Friday, March 26, 2010

I Like To Paint Flowers


The title of this post comes from one of the questions in the Minnesota Multiphasic Personality Inventory, which I had to take when I applied to medical school. And I do like flowers. One of the things I like about the place where I work now is the fact that it's filled with plants---I don't know enough about horticulture to say what they are---but I think they are mother-in-law's tongue, ferns, philodendrons and other bushy green things. In front of the hospital there's a bed of tiger lillies and I can't wait for them to start blooming now that it's Spring.

Our hospital has a horticulture program. Patients who have worked their way up through the privilege level system and are safe enough to leave the ward are allowed to tend the many green plants lining the hallways and windows of the hospital. They do a terrific job and the place is beautiful and warm. I appreciate this a lot because I have a black thumb. When I walk into a nursery the plants scream and run for cover.

I think the patients appreciate the program because being able to participate is a sign of progress. Being able to gain some freedom and be responsible for another living thing gives a sense of independence and responsibility. It's also quite relaxing and peaceful to be surrounded by beauty.

Psychiatric hospitals and prisons have frequently used agriculture or horticulture for therapy and rehabilitation. I know of a maximum security prison where inmates with the highest privilege level are allowed to participate in a bonsai program, growing miniature trees.

Nineteenth century psychiatric hospitals relied upon hospital farms to provide for the needs of the patients. They grew their own food and milked their own dairy cows, which for some patients I'm sure was a source of self-sufficiency and pride. One former hospital farm, the Brattleboro Retreat Farm, still exists and is open to the public. In 2008 the New York Times published Tara Parker-Pope's article Better Mental Health, Down On The Farm in which commenters talked about their own experiences caring for animals during episodes of mental illness. One commenter talked about his horses as "a reason to go on" while depressed, because he had to feed and groom them even in bad weather.

While I didn't grow up on a farm, I did live in a rural community and many of my friends were farm kids. I still get teased for commenting on the progress of the corn crops as I drive through the country. I know farm life is not for everyone. The NYT article mentioned a Norwegian study that compared psychiatric patients treated with standard pharmacotherapy versus a group given standard therapy along with a "farm intervention", where they were asked to work with cows, sheep and horses for three hours a week over a 12-week period. By the end of that time the patients with farm experience had significantly higher self-efficacy and coping skills. Coincidentally, the farm group also had a higher dropout rate. The article didn't mention why the patients dropped out, but I can imagine why----cow pies are definitely not therapeutic.