Gardens and wellbeing
The elements of gardens which may help with wellbeing, plus what a large scale review of research on the relationship between gardening and wellbeing found.
“The garden is a place that brings us back to the basic biological rhythms of life. The pace of life is the pace of plants; we are forced to slow down and the feeling of safe enclosure and familiarity helps shift us to a more reflective state of mind.”
For many people a garden provides a place of both solace and restoration away from the busyness of life as Sue Stuart-Smith eloquently highlights in her highly recommended book The Well Gardened Mind.
Gardening provides an engaging way to connect with nature. In her book, Sue refers to gardening as a conversation with nature, where the gardener does something, nature responds, the gardener reacts and so on, with this forming a quiet, slow-paced dialogue between the gardener and the garden. I love that way of looking at gardening and think this touches upon some of the psychological elements of gardening which may be beneficial to wellbeing - patience, enjoyment, wonder, and surprise.
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The links between gardening to physical and mental health appear well established, both in terms of the everyday, informal activity many enjoy through to the use of gardening as a structured health intervention. Horticultural therapy to aid recovery and management of symptoms across a number of health issues has a long history and is part of current social prescribing initiatives alongside its use within clinical settings. During the recent lockdown periods of the covid public health response access to a garden appeared to take on greater importance, although whether there was actually a boom in gardening and greater connection with nature during that period is not as clear as some headlines suggested, as covered in this previous article.
Mark Gush and colleagues from the UKs leading gardening charity, the Royal Horticultural Society (RHS), published a paper last year highlighting four key research areas for the RHS. Firstly addressing climate change, which includes considering how changing weather patterns affect gardens and how initiatives such as removing peat from growing mediums may influence plant growth. Secondly planting, including considering how plant choices can help soil conditions and promoting tree choices within gardens. Thirdly to help inform environmentally sustainable behaviours and choices within gardens to help reduce climate change risks, an area that my research also considered. Lastly the relationship of gardens to health and wellbeing, including the use of gardening within social care and exploring the garden features which invoke emotional responses which may help foster wellbeing benefits.
This lead me to wonder more about the features within a garden which may provide a boost to our wellbeing and what is the current state of the evidence on the relationship between gardening and wellbeing. Some recently published papers help to consider both.
A design for wellbeing
Bethany Harries and colleagues from the RHS and the University of Surrey published a 2023 systematic review paper which reviewed garden design literature to summarise and provide recommendations on the elements of a garden which may be helpful to wellbeing.
Research geek aside - a systematic review takes a structured approach to addressing a specific research question by reviewing published literature using defined inclusion criteria informed by the question being addressed. The review follows a research protocol similar to the standards expected of studies to provide a summarised perspective on the findings and quality of the reviewed studies. It is useful in gaining a wider perspective on the evidence base and helps to inform recommendations. Systematic reviews can also include meta-analysis of the combined results from the studies which may provide greater insight, although care should be taken around the interpretation of combined results.
Wellbeing was defined in the review as relating to the positive psychological benefits from time in the garden, including an increased sense of restoration and reductions in negative emotions such as stress. Garden design has often suggested aspects such as viewpoints, accessibility, plant variety and multi-sensory elements as being beneficial. The review selected 17 studies which covered various garden settings including community and hospital gardens from the USA, UK, Sweden, Germany and Latvia. Of the 17 studies reviewed, 6 specifically considered garden aspects which were deemed important for wellbeing, while the others evaluated gardening and wellbeing in a wider context.
The results of the review informed six recommendations to help promote wellbeing benefits within garden design .
Accessibility, including paths to enable the easy of navigation around a garden and the provision of seating, to support taking time to pause and notice elements of the garden.
Way finding, using the paths to encourage exploration and moving around the garden.
Serenity, fostered by using sounds such as from running water or from plant foliage moving in the wind and by encouraging wildlife into the garden.
Using a variety of plants, to provide different colours and smells, along with considering the seasonal changes within the planting to support interest throughout the year.
The consideration of spatial organisation, such as dividing the garden into “rooms” or zones using natural materials, and thinking about how spaces in the garden are used e.g. social use, quiet space, and how the weather may influence that usage.
The use of cultural artefacts, such as fountains or garden structures which provide additional interest alongside the planting, as well as considering the garden within its wider environmental context.
The systematic review suggested that accessibility, serenity, variety of planting, and spatial organisation were essential considerations for wellbeing with strong to moderate evidence base, while cultural artefacts was optional and had the weakest evidence base. The recommendations also included things such as signage within way finding that are not needed in the average urban garden and are more applicable within larger public gardens. I thought the recommendations were useful and can be applied within most gardens, suggesting ideas that may be helpful to our wellbeing and also supportive of wildlife. For example many gardeners actively work in the garden, but by adding seating perhaps that encourages taking time to pause and notice the wildlife, such as birds, who share the garden with us.
Getting more specific
The same team published a more recent paper in January 2024 which looked at the emotional reaction to specific garden features and plants to further understand which elements helped with wellbeing. In the study participants instant emotional reactions to elements such as colours, smells and sounds in a garden was captured. The study was carried out in the wellbeing garden at RHS Wisley, which includes several different zones linked to various senses and emotions. The study used four of the zones, with two being designed to heighten emotional arousal, such as excitement, and two designed to lower emotional arousal, such as invoking calmness.
The study sample consisted of 142 adults, the majority of whom were regular visitors to Wisley and predominately female, with an age range from 19 to 85 years-old, with an average age of 54. The research was carried out across two time periods - 79 participants during April-July 2022 and 63 participants during October 2022 - January 2023. The participants were randomly allocated an order within which to visit the four zones and were asked to provide their emotional reaction, sense of restoration and feedback to each garden zone.
The results found that brightly-coloured flowers and a sense of open space invoked excitement, while gentler colours and viewpoints were more calming. The scent of lavender and the sound of running water were also reported as calming. Greater variety of planting and seeing wildlife such as bees or birds visiting the garden invoked feelings of pleasure. In zones with reduced planting the participants reported less sense of restoration, while diversity of planting appeared to support an increased sense of restoration. Space and structures were important, with curving paths aiding curiosity and seating providing opportunities to stop and enjoy the garden. The study has a relatively small sample which consisted mainly of female participants and the results are based on one location, although that location had specific garden zones designed with wellbeing in mind. The elements identified are supportive of other garden design research and I think the findings can be applied within most gardens, to consider planting choices and how spaces in garden can be used to foster certain emotional responses. The authors also highlight an important point - the aspects that are most associated with wellbeing are those which are beneficial to nature too.
Evidence base
Those studies have suggested elements that can be incorporated into a garden which are beneficial to our wellbeing. How good is the evidence for the link between gardening and wellbeing benefits? An umbrella review of research on the relationship between gardening and wellbeing was also published in January 2024 by a team from Romania and the UK.
Research geek aside - an umbrella review collates information from systematic reviews and meta-analyses. It uses a similar formal structured protocol as a systematic review and is useful for gaining a broad perspective on a research topic which may help to inform policies or interventions as well as helping to assess the quality of the research evidence.
Irina Panțiru and colleagues carried out the umbrella review on systematic reviews published between 2000 -2022 which had considered the relationship of gardening to wellbeing of adults within home, allotment or community and therapeutic gardens. The systematic reviews had included assessing psychological wellbeing aspects such as cognition, emotion, specific mental health measures (e.g. depression) and quality of life. The umbrella review included 40 published reviews, with the majority being systematic reviews of studies which had used a combination of observational and interventional designs. 28 different countries were represented within the reviews.
The quality of the systematic reviews was assessed, finding that of the 40 selected reviews, 29 were deemed to be of critically low quality. The reasons for this included the rationale of the systematic review being unclear, the risk of bias within individual studies not being fully assessed or the lack of a full rationale for the exclusion of studies. Only 2 of the 40 systematic reviews were classed as high quality.
The results of the umbrella review found that overall the selected systematic reviews indicated positive benefits to psychological and physiological wellbeing from gardening. A number of the individual studies highlighted these benefits within specific groups, such as elderly individuals or those living with dementia. There were positive benefits reported to poor mental health through gardening activities, specifically towards depression, stress and anxiety. Overall improvements in quality of life, through social interactions, personal satisfaction and gardens providing a place of safety and restoration were highlighted. Participants of the studies had also reported benefits in diet, greater connection with nature, increased outdoor activity and fostering social relationships within the local community.
Of the 40 systematic reviews, 6 also included meta-analyses which the authors of the umbrella review performed further analysis on. This analysis indicated an overall 55% increase in wellbeing as assessed by the measures used in the studies included in those 6 meta-analyses, with effect sizes ranging from small to moderate. Of the small number of studies that were conducted using a clinical trial design gardening was found to have a positive influence on wellbeing.
However the umbrella review urges caution on the interpretation of the results. The systematic reviews included were of differing quality, with only 7 rated of moderate or high quality. Only 6 had included meta-analyses and while those were used within the umbrella review to create an overall estimate of wellbeing benefits from gardening, there was a lot of differences across those meta-analyses which reduces confidence in the results. Additionally the umbrella review highlights that many of the studies included in the systematic reviews may also have quality issues or limitations which further reduces confidence in results. These include the use of self-report measures, correlational findings, limited number of longitudinal studies and small sample sizes. To address some of these limitations the umbrella review recommends future studies should include more Random Controlled Trail designs. It also recommends that future systematic reviews of studies should present data by study design and gardening activities to help with comparisons.
Causality of the relationship between gardening and wellbeing is perhaps the biggest limitation that the umbrella review highlights. Studies of gardening and wellbeing include various activities within the garden, with the research carried out in different contexts (eg. private garden, community garden) and use different wellbeing measures, as well as sometimes only focusing on specific elements of wellbeing. This makes it difficult to review and compare research findings. Crucially many studies do not identify whether the act of gardening is providing benefits or is it an indirect benefit, such as through the physical exercise involved.
These limitations aside, overall the umbrella review found that the systematic reviews and their underlying studies indicate a positive relationship of gardening upon wellbeing. More research is needed on the specifics, such as the type of gardening, and on understanding the causal relationship to help provide evidence that informs the best ways of helping people benefit from gardening, especially within a social prescribing context.
It may perhaps seem obvious that being out in a garden, whether passively visiting a public garden or working in your own garden provides wellbeing benefits, and so what is the need for research around this. However greater understanding of the elements that are helpful to both the gardener and the garden, including the wildlife which lives in or visits it, is important as our gardens adapt to changing weather patterns and with gardening increasingly used within social and health care programmes.
“A garden to walk in and immensity to dream in - what more could he ask? A few flowers at his feet and above him the stars”.
Victor Hugo’s words from Les Miserables highlight that being in a garden provides more than contact with nature, it may provide a deeper connection to and understanding of nature. However not everyone has access to their own garden and as highlighted in previous articles, research suggests that many people especially within urban areas may have less access to green spaces while also feeling a reduced sense of nature connectedness. In the next article I will look at research around how allotments, community gardens and other opportunities within urban settings may help.
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References
Gush, M. B., Blanuša, T., Chalmin‐Pui, L. S., Griffiths, A., Larsen, E. K., Prasad, R., ... & Sutcliffe, C. (2023). Environmental horticulture for domestic and community gardens—An integrated and applied research approach. Plants, People, Planet. https://doi.org/10.1002/ppp3.10444
Harries, B., Chalmin-Pui, L. S., Gatersleben, B., Griffiths, A., & Ratcliffe, E. (2023). ‘Designing a wellbeing garden’ a systematic review of design recommendations. Design for health, 7(2), 180-201.https://doi.org/10.1080/24735132.2023.2215915
Harries, B., Chalmin-Pui, L. S., Gatersleben, B., Griffiths, A., & Ratcliffe, E. (2024). Identifying features within a garden linked to emotional reactions and perceived restoration. Cities & health, 1-13. https://doi.org/10.1080/23748834.2023.2300235
Panțiru, I., Ronaldson, A., Sima, N., Dregan, A., & Sima, R. (2024). The impact of gardening on well-being, mental health, and quality of life: an umbrella review and meta-analysis. Systematic Reviews, 13(1), 45. https://doi.org/10.1186/s13643-024-02457-9
I've always found healing amid nature, and a relationship that has changed my life over the years, leading me to farming and environmental activism. Nature soothes my wounded soul, loves me as I am, and inspires me to new greatness. Through my burgeoning ecological reserve, I hope to connect more people with nature and share those healing powers with them. This research will help me create those sorts of spaces that will foster the well-being of anyone who visits the Runamuk Acres Conservation Farm. Thank you for your efforts, Chris!!!
Interesting and thought-provoking. The previous owners of my garden had definitely put a lot of thought into it. Unfortunately, much of the plants grew too big and it didn’t cater for the space needed for kids to play. It’s now ideal for ball-games but lacking in both emotional and calming spaces. More thought needed in this area this year, I think…
I’ll keep reading your blog and hopefully find inspiration there :)