An abridged version of the podcast.
Can you tell us a little about what you do as a horticultural therapist with Horatio’s Garden?
Horatio’s Garden build and maintain beautiful gardens for spinal injury patients within NHS hospitals. The aim is to have one garden for every spinal injury centre, and the one I work at is the fourth of these gardens. My role as a horticultural therapist is to encourage patients outside, which often isn’t difficult at all because after being stuck inside hospital for weeks on end, they are happy to be able to come outside. The gardens are absolutely stunning and patients are able to access the gardens in their beds as well as wheelchairs. My role is to enable that first entry into the garden, then taking that a little bit further as a therapist, encouraging and nurturing that connectedness with nature. I organise group and one to one sessions with patients through gardening groups, which are really good for developing fine motor control, improving balance, and all sorts of different physical attributes such as stretching and efficient use of our arms. The sessions are also good for mental well being: I run mindfulness in nature sessions as well. And the social aspect is as important as the horticultural side.
Do you work closely with the head gardener on one side and the clinical team on the other?
I am the head gardener here! It isn’t unusual to combine the two roles, particularly as I’m a trained horticultural therapist. I am in charge of maintaining the garden with a fantastic team of volunteers I couldn’t do without. I also work closely with the hospital, particularly with the physiotherapists, the occupational therapists, and the psychology team as well, so I get referrals from all of them.
Could you tell us about your garden?
The garden, designed by Bunny Guinness, wraps around two sides of the ward, which is on the ground floor and many of the patient bays open directly into the garden. We have a series of raised beds that are available for patients to work on. I work with patients to determine what goes into the beds and we grow a lot of edible plants like strawberries and tomatoes, but also scented and other sensory plants. We have a fabulous Griffin Glasshouse with benches at the height suitable for patients to be working on as well as automated doors. At the moment, we have kumquats and lemon trees in there. A little further down, we have the woodland walk which includes river birches and a water rill to create a calming atmosphere. This area is popular with goldfinches as well as bees and butterflies. The whole garden is planted for wildlife. Then there’s an area with three separate bays for events and activities: anything we can celebrate, we celebrate! We’ve got a long avenue planted with Rosa ‘Olivia Rose Austin’, Verbena bonariensis and Nepeta. The path is wide enough for patient beds and is absolutely smooth, to prevent any jolting. At the top there’s a magnificent magnolia tree that’s obviously been there for a very long time. This area has been made into a children’s play area and an area for wheelchair skills training. Whereas the rest of the gardens is absolutely smooth and easy to navigate, this section intentionally has dips, bumps and camber, so that patients can learn how to use their wheelchairs. We’ve got play equipment out there, for visiting children. Before the garden was here, there was a scrappy bit of grass which was open to the pavement at the front although there were some nice trees. That was a tiny patio and a few shrubs but it all looked very small. When I came for my interview, I thought it was tiny but by the time I started to work, it looked completely different and so much bigger!
Where you involved in the garden build?
I came in mid construction so it was amazing to watch it take shape. The larger trees were in but there were hundreds of pots ready to be planted. I had to move them round the garden to keep them out of the way of construction – and keep them alive during the hot and dry summer of 2019. I haven’t mentioned the fantastic garden room, opposite the greenhouse, which has floor-to-ceiling windows and means you can be in the garden even if it’s raining.
Do you get feedback from the patients about the garden?
During the build, the windows of the ward were blacked out to give the patients privacy but they asked for this to be taken down so they could see what was happening. I think we can all appreciate that activity outside is interesting when you are stuck inside. By the time the garden opened, the patients were desperate to get outside and the day we opened was probably the most moving day of my life, maybe apart from my children being born! I get feedback all the time which is just so lovely; there is so much gratitude. It is also good for the NHS staff too as looking after people with spinal injuries is a huge job, it’s very tiring and taxing and the staff here are just amazing. So we’ve been able to provide somewhere where they can just take a breather and during COVID it has just been amazing, it’s made a world of difference to people.
How has COVID 19 affected you and how you work in the garden with the patients?
I’ve been working throughout. The Ward Manager said that she very much considers the garden to be an extension of the clinical area. It has been important for physical as well as mental well being as without this space, patients wouldn’t have been able to practise their wheelchair skills. I have a team of 30 volunteers but initially, none could come in so we lost the support they provide to the garden and to the patients. We have a few back now, one a day, but they can’t interact with the patients but are really essential in helping to maintain the garden to ensure it is safe to use by the patients. It became quite challenging maintaining a fairly large garden by myself when I usually have a lot of help from some very talented gardeners. The staff and the patients really helped when the volunteers were absent with the Clinical Lead Consultant and Ward Manager helping with watering. The patients supported each other more and we did manage to have some events during lockdown including a sports day, VE Day celebrations, a bagpiper (socially distanced) at Midsummer and the staff acted out a scene from A Midsummer Night’s Dream with the help of a donkey over the road. It’s been challenging but it’s really interesting and again very moving. I’m very lucky to have been able to work.
What was your route to horticulture and horticultural therapy in particular?
I’ve always loved being outside and I’ve always engaged with nature. Until I was six years old, my family and I lived in Croydon with quite a large garden which merged with woodland at the far end. I remember spending a lot of time in the woodland with my mum, watching badgers and collecting material for arts and crafts. When we moved, we again had quite a large garden where my mum grew lots of fruit and vegetables. I always loved being outside so trained in environmental conservation, leading groups in hedge laying, clearing ponds, planting wildflower meadows and all sorts of different activities. I was very aware how beneficial these activities were to so many people and how much they got out of interacting with nature.
I went on to study a psychology degree and then took various courses in positive psychology and grief solution-based therapy. I worked for Mind in various roles, but I always tried to incorporate nature-based therapy such as walking groups and gardening groups. Then I moved to a role in Leicester working in a plant nursery run by the NHS – the only one in the country and now sadly closed. It was open to the public, providing a realistic work-based setting for clients to undertake occupational therapy in a horticultural environment: sowing seeds, potting up, planting hanging baskets, working on an allotment. The clients were based in the community or brought along from a nearby psychiatric hospital. It was just so apparent how hugely beneficial and rewarding it was for those involved. I then moved on to the Bethlem Royal Hospital in southeast London, working as an horticultural instructor and doing horticultural therapy with patients with severe and enduring mental health needs. I maintained a walled garden, three orchards and a courtyard garden with the help of patients. In conjunction with the John Muir Trust, I set up a specific group which included different aspects of nature inspired therapy such as art, building bird boxes, mindfulness in nature, nature journaling, etc. that was very patient-centred. It was amazing to watch the transformation of different people involved in the group.
I loved working there but it came to the point where we really didn’t want to live in London anymore so I was looking for something else but it needed to be something pretty amazing to be as good as that job. I’d heard of Horatio’s Garden so spoke to a few head gardeners and it seemed like an amazing place to work. So when the opportunity came up to work here, I went for it. I’d also studied with the RHS for horticultural qualifications and took a masters degree in social and therapeutic horticulture at Coventry University: I was completing the dissertation when I started the job here.
What advice would you offer to someone who is really interested in horticultural therapy and really wants to explore it as a career?
Find somewhere local where they’re offering horticultural therapy and volunteer there. Get as much experience by shadowing a horticultural therapist as possible. Explore the courses offered by Thrive. Coventry University used to offer a really good diploma course, as well as the masters, but they’re not running either of them at present. Thrive are offering training in social and therapeutic horticulture and do lots of short courses. Horticultural therapy is more than simply gardening with people: there is a lot of planning, understanding the needs of the individual or group, observing and adjusting the plan depending on progress etc.
Is there a project you are working on at the moment?
I’m hoping to be going to the Chelsea Flower Show this year as I’ve never been and last year was meant to be my first visit, helping at the Horatio’s Garden stand. I’m also looking forward to the garden being open to the National Garden Scheme on 19th September (Covid-19 restrictions permitting), as they have been fundamental in helping to deliver this garden and all Horatio’s Gardens. We are very proud to be opening for them. I’m also looking forward to opening our tours of the garden to the public which helps raise funds for the charity. Horatio’s Garden is funded directly by donations.
What does the future hold for you?
I’m very happy where I am. I’d like to be more involved with advocacy for horticultural therapy, helping people to understand the benefits of therapeutic horticulture and supporting health care workers to ensure that social prescribing is successful. The benefits of gardens for anyone in hospital are well recorded and it can make such a difference to people and their recovery but you can’t just planted a garden and expect it to look after itself. Within hospitals, funding is obtained to create a gardens but then there can be little though to its aftercare.
I’d also like to do more research on a specific outcome measure for horticultural therapy. There are hundreds of different tools that are used to assess the results of interventions but these often vary because of the reason behind the therapy e.g. if it is for physical rather than mental health. I wonder whether we are not capturing the full impact and feel that there might be something specific for horticultural therapy.
What or who have been your horticultural inspirations?
When I was young, it was definitely my mum because of her love of being outside in nature and gardening. I feel I grew up listening to Bunny Guinness on GQT so it is amazing to be now working on a garden Bunny designed. I worked reasonably closely with her and she’s still very much engaged with the garden. I suppose my main inspiration for horticultural therapy is the people that I’ve worked with, knowing how much difference it’s made to people. Here, I often work with people who are very much outdoors people anyway so they come out in the garden because they know they love being outside. And then we do mindfulness in nature sessions and they realise this even more. If enhances that connection. I’ve also been inspired by people like Cleve West, who designed the first Horatio’s Garden which is maturing into a stunning garden.
What three plants or three horticulturally-related items would you take with you to a deserted island?
I’ve got two different answers for this. I would take a black mulberry because they are just the most delicious fruit and a beautiful, multifunctional tree. From a horticultural therapy perspective, I would need to take something beautiful. A mulberry is beautiful as is hazel – which also tastes good and can be used for weaving. I’d also take the Nepeta from the garden – Nepeta ‘Summer Magic’ – as it so long flowering. However, I’d be concerned that these aren’t native to the island so perhaps I’d take a good plant identification book with foraging guide, a pair of Felco secateurs and some Donkey Works gardening gloves.
Is there anything about you that might surprise people?
If I hadn’t have chosen to be a horticultural therapist, I might have become a dance therapist. I’m an Egyptian dancer and used to teach it five nights a week.
With thanks to Bruce Langridge and Will Ritchie of National Botanic Garden of Wales for question format and original podcast idea