Thank-you so much for inviting me. Spent 4 happy years in Australia in the 80’s and great to be back!
Going to talk about HT and the military in the UK. I have always loved walled gardens and after my beloved Mother died in 2004 following a long struggle with Parkinson’s I wanted to do something in her memory.
She was a much better gardener than I will ever be, started the Yellow Book (http://www.ngs.org.uk/) in Northumberland where we live and was a Nightingale Nurse (trained at St Thomas’s Hospital in London where Florence Nightingale trained).
I knew HT had been used by the military in the US since Vietnam and Thrive http://www.thrive.org.uk/ was already doing great work with other client groups including children with behavioural problems and adults with dementia but somehow HT had passed the military by…
I am a keen amateur gardener with no professional qualifications having spent most of my working life in racing and self-employment, so I needed a qualification.
Coventry University do a course http://www.coventry.ac.uk/course-structure/health-and-life-sciences/cpd/social-and-therapeutic-horticulture-diploma/ and I got my PDD in STH in 2006.
Gardening Leave got charitable status in late 2006 and the adventure began.
We all know how important research and evidence are when establishing any new project or service and I approached Combat Stress, formerly known as the Ex Services Mental Welfare Society which had been founded in 1919 by the wives and mothers of returning servicemen after the Great War.
The CEO Commodore Toby Elliott was hugely supportive when I explained that I wanted to see if HT would work for veterans and he remembered the days when all military hospitals kept animals and grew their own veg.
In 1904, the Army Medical Service authorised the employment of gardeners at their hospitals and Army Orders listed gardening equipment in their schedules (Journal of the Royal Army Medical Corps RAMC 1904 vol 3) so he knew that what I was proposing wasn’t reinventing the wheel…
Fate found me a walled garden 4 miles from Hollybush House, the Combat Stress treatment centre on the west coast of Scotland where there had been a National Collection of poppies – I couldn’t say no could I..??!!
On 3rd April 2007 the first 2 veterans turned up, more out of curiousity but soon the word spread and we opened Monday to Friday all year round.
The walled garden was critical to the success of the mission as many of the veterans who came to Gardening Leave suffered from hypervigilance and found it very difficult to relax, as they were constantly looking around them for danger.
With only one entrance which could be clearly seen, and high walls all around, the walled garden provided a haven where tea could be drunk and the Hort Therapist and volunteers ensured that the gardening year rolled on and there was always a variety of interesting and meaningful things to do in the garden.
The fact that they could take all the veg back to Hollybush for the retired Army chef to use in the kitchens gave Gardening Leave extra meaning as for many veterans, being thanked and appreciated for bringing back a box of tomatoes or some herbs was a huge boost to their battered self-esteem.
There is a big debate in the UK at the moment as funding gets more and more squeezed, about the difference between ‘treatment’ which is evidence based and measurable, and ‘therapy’ which is essentially nice to have, but harder to evidence.
In 2009 I commissioned Professor Jacqueline Atkinson of the University of Glasgow to evaluate the benefits of HT to Gardening Leave’s veterans and by 2010 I had started 3 more Gardening Leave projects, the last of which was at the Royal Hospital Chelsea, home of the Chelsea Pensioners.
In 2010, the then Commanding Officer of the Defence Medical Rehabilitation Centre (DMRC) at Headley Court in Surrey invited me to visit.
This facility is for serving personnel from the Royal Navy and Royal Marines, Army and RAF and Headley Court had been gifted to the RAF in 1947 when many of their injured aircrew needed somewhere to recover from their injuries.
It had been quietly going about its business mending injured service personnel to either return to their units or if their injuries prevented this, be medically discharged until it came to public attention in the mid 2000’s when, at the height of the conflicts in Iraq and Afghanistan patients began arriving with serious injuries caused by IEDs.
At the time, Headley Court didn’t have a swimming pool of its own and Help4Heroes http://www.helpforheroes.org.uk/ was started with the intention of raising the funds to build one and during this intense period for the UK’s armed forces, a physio and keen gardener called Major Le Feuvre was working at Headley Court.
He realised the need for his very young patients whose lives had been profoundly and in many cases permanently changed by injury, to have some outdoor space within the high pressured and intense environment of Headley Court where the focus was, quite rightly, entirely on injury and the present.
Major Pete as we all called him, recognised the restorative powers of being outdoors and caring for and raising plants and as a physio he recognised the benefits of the outdoors in his own words as “ Providing a challenge nearer to real life; enhancing functional rehab; new skills for soldiers and adding variety to the rehab programme.
On a cognitive level he also recognised the additional benefit of building confidence and self-esteem, addressing social inclusion and aiding concentration and cognitive processing.
Headley Court’s gardens were laid out by Lord Cunliffe who was Governor of the Bank of England between the wars and their high hedges and existing greenhouses lent themselves perfectly to a new project to create a calm, relaxing environment where injured service personnel could get away from OT’s and physios and feel ‘normal’ by getting dirty and exercising mind and body in the fresh air, surrounded by sky and birdsong.
During this time there were a lot of amputee patients and the Test Track garden with lots of different slopes, surfaces and gradients was created in the gardens so amputees could test themselves and their new limbs.
We built a mini version at Chelsea Flower Show in 2012 which won a Bronze Medal and in 2013 Major Pete was posted to Germany, and I set up HighGround to carry on his work with funding from The Soldiers Charity and the Westminster Foundation.
I would have loved to have done the HT’s job myself but running HighGround and developing the land-based employment service for Service Leavers, Reservists and Veterans which makes up the other side of our work meant I needed to find an HT.
Where to look..??
Gardening Leave had taught me that the military is a unique client group. They are used to structure, routine and order and the person I was looking for needed to have excellent horticultural skills and knowledge as these boys and girls don’t suffer fools and are hungry for knowledge.
Enter Carol! She was teaching Horticulture in a mens’ prison and is a Member of the Chartered Institute of Horticulturists http://www.horticulture.org.uk/. HMP Service is the nearest comparative client group to the military in an HT context.
It was tough going for Carol initially, as Headley Court is a clinical facility and the OT’s and physios were deeply suspicious of a grey haired middle-aged woman who didn’t speak their language and wanted to keep chickens…
In her first year Carol delivered 1,522 30 minute sessions of HT to 460 patients.
Everyone must be referred to HT by their OT. There are 3 patient groups, Complex Trauma (amputees); Neuro (head injuries) and Force Generation (spines and joints) and Reasons for Referrals to HT are different according to each patient group.
We all know how wonderfully adaptable HT is, and it took a while for the OT’s to see how Carol could help their patients to increase standing tolerance, improve fine motor skills, concentration and all the things you do every day as fellow practitioners.
It took even longer for them to see the socialisation side of HT.
The biopsychosocial model of care and growth brings patients a vision of hope and alters their focus from themselves to something which is beyond self – it’s a work in progress but HT is now included in the locum OTs’ induction which is a huge step in the right direction….
Remember, these are predominantly young, proud, macho men who are not natural help-seekers and the reason they are at Headley Court is because their military careers have been in some cases permanently interrupted by injury.
I mentioned meaning earlier, and for this client group in particular ensuring everything in the garden has purpose and meaning is critical.
They need to see the reason behind what they are being asked to do (get on the bus get off the bus) and once this becomes clear, there is no stopping them.
In spring 2015 we started a farm shop in the gardens one day a week to sell the produce we had grown (and eggs from Carol’s chickens, she got her way..) to staff.
This began as a project for the Neuro patients to encourage social interaction and help them with money handling and other cognitive tasks. Staff got organic, fresh produce at a minimal cost and all the money went back into the project, mostly to buy teabags..!
This had the added benefit of getting hitherto suspicious staff to visit the garden and Carol soon needed an Assistant….
As the benefits to both patients and staff of the therapeutic environment we had created became apparent and the garden got more and more hammer, I managed to persuade the MoD who don’t ‘do’ volunteers, that Gardening Volunteers were needed and our first intrepid GV’s both also volunteers at nearby RHS Wisley https://www.rhs.org.uk/gardens/wisley arrived in March 2016.
It has been quite a journey and the 3 year HT pilot ends in February 2017. The HT service is now fully integrated into the range of rehab interventions provided by DMRC for injured service personnel.
When Headley Court moves to the late Duke of Westminster’s magnificent Defence National Rehabilitation Centre https://www.thednrc.org.uk/ in 2018 Team HighGround will go too. The walled garden at Stanford Hall is being transformed to form part of our new therapeutic environment and many new and exciting additions to our current facilities such as a dedicated Neuro garden are being created.
This has been a brief gallop through 10 hectic years. It has been hard going at times and the constant quest for funding can take over if one allows it to but I wouldn’t swap places with anyone; these unique and very special people have done their bit, and I’m very proud to be doing mine.
