Supporting service users

Southwark gardening group offers therapy for refugees and asylum seekers

Last year, asylum applications in the UK increased by 41% to 36,465 – the highest number since 2004. Many of those individuals who are granted asylum are suffering from post-traumatic stress disorder (PTSD) and there is a growing need for mental health services to support traumatised people in culturally accessible ways.

Southwark Integrated Psychological Therapies Team recognised the need to expand its existing project for treating asylum seekers and refugees suffering from PTSD. The team also wanted to inspire other NHS trusts and voluntary organisations to set up projects of their own.

Thanks to funding from The Maudsley Charity, the team was awarded funding worth more than £50,000 to enable the project to move to new premises and to devise a workshop programme to share its experience.

A new home in Kennington

Originally based at Vauxhall City Farm, the project moved to its new home in Kennington earlier this year, alongside youth charity Roots and Shoots.

The project aims to create a safe space in the centre of London where service users can access information to support their recovery. The new venue also has room to run workshops.

Clinical Psychologist Dr Gemma Eke and Horticultural and Integrative Psychotherapist Myriam Sarens manage the project.

Sharing tips for coping with PTSD

Gemma joined in 2014 and oversaw the move. ‘The service is in two parts,' she explains. 'On Mondays there is weekly ongoing gardening and community support managed by Myriam along with volunteers. And on Tuesdays we’ve been offering 12-week classroom-based psychoeducational groups, which run through the skills and tips for coping with PTSD.’

The sessions last an hour-and-a-half and draw on techniques from cognitive behavioural therapy (CBT), narrative exposure therapy (NET) and eye movement desensitisation and reprocessing (EMDR).

This is followed by time spent in the garden to introduce service users to the environment gradually. All the individuals referred to the project are refugees or asylum seekers who have been diagnosed with PTSD.

‘People do a 12-week course first as they often have less tolerance of the environment,' says Gemma. 'We also have interpreters. We try to explain things in ways which we hope are applicable to people from different cultures. Slowly, through meeting one another, people build an attachment to us, to one another and the environment.  They feel a bit safer, learn to trust and also learn tips such as breathing techniques and how to calm the nervous system.’

Raised beds support service users with physical disabilities

Service users are encouraged to return weekly for the Monday gardening and community sessions.

‘We explain how gardening and keeping active can help with depression,’ says Gemma. ‘But rather than just talking about it in theory, which is what you might do in a traditional therapy session, we’re then going out and actually doing it.’

So far, the participants have built and planted three raised beds. This helps service users with physical disabilities as it means they don’t have to bend over to garden. The project also has access to the huge on-site greenhouse for seed propagation.

Builds trust and reduces stress

*Hawa, a 46-year-old woman from Sierra Leone, explains how the project has helped her: ‘It’s great to be out of hospital. For example, in the hospital you think “I’m sick”. Here it make me feel I am working to make myself better.

‘On my first day I didn’t trust nobody. It wasn’t easy for me to open up, but as time has gone on slowly I feel more relaxed. It’s a place of relaxation, to build up your confidence and help with anxiety.’

*Bekele, a 40-year-old man from Ethiopia, is equally enthusiastic: ‘If I am not coming here I wouldn’t be alive. I had a lot of bad dreams and trauma. My life was in danger. Coming here you don’t have the stress. At home it’s just watching TV or thinking. It ’s like a different world when I joined this group.’

Inspiring others

As well as continuing to improve and promote the service, Gemma and Myriam are both keen to share their knowledge with other teams. To this end they have produced a booklet called **‘Grounding’, outlining how gardening can be used in recovery.

This can be used as a reference tool for other healthcare professionals. They will also be offering classroom-based training workshops to help other teams set up their own gardening project for PTSD sufferers.

Gemma says: ‘We want to inspire other NHS Trusts and voluntary organisations to consider running projects like ours, using nature and natural environments, particularly with refugee and asylum seeker populations.’

*Client names have been changed to protect confidentiality.

**Copies of the booklet ‘Grounding’ are available free to other NHS teams or charities or for a small donation. Contact the team at facebook.com/slamgrounding or at twitter.com/slamgrounding for a copy.