This article aims to make clearer, with supporting evidence, the clinical benefits of the nature-based rehabilitation program (NBRP) and the restorative values of visiting botanical garden for people with stress-related mental disorders.
Background:
Throughout the years, nature-based therapy has been acknowledged as a valuable rehabilitation practice that integrates specially designed natural environments and nature-related activities for people with mental health conditions.
Subject and Methods:
The comparative analyses of parallel conducted the NBRP at botanical garden and occupational therapy realised at the Day Hospital of the Institute of Mental Health in Belgrade included 27 participants divided into two groups. The data collection employed a mixed method combining a Clinical Global Impression (CGI) Scale and on-site observations.
Results:
The positive findings on the psychological recovery of the participants seem to be related to NBRP. The restorative potential of the garden was recognized through the observed interaction between participants and the natural entities employed through the various themed activities. The observed landscape elements especially solitary plant specimens or tall and single-form trees within the garden can be embraced as design guidelines for the development of an evidence-based practice that can support the recovery process of people with mental health conditions.
Conclusion:
Our findings endorse that ongoing social development and progressive urbanization have broadened the interest in scientific research involving nature-based solutions that help preserve the physical and mental health of people in low- and middle-income Western Balkan countries with a high prevalence of mental disorders in the urban environment that relates to social inequalities and natural disasters.
AdeviA. A. (2012). Supportive nature—and stress: Well-being in connection to our inner and outer landscape[Doctoral thesis, Swedish University of Agricultural Sciences Alnarp].
2.
Annerstedt van den BoschM.ÖstergrenP. O.GrahnP.SkärbäckE.WährborgP. (2015). Moving to serene nature may prevent poor mental health—Results from a Swedish longitudinal cohort study. International Journal of Environmental Research and Public Health, 12, 7974–7989. https://doi.org/10.3390/ijerph120707974
3.
BackmanJ. (2001). Rapporter och Uppsatser [Reports and essays]. Studentlitteratur.
4.
BechtelR. B. (1997). Environment and behavior: An introduction. Sage.
5.
BielinisE.TakayamaN.BoikoS.OmelanA.BielinisL. (2018). The effect of winter forest bathing on psychological relaxation of young Polish adults. Urban Forestry & Urban Greening, 29, 276–283.
BratmanG. N.AndersonC. B.BermanM. G.CochranB.de VriesS.FlandersJ.FolkeC.FrumkinH.GrossJ. J.HartigT.KahnP. H.KuoM.LawlerJ. J.LevinP. S.LindahlT.Meyer-LindenbergA.MitchellR.OuyangZ.RoeJ.ScarlettL.SmithJ. R.van den BoschM.WheelerB. W.WhiteM. P.ZhengH.DailyG. C. (2019). Nature and mental health: An ecosystem service perspective. Science Advances, 5, eaax0903.
8.
BrymanA. (2008). Social research methods (3rd ed.). Oxford University Press.
9.
BuckD. (2016). Gardens and health: Implications for policy and practice. The King’s Fund. The National Gardens Scheme.
10.
BusnerJ.TargumS. D. (2007). The Clinical Global Impressions Scale: Applying a research tool in clinical practice. Psychiatry (Edgmont), 4(7), 28–37.
11.
CarrusG.ScopellitiM.PannoA.LafortezzaR.ColangeloG.PirchioS.FerriniF.SalbitanoF.AgrimiM.PortoghesiL.SemenzatoP.SanesiG. (2017). A different way to stay in touch with “Urban Nature”: The perceived restorative qualities of botanical gardens. Frontiers in Psychology, 8, 914. https://doi.org/10.3389/fpsyg.2017.00914
12.
CloningerC. R. (2004). Feeling good, the science of well-being. Oxford University Press.
13.
CoburnA.KardanO.KotabeH.SteinbergJ.HoutM. C.RobbinsA.MacDonaldJ.Hayn-LeichsenringG.BermanM. G. (2019). Psychological responses to natural patterns in architecture. Journal of Environmental Psychology, 62, 133–145.
14.
Cooper MarcusC.SachsN. A. (2014). Therapeutic landscapes: An evidence-based approach to designing healing gardens and restorative outdoor spaces. John Wiley.
15.
CorazonS. S.Karlsson NyedP.SideniusU.PoulsenD. V.StigsdotterU. K. (2018). A long-term follow-up of the efficacy of nature-based therapy for adults suffering from stress-related illnesses on levels of healthcare consumption and sick-leave absence: A randomized controlled trial. International Journal of Environmental Research and Public Health, 15(1), 137. https://doi.org/10.3390/ijerph15010137
16.
DavisB. E. (2011). Rooftop hospital gardens for physical therapy: A post-occupancy evaluation. Health Environments Research & Design Journal, 4(3), 14–43. https://doi.org/10.1177/193758671100400303
17.
DeanJ. H.ShanahanD. F.BushR.GastonK. J.LinB. B.BarberE.FrancoL.FullerR. A. (2018). Is nature relatedness associated with better mental and physical health. International Journal of Environmental Research and Public Health, 15, 1371. https://doi.org/10.3390/ijerph15071371
18.
DenzinN. K.LincolnY. (2005). The Sage handbook of qualitative research (3rd ed.). Sage.
19.
DzhambovaA.HartigT.MarkevychI.TilovB.DimitrovaD. (2018). Urban residential green space and mental health in youth: Different approaches to testing multiple pathways yield different conclusions. Environmental Research, 160, 47–59.
20.
ErbinoC.ToccoliniA.VaggeI.FerrarioP. S. (2015). Guidelines for the design of a healing garden for the rehabilitation of psychiatric patients. Journal of Agricultural Engineering, XLVI:426, 43–51.
21.
GuyW. (1976). ECDEU assessment manual for psychopharmacology. Department of Health, Education, and Welfare.
22.
HartigT.van den BergA. E.HagerhallC. M.TomalakM.BauerN.HansmannR.OjalaA.SyngollitouE.CarrusG.van HerzeleA.BellS.PodestaM. T. C.WaasethG. (2011). Health benefits of nature experience: Psychological, social and cultural processes. In NilssonK.SangsterM.GallisC.HartigT.de VriesS.SeelandK.SchipperjinJ. (Eds.), Forests, trees and human health (pp. 127–168). Springer Science.
23.
KamiokaH.TsutaniK.YamadaM.ParkH.OkuizumiH.HondaT.OkadaS.ParkS. J.KitayuguchiJ.AbeT.HandaeS.MutohiaY. (2014). Effectiveness of horticultural therapy: A systematic review of randomized controlled trials. Complementary Therapies in Medicine, 22(5), 930–943.
24.
KaplanR.KaplanS. (1989). The experience of nature: A psychological perspective. Cambridge University Press.
25.
KellertS. R.WilsonE. O. (Eds.), (1993). The biophilia hypothesis. Island Press.
26.
KimH. J.MinJ. Y.KimH. J.MinK. B. (2016, December). Parks and green areas are associated with decreased risk for hyperlipidemia. International Journal of Environmental Research and Public Health, 13(12). https://doi.org/10.3390/ijerph13121205
KullbergB. (1996). Etnografi i klassrummet [Ethnography in the classroom]. Studentlitteratur.
29.
Lecic TosevskiD.Pejovic MilovancevicM.Popovic DeusicS. (2007). Reform of mental health care in Serbia: Ten steps plus one. World Psychiatry, 6, 51–55.
30.
MantziosM. (2020). Mental health first aid and exciting opportunities for peer-support networks within universities with prospects of influencing public health and treatment. Journal of Public Health (Berl.), 28, 219–221. https://doi.org/10.1007/s10389-019-01057-5
MotlochJ. L. (2001). Introduction to landscape design (2nd ed.). Wiley. ISBN-13: 978-0471352914.
33.
NilssonK.BentsenP.GrahnP.MygindL. (2019, May13). De quelles preuves scientifiques disposons-nous concernant les effets des forêts et des arbres sur la santé et le bien-être humains? [What is the scientific evidence with regard to the effects of forests, trees on human health and well-being?]. Sante Publique, S1(HS), 219–240 (in French). https://doi.org/10.3917/spub.190.0219. PMID: 31210482
34.
OdmanP. J. (2001). Tolkning, forstaelse, vetande. Hermeneutik i teori och praktik [Interpretation, understanding, knowing. Hermaneutics in theory and practice] (In Swedish). Norstedts Forlag.
35.
OttossonJ.GrahnP. (2005). A comparison of leisure time spent in a garden with leisure time spent indoors: On measures of restoration in residents in geriatric care. Landscape Research, 30, 23–55.
36.
PálsdoóttirA. MPerssonDPerssonB.GrahnP. (2014). The journey of recovery and empowerment Embraced by nature—Clients’ perspectives on nature-based rehabilitation in relation to the role of the natural environment. International Journal of Environmental Research and Public Health, 11, 7094–7115. https://doi.org/10.3390/ijerph110707094.
37.
SandiferP. A.Sutton-GrierA. E.WardB. P. (2015). Exploring connections among nature, biodiversity, ecosystem services, and human health and well-being: Opportunities to enhance health and biodiversity conservation. Ecosystem Services, 12, 1–15. https://doi.org/10.1016/j.ecoser.2014.12.007
38.
SeoS.ChoiS.KimK.KimS. M.ParkS. M. (2019). Association between urban green space and the risk of cardiovascular disease: A longitudinal study in seven Korean metropolitan areas. Environment International, 125, 51–57.
39.
SmithW. G. (1913). Raunkiaer’s “life-forms” and statistical methods. Journal of Ecology, 1(1), 16–26. https://doi.org/10.2307/2255456
40.
SpearingM. K.PostR. M.LeverichG. S.BrandtD.NolenW. (1997). Modification of the Clinical Global Impressions (CGI) Scale for use in bipolar illness (BP): The CGI-BP. Psychiatry Research, 73(3), 159–171.
41.
SpitzformM. (2001). The ecological self: Metaphor and developmental experience. Journal of Applied Psychoanalytic Studies, 2(3), 265–275.
42.
StigsdotterU. K.RefshaugeA. D.SideniusU.GrahnP. (2014). Concept manual for the Health Forest Octovia®. University of Copenhagen(in Danish).
43.
TaylorL.HahsA. K.HochuliD. F. (2018). Wellbeing and urban living: Nurtured by nature. Urban Ecosystems, 21(1), 197–208.
44.
UlrichR. S. (1993). Biophilia, biophobia and natural landscapes. In KellertS. A.WilsonE. O. (Eds.), The biophilia hypothesis (pp. 74–137). Island Press.
45.
UlrichR. S. (2019). Evidence-informed design recommendations for juvenile facilities in Sweden report prepared for the Swedish National Board of Institutional Care (SiS). Chalmers Centre for Healthcare Architecture Publication 2019:1. ISBN 978-91-984301-3-4
46.
Van den BoschM.SangO. (2017). Urban natural environments as nature-based solutions for improved public health—A systematic review of reviews. Environmental Research, 158, 373–384.
47.
VujcicM. (2018). The effects of horticulture therapy on mental health of people in urban areas[Doctoral Dissertation. Faculty of Forestry, University of Belgrade, Serbia] (in Serbian).
48.
VujcicM.Tomicevic-DubljevicJ.GrbicM.Lecic-TosevskiD.VukovicO.ToskovicO. (2017). Nature based solution for improving mental health and well-being in urban areas. Environmental Research, 158, 385–392.
49.
VujcicM.Tomicevic-DubljevicJ.ZivojinovicI.ToskovicO. (2019). Connection between urban green areas and visitors’ physical and mental well-being. Urban Forestry & Urban Greening, 40, 299–307.
50.
WilsonE. (1984). Biophilia: The human bond with other species. Harvard University Press.
51.
World Health Organization. (2016). Urban green spaces and health. A review of evidence. WHO Regional Office for Europe.
52.
ZeiselJ. (1984). Inquiry by design, tools for environment—behaviour research. Cambridge University Press.
53.
ZimringC. M.ReizensteinJ. E. (1980). Post occupancy evaluation. Environment and Behavior, 12(4), 429–450.
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