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How do gardens make a difference?

It’s a spring day in Horatio’s Garden at The Duke of Cornwall Spinal Treatment Centre at Salisbury. A light breeze ruffles the long grasses on the herbaceous border, and the air hums with the sound of insects and birdsong.

Usually, this garden – and its sister gardens in the Glasgow, Stoke Mandeville and Oswestry regional spinal treatment centres – would be filled with people. Patients, visitors, staff and volunteers alike enjoy the beautiful grounds, created by award-winning landscape designers, whether they’re looking to socialise or simply to snatch some peace and quiet in a restful natural setting. Throughout the year, they can look forward to a range of events, from hog roasts to tea parties to storytelling sessions to musical performances.

Yet the coronavirus crisis has brought proceedings to a sharp halt. All group activities have been cancelled as patients and visitors observe social distancing regulations. The charity’s dedicated volunteers, who would normally support patients, run events and activities, and help with the gardening, are no longer allowed on hospital sites. Horatio’s Garden also faces a 27% drop in its annual income due to the cancellation of events.

In times like these, the need for a garden sanctuary – a place where patients can get away from the strain of everyday ward-life for a while – feels more pressing than ever. But is it vital? The gardens certainly provide a splash of colour in an otherwise sterile clinical routine, but can they have a tangible impact on recovery?

Most patients arrive at treatment centres following a traumatic incident. After the initial pain has passed, they face the added challenge of adjusting to a completely new lifestyle: using a wheelchair for the first time, learning to accept help from others, and postponing long-standing plans (the treatment process can last for months).

Needless to say, it’s a scary, isolating time. 23-30% of patients are at risk of becoming depressed during their rehabilitation period at a spinal cord injury (SCI) treatment centre, a statistic made all the more concerning by the fact that patients’ mental wellbeing at this time is a crucial factor in determining their future happiness.

Statistics show that life satisfaction tends to improve significantly during the first three months of the inpatient experience but remains relatively stable thereafter. For this reason, it’s vital to enrich the patients’ clinical experience as much as possible.

This is where Horatio’s Garden comes in. A lack of control during the initial recovery period is one of the main factors contributing to patients’ negative mood following their release from hospital, and time spent in the gardens offers some much-needed respite from an otherwise dependent indoor existence. The wide, flat pathways are the perfect space in which to practise using a wheelchair, while ‘garden therapy’ sessions enable patients to take an active part in the cultivation of plants which they can later help to harvest, cook and eat.

The gardens can also complement more traditional treatments such as Cognitive Behavioural Therapy. While counselling may seem the most obvious way to directly target psychological issues, it is not always effective in people with impaired cognitive function – a common side effect of SCI. Patients can therefore immerse themselves in the garden as a gentle, ‘natural’ alternative to treatments which require strong cognitive abilities.

And researchers are coming to understand that psychological wellbeing is even more important than once thought. Aside from contributing to the patients’ quality of life, it can also have an impact on ostensibly unrelated physical symptoms.

Studies have shown that the negative emotions triggered by pain are often more distressing than the physical experience itself. Treating patients’ psychological symptoms can therefore ease the physical burden of pain, which will make them less likely to resort to self-medication with sensation-numbing drugs and alcohol further down the line. This in turn can lead to an increased life expectancy.

Effective psychological treatment can be genuinely be life-saving in other ways, too. The most common causes of death for people with SCI are pneumonia and septicaemia, but psychological factors can modulate the risk of dying from these illnesses. A lack of purpose in life has been shown to correlate with a higher mortality rate from pneumonia, while neuroticism leads to an increased chance of death from septicaemia. Encouraging SCI patients to change their negative thought patterns is therefore crucial in increasing their life expectancy as well as their quality of life.

Do these statistics resonate with patients? According to a study undertaken by interns at Oxford University over the summer of 2019, 91% of patients believe that spending time in Horatio’s Garden has a positive effect on their wellbeing – and 100% of staff members agree with them.

Backed by such an overwhelmingly positive response, Horatio’s Garden has climbed from strength to strength since its genesis in 2012. Its ultimate goal is to build and maintain gardens in all eleven of the UK’s NHS spinal treatment centres so that every SCI patient can reap the benefits of spending time in nature.

Even though the coronavirus crisis has led to the cancellation of several events scheduled for the coming months, there are still many ways for would-be donors to get involved. The ‘Give to Grow’ Campaign will be running throughout the spring and summer in an attempt to encourage friendship and community in this era of self-isolation and social distancing. Supporters can also choose to buy items from the charity’s online gift shop or give a simple donation.

Proceeds from these schemes will raise much-needed funds for the construction of the planned Horatio’s Gardens in London and Cardiff, as well as enabling the existing gardens to keep running even without their usual army of volunteers.

All of the gardens are beautiful, but looks can be deceiving: they’re also a vital part of the patients’ recovery process. Here’s hoping that their crucial work can continue in these trying times.

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