As I read this paper I was caught between seeing it as a statement of that paradoxically elusive concept that we call common sense and maintaining my reviewer focus on considering whether the paper meets the stated intention, that is, to evaluate the impact of a Mental Health Recovery Programme (MHRP).
In addressing the latter, I offer several comments that relate to:
the literature review;
the data; and
a sense of the whole paper.
The literature review provides a simple scene-setting, highlighting the benefits of access to nature in fostering good mental health. The authors introduce key concepts that are relevant to their evaluation, for example MHRP and recovery star. There is also a helpful rationale for the mixed-methods approach to evaluation that follows.
I found the section on quantitative data a little vague and was glad to reach the subsequent presentation of the qualitative data, especially as the authors promised that it would ‘provide depth and meaning’. I certainly found this to be the case.
The verbatim quotes from participants in exit interviews and focus groups were powerful pointers to the success of the Therapeutic Horticulture (TH) approach. The authors made considerable efforts to set this apparent success in the context of the MHRP. The social enterprise responsible for developing this MHRP seems to be particularly open to social prescribing, looking beyond the mental health label and creating a local solution that uses what is available, as indicated by the commentary that ‘the project builds on the existing work undertaken by the social enterprise’. My sense, after reading this paper, is that TH is one of an abundant range of possibilities that could be used to promote wellbeing through developing practical ways to reduce social isolation. In offering such approaches, service providers may be limited by resource shortages (e.g. location or money), but I hope that this paper will encourage readers not to be limited by imagination as they seek to support people with mental health problems. Overall the paper makes a strong argument for creative attempts to help people integrate into their community and move beyond any limitations implied by their mental health history or diagnosis. The reminder that professionals should be ‘on tap, not on top’ was one of many hints at the underlying philosophy of the writers that seem to support their commitment to their work.
It was a particular pleasure to read the comment in the conclusion that ‘people felt valued for what they could do and for their contribution, rather than being defined by their diagnosis and what they could not do’. This phrase alone makes me want to support the authors and those who kindly cooperated in their evaluative efforts. To return to my initial point, if this paper confirms the usefulness of common sense then we are indebted to the authors for reminding us of the importance of thinking holistically and creatively about working with the soil. One could say that this paper explores grounded theory in both senses!
Biography
Steve Dilworth is a facilitator, specialising in reflective practice. With an original grounding in mental health nursing he currently works with end-of-life care professionals and staff in custodial settings in the UK.