Psychiatrists Sow Seeds of Good Mental Health

Radishes are not mentioned in DSM-IV. Nevertheless, the crunchy little vegetables are part of the therapeutic toolkit that Bella Schimmel, M.D., Ph.D., carries with her to the school children she sees each week as part of her practice in Los Angeles.

Digging in a garden, watering plants, or even just looking at or tasting unfamiliar fruits and vegetables can open doors for children with psychiatric or learning disabilities and help them improve other aspects of their lives.

“Everything a youngster does in a garden—eye-hand coordination, following directions, smelling, tasting—enlarges their experience and helps them across the board,” said Schimmel in an interview. On days when she isn't working with school children, Schimmel teaches at UCLA or conducts her private practice.

Schimmel, a child psychiatrist who just attended her 55th medical-school reunion, is a part-time practitioner of horticultural therapy, a small field with a long history.

Nineteenth century mental hospitals in Britain and America were often built in rural areas, and patients were assigned to work in fields or gardens as part of their therapy. Benjamin Rush claimed that digging in the asylum garden helped patients recover. Able-bodied patients at the Milledgeville Asylum in Georgia, among other places, worked in the garden to grow food that helped defray the costs at the institution.

A brief article in 1959 in Mental Hospital (a predecessor of Psychiatric Services) reported that 40 boys committed to Pontiac State Hospital in Michigan as “delinquents and criminals” were“ digging their troubles into the soil” in a gardening program.

However, the modern history of horticultural therapy can be traced to Karl Menninger's interest in gardening, which led him to support patients' work with plants as a valuable adjunct to therapy.

“Menninger began working in greenhouses and outdoor gardens with World War II veterans who experienced physical and emotional problems,” said Teresia Hazen, M.Ed., a registered horticultural therapist and coordinator of the Legacy Therapeutic Gardens at the Legacy Health System in Portland, Ore. “He believed that it promoted work, social, and cognitive skills.”

Ken Ensroth, M.D., a psychiatrist at Legacy Health, did his residency at the Menninger Clinic in 1988 and found that greenhouses remained part of the therapeutic setting. “Even severely depressed patients who grew plants would brighten up and engage their recreational therapists,” he said.

That modest introduction at the Menninger Clinic eventually developed into a graduate program in horticulture therapy at Kansas State University, said Richard Mattson, Ph.D., a professor of horticulture and coordinator of the horticultural therapy program there. After his arrival at Kansas State in 1969, Mattson worked with the university's horticulture faculty and with Karl Menninger and others at the Menninger Clinic to develop the first horticultural therapy bachelor's degree in 1971.

“There's strong medical evidence that working with plants or exposure to nature has incredible therapeutic power,” said Mattson, who is realistic about the value of his specialty. “Horticulture doesn't cure anyone, but it opens doors and broadens horizons.”

On her trips to Los Angeles area elementary and middle schools, Schimmel may start by bringing gardening materials into classrooms.

“You always have to have a project,” she said. She shows them seeds or plant cuttings. The children examine them, then place them on water or in earth and watch them grow. She may ask them to draw plants or foods or write about them.

“Many of these kids have problems with reading, writing, and self-esteem,” she said, and the activities she directs address those problems.