McLean Hospital 115 Mill Street Belmont, MA 02478
In the enclosed courtyard behind the Admissions Building, where others see an expanse of ugly crabgrass, Jeannie Kingsley, RN, sees a huge garden bursting with fragrant, colorful perennials. She imagines a labyrinth that patients and staff can walk to soothe their thoughts and a pathway that weaves through different sections of the garden-to-be. Kingsley, a 30-year veteran of McLean and a nurse on the Short Term Unit, is determined to make her vision come true. “Magical things happen every day when you’re in a garden,” she says. “It draws patients out and puts them in a more positive frame of mind.”
Kingsley knows from experience. When Jim Kahn, the activities director in the Psychotic Disorders Division, retired in 2013, she took over the modest-sized courtyard flower garden he had tended for years. The courtyard gets lots of foot traffic and is visible from many of the Admissions Building’s windows. With the help of clinical coordinator Terri Quinn, Kingsley added more flowers to Kahn’s garden, including zinnias, lilacs, and hibiscus, and cared for it with the help of staff and patients. During the second season, she recruited a very ill teenage girl to plant lots of sunflower seeds and used the process as metaphor. “We would talk about how plants grow and then how sometimes they have to go through a difficult period, maybe losing a branch and then growing another one,” recalls Kingsley. “That’s the premise of garden therapy: people can see how nature works and heals itself and how it continues on, despite the setbacks. That young patient was so calm when we were in the garden.”
After several years of witnessing the positive effects of the garden on patients and staff, Kingsley is ready to move her horticultural project to the next level. When the Admissions Building renovation was completed last year, its once verdant courtyard was left looking bedraggled. Kingsley saw an opportunity. Her determination to expand the plantings, beautify the courtyard, and get more patients and staff involved have been embraced by Kelly Carlson, PhD, McLean’s nursing professional development specialist, who has been working on nurse-led quality improvement projects around the hospital. Carlson viewed Kingsley’s garden project as a perfect way to educate staff about “grounding techniques”—a therapeutic skillset to improve patient care that nurse directors had requested training in.
Grounding techniques help people detach from emotional pain by reconnecting with the external world and the present moment. Therapeutic horticulture can be a powerful way to ground psychiatric patients because it puts them in contact with nature and other people and gets their bodies moving. While researchers are still learning exactly how tending plants affects the brain, what is known is that gardening reduces stress by decreasing the production of cortisol. And some qualitative and quantitative studies have confirmed its beneficial effects—particularly on elderly patients and people with developmental delays.
Kingsley doesn’t need evidence to confirm what she has seen over and over with her own eyes. There was the young woman experiencing suicidal thoughts who did some planting with Kingsley recently, and reported that their work was the only positive thing in her day. Another patient, a young man, whose aggression worried staff, reluctantly agreed to come out to the garden with Kingsley. Once there, he began talking enthusiastically about how he used to help his grandmother in her garden and would Kingsley allow him to help her? He was a tremendous worker, weeding, raking, digging, and planting. “He and another challenging teenage boy bonded around the garden, working together, and experiencing a calmness not seen on the unit,” recounts Kingsley. Then, there was the very depressed man who for months would silently watch others at work in the garden from the adjacent patio. After a while, he began identifying the plants as well as the weeds and sharing his own long history with horticulture. When he was discharged, he donated flowers to the garden. While many patients get their hands dirty on a regular basis, others simply enjoy the garden from a seat on the patio or from a window in their room.
Kingsley is not the only staff member who is bringing more green into the lives of patients and staff. The Schizophrenia and Bipolar Disorder Inpatient Program, also in the Admissions Building, has a vegetable garden next to Kingsley’s. And Ginybel Belgira, a nurse at the Cognitive Neuropsychiatry Program, part of the Geriatric Psychiatry Inpatient Services, plans to create a garden for her patients. Meanwhile, Todd Snyder—a Klarman Eating Disorders Center behavior therapist who is pursuing a certification in horticultural therapy—is hoping to plant herbs, with information explaining their therapeutic properties, around the dining area outside the de Marneffe Building, welcoming people to smell, touch, and enjoy them.
Carlson said that these horticultural therapy projects fit in well with McLean’s long history of capitalizing on its landscape for the benefit of patients. “We have beautiful grounds and lots of natural beauty,” says Carlson. “McLean patients have long used grounding techniques as a way to wake up their senses, come out of their painful places, and connect with the outside world, whether by taking a walk, looking at a colorful tree, or picking up a pine cone and examining it.”