty or whatever ... I just give them a hand
to get it done …’
Tim, Volunteer
In addition, primary care workers (CPNs or support workers) beyond the garden
projects were sometimes invited in to work alongside volunteers in the gardens or
allotments. This was considered a beneficial practice as volunteers could demonstrate
activity, concentration and expertise to care workers who may have only regarded
them in the passive patient role previously.
In some projects there are mixed working teams of people with mental health
problems and people from the local community (although this is not common), and
here there are opportunities for social integration that stretches beyond peer and staff
networks (see also below). In such schemes, it is important to stress the equality of all
volunteers, regardless of ability.
33

35. ‘Ecoworks have a policy of calling everyone a volunteer and I might be on the
management committee and helping with funding raising and someone else might
need help with keeping his jumper on in the garden, but we’re both called volunteers
and no one ever makes a distinction about ability or mental health status or anything’
Kit, Volunteer
Staff report that garden work can make differences to the social skills of
volunteers. Volunteers are commonly discussed in terms of their progression from
withdrawn and isolated social states to a point at which they are able to socially
engage with others. Staff often use the environment as a way to encourage
conversation with quieter members of gardening teams, arguing that the shared nature
of garden work and the ability to focus on natural surroundings reduces the pressure
on people who find socialising and maintaining relationships and conversations
difficult:
‘It’s very easy to look at something and say come and have a look at this in the pond,
or come and have a look at this that’s flowering or whatever and that provides visual
distractions that are useful. It makes it an easy setting to talk to people …’
Staff
As reported in the literature, there is some evidence from this study that people
involved in garden work subsequently gain experience of new social roles, partly tied
to increased political awareness of their roles as consumers of mental health services.
Some volunteers participate in garden management committees, team meetings and
planning processes associated with garden work. Others present talks on mental health
to interested parties or get involved with national conferences on horticultural or
mental health issues. While garden work does not seem to be particularly notable for
the raising of political awareness and participation amongst its volunteers, there is
evidence that this does occur.
Key summary points
• Gardening activities involve a range of social opportunities for isolated volunteers
• Garden work can involve senses of shifting social roles for volunteers
• Socialising and routine conversations can be linked to the natural environment
• Teamwork in garden can involve peer support
• Staff and client relationships can benefit from joint garden work
34

36. Gardening as a physical experience
An important part of garden work is the benefit gained by increasing the physical
activity of people who lead very sedentary lifestyles. For many people with severe
and enduring mental health problems, medication use and lack of daily activities and
structure in their lives can mean that they are not usually physically active. This has
implications both for physical fitness and psychological health. Staff in garden
projects point out that the lifestyles of people who live in institutional care, or who are
predominantly bound into mental health care networks, often feature what are
conventionally understood as ‘unhealthy’ characteristics such as:
• High rates of smoking
• Low rates of physical activity
• Diets lacking in nutrients
Engaging in garden work can raise levels of physical activity to levels that suit the
abilities of the worker involved. Many volunteers in this study reported beneficial
effects of physical activity in terms of the impact on mental health and sleeping
patterns (possibly reducing medication use):
‘If it’s winter time and you’re digging … you’re going to dig like mad to keep warm’
Kim, Volunteer
‘Gardening is a very good piece of exercise and it’s like having relaxation …’
Mick, Volunteer
‘It’s physical and I enjoy it, at the end of the day to be quite frank I get a good nights
sleep, because I’ve been moving and active’
Tim, Volunteer
‘You’re that tired you realise, oh I got that anger out you know. The frustration you
take it out …’
Jock, Volunteer
Both staff and volunteers point out that garden work can mean not only increasing the
amounts and levels of physical activity, but also the development of different physical
strength and skills as they develop through particular tasks such as:
35

37. • Manual dexterity with seedling and plants
• Handling complex garden equipment with care
• Building muscle strength with lifting and digging
• Visual focusing on seeds, plants and wildlife
For some volunteers, the physical benefits acquired from garden work are not only
tied into strength, relaxation and skills, but also connect to the acquiring of different
sensual and sensory experiences, which simply expand and improve their sense of
‘quality of life’. Particularly for those garden workers who work in allotment
environments, where they are exposed to prolonged experiences of wood-smoke,
fires, rain, cold and heat, physical experiences can be quite profound:
‘People for instance living in a residential home, it can tend to be a very stifled and
claustrophobic environment. So people having the opportunity to come to somewhere
like this, where it is open, and they can get out in the fresh air and get wet through if
it’s raining, and get muddy, is actually quite an unusual thing. To have somewhere to
sit by the fire and all this sort of stuff, I think is important.’
Ade, Volunteer
‘It’s about getting dirty, it’s about shoving your hands in the ground.’
Steve, Volunteer
In times of ill-health the physical dimensions of garden work can take on more
meaning in terms of both the difficulties and the relief that this can bring. For those
who have experienced disabling levels of depression, for example, the challenge of
garden work can seem too physically demanding at points. For others, acute phases of
illness involve different physical experiences of garden work. For those with bi-polar
illness for example, frenetic and high-speed garden work can help to channel energy,
although this pace of work can be disruptive and alarming to others. Zoning garden
work can help to alleviate this problem.
36

38. ‘You can suit a job to how you’re physically feeling. If I’m really tired and got no
energy I can sit and sort seedlings’
Dave, Volunteer
‘I was once in the garden helping to mix some compost, and the big bin was oozing
and they were doing it on a tarpaulin, but I was a bit hyper that I did it so hard and
fast that I stretched the entire tarpaulin beneath it and around it. But the staff were
fine about it, they were understanding. I got the work done fast though’
Mick, Volunteer
Garden project staff also argue that improved healthy eating is a key physical
outcome for participants who have mental health problems. For those newly resident
in community settings, or who live in institutional care, diets are often poor due either
to levels of cost or a lack of skills in terms of the preparation and consumption of
fresh fruit and vegetables. All of the garden projects in this study provide food for
their volunteers on a daily basis, and most used produce from the garden or allotment
(although not consistently throughout the year). This practice results in the double
benefit of raising consumption of nutritious (often organic) food and celebrating and
sharing the result of communal work efforts.
Key summary points
• People with mental health problems may have conventionally unhealthy lifestyles
• Garden work helps raise levels of physical activity
• Different physicals skills and strengths may be developed
• New sensory experiences may be acquired
• Physical activity can help in the management of symptoms of ill health
• Healthy eating levels may be increased
Achieving social and community integration through urban nature work
People with mental health problems who work in gardening and horticultural projects
report in general that their social networks are often strengthened as a result of their
participation. While there may be particular features of the social relations that are
created and maintained in garden projects (see above), there is a sense in which any
collective community activity amongst mental health service users will be likely to
strengthen peer networking to some extent. Beyond the formation of social
37

39. networking and development of social integration with other project users and project
staff, it is useful to discuss the wider potential for community integration.
In terms of wider social and community integration, the projects that took part
in this study had developed in different ways. For the projects based on allotment sites
or removed nature spaces, the potential for integration with community residents was
diminished, although relationships between individual and other plot-holders workers
were in evidence/had the possibility of being created5. For garden projects based in
densely populated locations, the integration between the project, its workers and the
local community is particularly important and forms the basis of commentary in this
section.
The garden projects under study comprised the following types of ‘garden
space’:
Broad types/categories of garden space
• Allotments in residential areas
• Allotments on ‘wild’ common land/allotment sites
• Removed garden spaces (walled gardens)
• Community gardens (predominantly used for project work, but with public access)
• Community gardening, landscaping and recycling projects
In general, the latter two ‘types’ provide most opportunity for face-to-face interactions
between volunteers and local community members. The allotments and removed
gardens provide less opportunity for daily contact with local community members
(based on reported and ethnographic observations) due to their less accessible
physical locations and site features (such as high border hedges or walls).
In terms of the community gardens and community landscaping projects,
being literally placed within well used residential and commercial spaces offered
multiple opportunities for volunteers to build senses of belonging and community in
place. The function of such spaces and schemes (ie. regenerating and creating usable
and visually pleasing green spaces) increase the sense in which volunteers are seen as
‘useful citizens’ providing local services, instead of ‘just’ receiving services. Both
staff and workers agree that (in particular) the transformation of wild or wasteful
5
These projects did hold well-attended social and open events for local communities.
38

40. urban nature into manicured and aesthetically pleasing public spaces is a powerful
symbol of the purpose and capacity of people with mental health problems. Such
symbolic transformations of space serve a dual purpose; as they involve the practical
re-skilling of a deskilled population: and help to convince local residents that people
with mental health problems contribute to the improvement of community life:
‘The people round about are great, they see what a great job the Coach House does
and I think it helps empower everyone that’s here because the people around … don’t
look at the negative side of people, they look at the positive side and they don’t look
and say, ‘well because they’re disabled they can’t do that’ … there are some people
in here, myself included, that are classed as being not able to live in society, and
we’ve got our problems, but the level of knowledge and the things they [we] can do is
incredible – you’ve seen yourself’
Terry, Volunteer
‘What we’re trying to do here is help people realise their full potential as opposed to
everyone being at the lowest common denominator …. A lot of people from the local
community are in and out the building all the time, or they’re in the shop, or they see
people round the lanes and they can see what people are doing, and they just get
involved. They [the volunteers] all speak to people, the people coming to do their
recycling or coming to buy their herbs, so it’s all part of the community, it’s about
breaking the fear factor ….’
Staff
While community landscaping, and community gardens provide value for the local
community, which helps the acceptance of mental health services (breaking down the
NIMBY factor), organic food production also benefits residents and provides points
of interest for nearby schools and so on. Such contact is important in terms of
breaking down barriers to integration due to stigma and negative attitudes towards
mental health issues. Community garden projects help local people understand that
people with enduring mental health problems can work, are able and can interact in
friendly, sociable ways on an everyday basis.
Urban gardening projects, then, can be argued to help to engineer change in
the social status of this group. More pragmatically, for the people involved, gardening
in community settings helps them in becoming more confident literally to be and to
socialise within these spaces. As a result, shifting expectations and relations are
traceable in the neighbourhood streets around which these kinds of activities are
based:
39

41. ‘It [the garden work] does change attitudes, it does, because you become more
socialised, you get to meet people, talk to people, it becomes therapeutic as I say, you
get to know people and it helps you a lot. It’s a familiar place with familiar faces and
you get to know them you know …’
Gavin, Volunteer
Evidence of levels of integration between volunteers, projects and local communities
included the encouraged patronage local pubs ‘after work’, the support of the local
residents’ committees, sharing sheds and tools with neighbours, operating local
resident key holder schemes, selling garden produce, having significant local support
for ‘open days’ and gaining commissions for private landscaping and garden work.
Such examples suggest that fear and stigma are not the dominant ways in which
project workers are understood.
Examples of integrative social relations between garden projects and
communities
• Local resident committee support
• Routine community use of garden project space
• Routine conversations between community members and volunteers
• Sharing tools and garden sheds with neighbours
• Local key holder schemes
• Garden produce sales
• Collective use of local cafés and pubs by project workers
• Commissions for garden work
• Large numbers at open days
Ethnographic work over several months at one garden project confirms that
local residents do interact with garden workers on a daily basis, and that in some cases
casual friendships are formed between certain residents and workers that are
sedimented by routinised visits and conversational exchanges in the gardens.
However, there are limits to these inclusionary relations in that not many (if any)
volunteers appear to have built sustainable friendships that cross the community-
project divide that involve private home visits or phone calls (although this true of
most work-place settings). Despite this, some workers feel valued as a result of their
40

42. work in local community settings. These are very unusual words from someone with
severe and enduring mental health problems:
‘You’re not isolated in a wee box on your own, you’re part of the general community
and well respected’
Mike, Volunteer
Volunteers seem to feel most pronounced senses of local integration when
they have worked on community gardens or private garden spaces through contract
work. Examples of social integration can occur on allotment sites, however, whereby
fellow plot holders share produce and advice about growing, visit project space and/or
offer visits to their plots. However, allotment spaces, like some community gardens
can risk isolation if their physical layout is not conducive to casual community
encounters, or if they are located away from busy allotment roadways or residential
areas. Such gardens and allotment sites offer other advantages in terms of protective
or restorative space for garden work while also still acting as important spaces of
social contact amongst volunteers6.
Gardens and allotments can occasionally be the focus of negative community
actions with acts of vandalism being recorded in some projects that formed this study.
There is little to suggest that these are the result of negative attitudes towards mental
health issues. Moreover, it is suggested that there may be beneficial implications for
wider public mental health, as discussed below.
Key summary points
• The location and layout of garden projects affects the opportunities for community
contact and integration
• Community garden work offers the potential to change attitudes to mental health
issues
• Local communities integrate with garden projects in a range of ways
• Volunteers can feel increased senses of belonging as a result of garden work
6
It is important to note that these spaces are not ‘asocial’ when it comes to community
contact, they simply do not have the same amount of casual, daily encounters with local
residents as other garden spaces. This does not make them any less of a valuable resource.
41

43. Gardening as work and work training
4 of the 5 garden projects that contributed to this study claimed that their project was
in part orientated towards work and work training. For garden staff and project
managers training for mainstream work is often important in terms of funding and the
criteria under which this is acquired. Managers claim that health and social services
(often core funders for such projects) are understanding about the needs and skills of
the client base, but that they also require attempts to move volunteers on from projects
after a set period of time to further education, training or work. This depends,
however, on the client and the funding stream. Volunteers encountered in this study
had attended projects from between 1 month to 8 years, with the majority attending
for 3 years or more. There were no formal pathways to work in any of the projects in
the study and only a handful of examples of volunteers who had moved onto full time
mainstream work were cited by project staff.
In terms of formal training, all the garden projects had, at some point in their
history, offered horticultural training qualifications (such as SVQs, City and Guilds,
NVQs and John Muir Trust Awards). Approximately 30% of the interviewees in this
study had acquired some sort of qualification as a result of their participation in the
projects they attended7. For those that discussed the gaining of qualifications, this
resulted in feeling of achievement and pride, although not always directly in any
further education, training or work. In terms of ambitions, most volunteers aspired to
mainstream work, although not in always in gardening and horticulture. However,
they were also realistic in terms of their self-assessed low likelihood of success. Staff
were also pessimistic about the reality of moving volunteers into mainstream work
and pointed to the contradiction of external pressures to train volunteers for job
markets that are not likely to accommodate their needs. Green jobs relating to
gardening and horticulture are also in short-supply in the mainstream economy. For
some projects the solution to this problem is to create paid jobs for volunteers (and
there were examples of people who had moved on within particular organisations);
although the barriers to doing so are keenly felt by both staff and volunteers alike in
terms of:
7
Some volunteers could not remember or did not know.
42

44. • Losing benefits and access to supported accommodation
• Being exposed to workplace performance pressures
• Coping in a work environment where other people have mental health
problems
Turning to the garden work itself, some volunteers understood their gardening
activity as ‘real work’, and not as recreation, therapy, education or training. In some
projects expenses are paid to volunteers (a maximum of £20 per week) and these are
regarded as wages, reinforcing the notion of (some, but not all) garden projects as
primarily work spaces.
‘I see it as a real job for me … I see it as a lot of responsibility and I have to get out of
my bed to come in you know and sometimes I struggle with that. I’m still on
medication and that makes me tired in the morning …’
Peter, Volunteer
‘I think a lot of people will just stay here. I don’t think it’s like you come here and
learn stuff and just move on, although I might look at that one day you know …not
that I would know how or anything but … I don’t want to run before I can walk you
know … I am fortunate to be here in the first place’
Rodney, Volunteer
‘I can’t earn anymore than £20 or my benefits would be affected … it’s something to
look forward to.’
Tim, Volunteer
For some projects (such as The Coach House Trust), who attain money from other
sources than health and social services for environmental regeneration work, the
emphasis on work is justified by staff and volunteers by claiming that they are funded
to provide a local green community service. Many volunteers here discuss their work
in these terms.
‘I do feel like I am providing a service through the Coach House to help the local
environment and how to protect the Glasgow’s district environment … they pay your
wages, they give you £20 a week and that’s good money. I work here Tuesday,
Wednesday and Fridays 1-4pm for that.’
Tony, Volunteer
Conversely, to other volunteers, the garden work seems easy compared to what they
know or imagine of mainstream employment and it is conceived more as therapy or
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45. even relaxing recreation. Some volunteers see gardening as an escape from the
pressures of mainstream work. In one project there was attempts to provide two
different but linked gardening experiences relating to these perceptions by zoning
some garden spaces for therapeutic and restorative work and some as highly
productive or highly landscaped training spaces. However, only having formal or
clearly defined progression routes from one to the other enables this strategy to work
effectively.
Garden staff across the 5 projects differed in their approach to gardening as
work and work training. While some garden programmes are well structured with
defined tasks and clear daily, weekly, monthly and seasonal planning, with rotated
working roles for particular individuals and teams, other projects are adhoc and
seemingly disorganised about working roles, training and schedules. For some staff,
this latter situation is a principled approach to working with people with mental health
problems, while for others it is a source of frustration as mainstream work ethics do
not seem to define garden project spaces:
‘If you’ve got a job you feel more part of society, you can hold your head up, you can
speak to people easier, you discuss the Coach House. And the Coach House is quite
well known now so whenever you do discuss it you always get into a pretty good
conversation’
Kevin, Volunteer
‘My job is getting people job ready and I can’t get people job ready if lunch is
supposed to stop at 12.45 and people aren’t getting to work until 1pm or 1.15pm …
there’s sitting down for a couple of fags before they get going you know? In a real job
would that happen – no! your boss would come in and order them to work …’
Staff
‘If somebody’s saying I don’t want to do this, I’m not about to say ‘well, you’re doing
it’. That’s not right. I wouldn’t stand for that, so I don’t see why anyone else should,
you know. But if they come along and do a bit then that’s great. It’s whatever level
people are contributing, it’s valued.’
Staff
For all staff working with people who use strong medication, who may not be
physically strong and who lose concentration easily, training can be challenging and
there are numerous ways in which they seek to engage volunteers in gardening work
tasks:
44

46. • Providing clear instruction and explanation
• Repeating instructions and explanations
• Demonstrating the task
• Matching volunteers with appropriate tasks
• Creating understanding of task duration (start, process, end)
• Supporting and supervising the worker
• Being flexible with work speed and breaks
For projects that provide private garden contracting work, such levels of support may
be impossible to balance with the needs of the commissioning client, and one
difficulty is clearly maintaining this income stream and work experience base for
volunteers at the same time as providing a viable commercial service.
Project managers bemoan the lack of opportunities for green employment as a
‘next step’ for their volunteers. Staff suggest that proactive local state employment
policies might look to the social care sector for the provision of trained workers who
could then benefit regeneration initiatives, simultaneously addressing unemployment
levels amongst people with mental health problems, tackling stigma and improving
the environment.
Key summary points
• Gardening is understood as work and work training by most staff and some
volunteers
• Most garden projects offer horticultural training and qualifications are highly
valued amongst volunteers
• There are perceived barriers to volunteers moving on from garden project work,
particularly into mainstream employment
• Volunteers sometimes value garden work as a service to the local community and
think of their expenses as wages
• Garden projects differ widely in terms of their organisation of work and
philosophies about working amongst people with mental health problems
• Combining supportive work amongst people with severe mental health problems
with commercial contracting services is not easily achieved
• There are few ‘next step’ opportunities for trained volunteers
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47. Difficulties with garden work
All garden projects face challenges of working with a client base who have complex
needs, use medication, have varying capacities for physical work and may not have
any experience of gardening and horticulture. For most projects similar difficulties
surrounding issues of endurance, strength, concentration and adaptation were
common in terms of training and working with volunteers. In the UK, and Scotland in
particular, the weather also determines the level of garden work which is possible, and
all projects found that offering alternative activities (such as classes, workshops, arts
work) were necessary to supplement the physical garden work in bad weather and in
winter time.
For some projects, the gardening work carried out in public spaces was
deemed extremely important in terms of the levels of local community acceptance.
Therefore there is sometimes a pressure between the need to maintain visually
pleasing and productive gardens for the local residents, and working with people who
easily damage beds and plants and are not always neat and tidy in their gardening
practice. In one garden project there were also problems with volunteers and staff
(allegedly) using project space for personal or illegitimate activities (like drinking and
drug-taking), which created controversy amongst other garden workers who felt local
community relations were at risk, as well as the mental health of other volunteers.
In terms of working relations, staff expressed frustration when instructions
were not followed, needed to be repeated many times, when particular volunteers
needed intensive support or when gardening work required to be re-done after
volunteers had left for the day. Ethnographic observations also recorded that some
volunteers were favoured as ‘good’ people to work with over others who were less
competent and compliant. There were occasionally conflicts amongst volunteers about
who got what task and where they were to be located in the garden. As volunteers
built up their own expertise, conflicts could arise with staff in terms of what was the
best plan for the garden, resulting in complicated social and power relations between
these garden workers, particularly when volunteers feel that garden work is
disorganised.
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48. ‘Some say I don’t want them in my garden because they trample my flowers and
plants –so – teach them!, teach them!, that’s the whole point, so what if they’ve been
here 7 years, no one has taken the time to tell them where to put their feet, it takes
half a second …’
Staff
‘I’ve got more gardening education than [the staff]. I’ve got a diploma and they just
want to do things their way. Apart from that, we need someone with quality and
stamina and someone who can take the team, all of us, upstairs to talk about each
garden and what needs done and then we’ve all got our own jobs to do or we all work
with each other’
Rodney, Volunteer
General difficulties with garden work: volunteers perspectives
• Working in cold and wet weather
• Working when feeling ill
• Working in disorganised ways
• Feeling powerless over garden planning
• Lacking education about horticulture
• Unpleasant textures of nature
General difficulties with garden work: staff perspectives
• Working with demanding volunteers with complex needs
• Balancing the demands of garden work with support work
• Limited staffing and relevant expertise
• Limited equipment
• Limited funding
Other difficulties identified by project managers include the lack of or instability
of block or core funding from health and social services and other organisations. Most
projects exist on a complex amalgam of funding from a variety of sources, all of
which have competing demands in terms of demonstrable outcomes. In some other
cases, funding follows the client and when the client moves away, the project risks
being under-funded and hence acts as a disincentive to help volunteers achieve ‘next
steps’.
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49. Key summary points
• Gardening work is physically and socially demanding for staff and volunteers
• UK garden projects are limited in their activity by weather and need to diverse
into other areas
• Disorganised garden work can be stressful for volunteers
• Volunteers with complex needs are demanding in terms of time in projects that
have few staff
• Local community expectation of garden spaces can be a pressure on garden staff
and volunteers
• Resourcing, staffing and funding levels are a constant problem in terms of
adequate support, expertise and equipment.
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50. Section 4
Conclusion
The research findings of this study have demonstrated that garden and horticultural
projects for people with mental health problems are rich social spaces that are actively
engaging a hard-to-reach group on a number of different criteria. In terms of the broad
questions that defined this study:
• How does working with nature help to achieve social inclusion and stability
for vulnerable groups?
This research study demonstrates that gardening, in general, seems to offer
opportunities to engage in activities that help people with mental health problems in
terms of maintaining their health and their perceptions about recovering from
psychological difficulties. In terms of conventional understandings of social inclusion
(cf Sempik et al, 2003), garden work allows volunteers to further their capacity for
consumption (in terms of ‘wages’ which are distributed in some garden projects, and
their access to healthy food). Volunteers also engage in production (gardening is
understood as a socially valuable physical activity); social interaction (peer and
community social networks are strengthened) and to some small extent, political
engagement (experience of committee work, conferences and similar activities). In
terms of more generalised understandings of social inclusion and more particularly
how people feel included in the daily rhythms of places they frequent or live, garden
work is accompanied by feelings of worth, value and pride. These feelings are tied to
the sense that workers are making small, but important, differences to their local
environments. Such feelings are partly emergent from the positive community
responses to environmental and garden work, as well as from self, peer and staff
validation. For people with mental health problems to feel useful and that they are
making a difference to the world is a profound social act with positive psychological
benefits. Gardening projects may offer imaginative ways through which new versions
of social citizenship may be achieved and through which people with mental health
problems feel socially included in community settings. Caution must be noted,
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51. however, that garden projects spaces are not accessible to all and more work must be
done to increase numbers of women and ethnic minority participants.
• How are unstable identities positively changed through physical interactions
with land?
Many volunteers clearly found the gardening and horticultural work therapeutic and in
ways which helped them gain perspectives on their own difficulties or some insights
into their needs for recovery. As reported in the literature (Morris, 2003), physical,
sensory, emotional and spiritual experiences seem to be enhanced by garden work, and
volunteers in this study validated this claim to some extent. For people who
experienced themselves and their identities as fragmented and fragile, garden work
provided opportunities for them to feel more ‘grounded’ and secure through both the
structure of work patterns and through focusing on their multi-dimensional
relationships with plant and wildlife. Apart from these complex relationships between
the self and nature, volunteers also gained opportunities to socialise with peers, staff
and local resident in different ways, which offered them access to (potentially)
supportive and sustainable relationships in ways beneficial to senses of self-identity.
• What do people with enduring mental health problems feel about garden
work?
Volunteers who participated in this study expressed a range of feelings about garden
work, both (primarily) positive and (less so) negative. To summarise, dominant
feelings of pride, hope, self-worth and self-esteem accompanied garden work,
alongside an amalgam of emotional states that might broadly be expressed as versions
of nature-love or ‘biophilla’. These feelings helped to distract people from focusing on
negative aspects of their own lives or health problems. At the same time, nature work
was experienced as emotionally challenging with feelings of frustration, anger and
sorrow accompanying some aspects of gardening.
It is important to note that the emotions that are bound up with nature work are
experienced partly with reference to complicated human-nature relations and partly
with reference to the managing and structuring of garden project work and its place in
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52. the wider life of the individual volunteer. For example, ‘hope’ may be a feeling
experienced in relation to the sensations, psychological effects and metaphorical
readings prompted by seeing a seed grow into a plant, despite harsh weather
conditions. However, it may also be a feeling associated with a regular ability to get
out of bed and go to ‘work’, the new social networks acquired through project
attendance, or aspirations to move on to train and work in different natural
environments.
• Are there ways in which garden work might be best facilitated amongst this
group?
These following questions prompt more directive and summarised responses in terms
of conclusions:
• Garden work seems to be most effective in terms of widening opportunities for
social inclusion and social networking when garden space is located in or near to
residential areas
• Removed locations for nature work (walled gardens and allotments for example)
can provide important experiences of retreat and asylum, as well as increase peer
social contact and contact with communities of interest
• In general, well-structured garden work with clearly assigned working roles most
obviously benefits volunteers
• Combining practical work with education and joint-planning helps volunteers feel
ownership over garden space
• Combining individual and team working patterns offers a broad range of work and
social experiences
• Flexible working speeds, tasks and durations benefit volunteers
• Trusting volunteers with equipment like chain-saws and lawn-mowers is highly
valued and helps build their skills-base
• Combining individual plots with collective plots allows for different preferences to
be expressed and skills to be practised
• Food production creates particular interest in gardeners, although consumption of
healthy foods may only be assured when projects provide the meals
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53. • Making gardens accessible to the public through regular open days and events
increases the opportunities for social networking and community contact
• Peer buddy systems create friendly access points to garden projects for new
members and builds self-esteem amongst others
• Providing versions of counselling and support work is important in terms of
facilitating attendance in garden projects
• Creating pathways to work and training beyond garden projects would increase
their potential for helping people achieve their goals in terms of jobs and education
• What are the key outcomes of garden work for this group?
In general, volunteers are gaining:
• A positive focus and structure to daily and weekly life
• An opportunity to (re)learn skills and gain work experience/training
• Self esteem and self-worth and experimenting with different social and working
roles
• Access to safe spaces with opportunities for diverse emotional and sensory
experiences
• Developing physical strength and engaging in physical exercise
• Accessing opportunities for healthy eating
• Developing different social skills while interacting with peers, staff and the general
public
• Opportunities to rework stereotypical constructions of ‘the mental patient’ through
active citizenship in local communities
• Are there any wider implications for public mental health?
• Environmental regeneration benefits all in community settings in physical and
psychological terms
• The provision of natural spaces which are safe, visually stimulating and use-able in
urban settings are particularly valuable in terms of facilitating good public mental
health
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54. • The work by people with mental health problems to provide such spaces
simultaneously helps to change public attitudes to mental health as garden workers
are seen to be active, useful and expert
• Combining environmental regeneration with education about mental health offers
the opportunity to both raise levels of public mental health and reduce stigma
Visioning sustainable public mental health
In this report gardening and horticultural projects for people with mental health
problems are shown to benefit this group on a range of different criteria. However,
even a small study such as this one highlights the fact that garden projects differ
dramatically in terms of their remit, locations, funding structures and working
practices, and yet all seem to offer something of quite profound merit to the people
who access them. At present, despite the over-lapping and complementary national
political frameworks which can be argued to constitute a healthy climate for the
development of environmentally friendly mental health care, there is no one
organisation or lobby which is pushing this agenda forward. In addition, despite claims
about joined-up thinking in the national and local state, there is little evidence that
those authorities responsible for shaping ‘the environment’ and ‘mental health care’
have a co-ordinated agenda for tackling individual and public mental health issues.
This is arguably a missed opportunity to develop an innovative approach to social care
and urban environmental regeneration.
While there are effective national organisations such as Thrive who provide
networking opportunities between gardening projects, and valuable education and
training for therapeutic horticulturalists, uptake is varied and many gardeners work in
projects without much or any mental health training. The status of ‘therapeutic
horticulture’ (which Thrive promotes) is arguably not as integrated into mental health
or medical services as it is in other countries such as the United States. While this is
not necessarily a disadvantage in terms of community mental health, there remains a
gap for a strong organisational voice to be pushing a national political agenda for a co-
ordinated ‘environmental mental health care’ at different scales. Developing national-
level good practice guidelines for garden and mental health projects, and linking this
53