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Since the Covid pandemic, there has been an increased focus on the effects of nature/nature-based activities on our mental health.

The Government’s Green Social Prescribing Programme to tackle and prevent Mental Ill Health focused on patients with mild to moderate mental ill health and much of the research relevant to STH assesses the impact on mental health. The NHS 5-levels model of mental health was adopted by the Nottinghamshire test & learn site to provide a framework that link workers and providers could both use to ensure referrals were appropriate to the patient's needs.

The Therapeutic Horticulture Stakeholder Group has taken this model further and defined 5 types of gardening for mental health that map to those 5-levels:

  • ­Self-directed gardening: Gardening activities in everyday life. Aligns with Level 0.
  • ­Social Gardening: Social or community-based gardening with a supportive leader. Programme of gardening activity informed by garden needs or growing preferences. Aligns with Level 1.
  • ­Social & Therapeutic Horticulture: Gardening within an inclusive setting, led by a trained practitioner. Programme of gardening activity informed by garden needs, tailored to individual preferences. Aligns with Level 2.
  • ­Enhanced Social & Therapeutic Horticulture: Structured and facilitated gardening activities within an inclusive setting, led by a trained practitioner. Person-centred programme of gardening activity. Aligns with Level 3.
  • ­Horticultural Therapy: Structured and facilitated gardening activities, within a restricted-access setting, led by a trained practitioner with close involvement of a health or care specialist. Person-centred programme of gardening activity. Aligns with Level 4.
Types of gardening for mental health

The THSG have documented how these activities can be differentiated in terms of:

  • Who it is for - the mental health support needs and recovery pathway of the individual as described by the NHS 5-level model
  • Why it should be used - the desired outcomes and benefits for the individual engaging in the gardening activities
  • How the individual will engage in the gardening activities
  • What skills, quality assurance and evaluation processes the provider will need to have in place to achieve the desired outcomes for the individual

The document was created with inputs from a range of contributors including STH professionals, health care practitioners, academics, and policy officers.

The document can be downloaded below. It aims to provide much-needed clarity about how gardening can be used across a range of mental health needs, to assist health and social care professionals when assessing whether a gardening activity is suitable to meet the needs of the person they are working with, and providers to identify the level of need that they can support