Mental Health Intervention: A Summary

The study “Gardening and a mental Health intervention: A review, by (Clatworthy, Hinds and Camic, 2013) examines an array of allotment gardening tests to try and give us a good understanding of the possible benefits of allotment gardening. This study started of by collecting and examining hundreds of case studies so that it could use only the most prevalent case studies for its analytical data. It is stated that in 2003, there was “little to no evidence supporting psychological benefits from gardening” (Catsworthy, Hinds, Camic, 2013, Pg. 1). The results were set out to collect up to date data from clinical studies that date back to 2003. Using online resources such as PsychInfo, Medline, Web of Science, CINAHL, British Nursing Index and

applied social sciences index, 156 references were found. After examination of all papers, they narrowed down the results to 10, based on intervention strategies, methodology and rationale. It chose the studies which would best represent psychological benefits from stress. In the search for articles, authors used key words such as depression, schizophrenia and anxiety. The authors chose to presents the results from the top ten clinical test trials, all of which varied in procedure of the test and of taking test results. These studies came from Norway, U.k, Finland, Korea and Hong Kong and were addressed by many types of occupational groups. Some of these studies looked at elderly patients while some looked at chronically stressed patients. 20 to 70 years of age was the total range for participants across all studies. The sample sizes ranged form 10 to 50 across all studies. Some studies examined the effects of farm-based gardening programs, while others examined project based and leisurely based gardening. Some used more than one variety of gardening intervention and some used multiple gardens in one trial. These trials involved participants with depression, schizophrenia, mixed symptoms and some with undisclosed symptoms. Data was collected in a variety of ways, such as questionnaires observations, diaries, photos, while some trials were completely controlled. The results show a decrease in symptoms of depression and anxiety in every one of the studies. Studies indicate that participants showed an increase in the equality of their relationships and an improved sense of self esteem.
It is important to note that most all of the study participants were volunteers, meaning that we cannot assume that allotment gardening is a suitable treatment for everyone with psychological issues.

A hand picked selection of articles may create a self serving bias but in this case it should validate the results. Also, regarding each study, a larger sample size and repeat trials could be helpful in determining validity of these tests. A comparison like this one, which takes gardening intervention programs worldwide and places them side by side can properly analyze theoretical perspectives and study techniques to validate each test and find patterns within them. That is what this study sought out to do. It is important to note that these studies do not provide evidence of sustainability in mental improvement or long term effects of gardening as a mental health technique. Only one study examined the effects of the participants after the intervention took place and this was 3 months following the intervention. The results showed little evidence towards long-term sustainability of positive health benefits after these trials. The results did show a correlation in health benefits. The perceived quality of life was improved in the short-term in all trials examined by the

study.
Results from Van Den Berg and Custers (2010) in the Journal of Psychological Health has pointed to evidence that gardening as a leisurely act can promote neuroendocrine function that can restore many negative effects of stress. The study is one of experimental design where the effects of gardening were put under trial in a field experiment. A control was implemented in this study by having a group that would perform leisurely reading instead of gardening. The reading group would read articles of choice from magazines or books that were provided. A total of thirty individuals were put under the same exact conditions of stress whether they were in the reading group or the gardening group. They were all subject to perform a stroop test which is a test to induce stress via computer programing, in this case. A stroop test is a neuro-phsyiological test that is often used by psychologist. It shows a spelled out word of a color, while the person has to name the color it is printed in, instead of the spelled out color. A stroop test collects the number of errors which determines the score. Each individual performs 10 practice tests following 200 clinical tests during the induced stress portion of the study. Having an induced stress test helps validate the results by making each individuals stress relatable. After inducing stress, the patients were then administered to randomly assigned stress interventions, either reading or gardening. This portion of the test would last 30 minutes total. Cortisol levels were taken by salivary samples and measured using an immunoassay analyzing machine called Elecsys 2010. Self-reports of 10 negative and 10 positive moods were repeatedly measured as well. Perceives stress measurements were taken on a 1 to 5 scale. These measurements took place before and after the stress test, midway, and after the gardening procedure. While results showed that gardening and reading each led to decreases in cortisol during the recovery period, the decreases were significantly stronger in the gardening group. Positive mood was fully restored after gardening, more so than the results of the controlled reading exercise.
These findings provide experimental evidence that gardening can promote relief from acute stress. Participants were all volunteers. They were paid 12.50 euros for there time which lasted about 1.5 hours total. Base-line cortisol levels were measured at 5.4 compared to 6.94 after the stress induced test. Finding show that positive moods were lower and negative moods higher after this stage. Base-line cortisol levels were back to normal after 30 minutes of gardening. Some benefits of this test include the fact that all stress was induced using the same method. Also cortisol was measured in a lab whereas many other clinical studies use questionnaires. This test also had a control group. Some components of this test may be unsupportive of demonstrations how leisurely gardening can benefit chronically stressed patients. It does not address long term results and It only shows result for stress that is very short term and perhaps irrelevant to some of the volunteers. It only examines the individuals during a 90 minute period. Furthermore, It does not account for prior stressors that may effect the results.
In an epidemiological study to examine the effects of leisurely gardeners vs non gardeners (Van den Berg, Van Winsum-Westra, DeVries, and Van Dillen, 2010) took to the phones in the UK. They conducted a study of overall heath that compared allotment gardeners to their fellow neighbors who did not partake in allotment. This survey was done over the phone and asked a series of questions about the individuals overall health, ranging from social interactions to doctors visits. The results from this test were encouraging because home owners who gardened the most frequently had shown lower levels of perceived stress. Unfortunately this study did not give a clear indication of stress reduction as a clear benefit of gardening because it did not compare homeowners based on the type of mental ailment. It also did not account for other stressors that may effect ones life. Furthermore, it only took from small community or sample. Small sample, especially isolated samples do not show very much diversity within participants. Primarily, a study like this can show skewed results because of memory bias and differences in perceived levels of stress. On the other hand, questionnaires like this are good for many purposes, one being that it can account for long term benefit of gardening unlike other studies because most of these gardeners had been doing it for quite a while.
In conclusion from these studies, we can predict a correlation between perceived stress and physiological traits of stress in association with allotment gardening. Many different variations of gardening techniques in each of the clinical studies have pointed to decreased symptoms of stress. We have proven how cortisol levels are shown to decrease after gardening in light of acute stressors. These studies all have flaws as well as successes. Horticulture has always been associated with healthy living whether truth or not, the scientific community is now compiling hard evidence to make this case. In two of the studies above, participants all reported lower values of stress, depression and anxiety. They reported having improved social interactions and higher self esteem. In a another trial, cortisol levels were clearly improved or decreased by allotment gardening. However in that study, gardening was only compared to a reading intervention. We should include other side by side comparisons like this to compare to gardening in order to make a clear case. Further scientific research is required to give us information on how gardening can effect chronically stressed individuals. Prospective covert studies should be done to show how gardening can effect levels of stress in the long term.
To expand on the evidence that gardening has a therapeutic effect on humans, the article entitled Beyond toxicity by Frumkin (2001), explains the longstanding relationship that humans and all other animals alike share with the natural environment.

This article is focused on examining the factors of our environment and how it plays a role in our health. It states that, the evolution of primate to modern man has discoursed over the last 65 million years. For the majority of this time, it has been advantageous for any species to recognize the components of nature such as water, plants and landscapes. Knowledge of how to harness nature has been a key to our survival. Fresh water and edible plants are an indication of health and nourishment. Having a connection with the natural environment can give a person the feeling of calmness, tranquility and assurance. This is a potential outlet to recover and decrease levels of stress. The article states that “the concept that plants have a role in mental health is well established” and “horticultural therapy evolved as a form of mental health treatment, based on the therapeutic effects of gardening” (Frumkin, Pg. 236). The article promotes the need for the integration of the natural environment to become a new model for treating overall public health. It states that in just the last few hundred years humans have exposed themselves to an unnatural living environment, becoming further disconnected with nature as we once knew it. The author

explains the current environment of most men and women to be toxic for ones health. Toxic components include carbon pollution, artificial lights, radio waves and more. This assumption about our current environment entails that humans have disassociated things like food and shelter with the natural world. Many cases have been reported of hospital patients recovering faster because of the benefits off fresh air and plants.
The article goes on to state that we need to look at preventing negative health effects of this modern environment for common citizens, employees, and students as well. As knowledge about our ancestral ties with nature increase, we may need find a way to bring back gardens, natural landscapes and plants to our worlds largest cities, the face of architecture may change. “Perhaps we will build hospitals in scenic locations, or plant gardens in rehabilitation centers” (Fumkin, 2001, Pg. 239) This article ties gardening to an ancient form of stress response. It states how modern humans are at risk of chronic stress because our stressors now days are very different from those in the past. Modern humans also deal with these stressors in an indirect manner as opposed to using our fight or fight response. This puts us at even further risk for health disparities associated with stress. We need to examine the environment that we are living in and what we can to to prevent unwanted stress. Gardening is a tool for human survival and practicing it can help us stay in touch with our ancestral habits. We can harness the components of nature to decrease stress and ultimately help us cope with it.