When seeking to creatively foster positive change in the mental health of individuals, a community-based approach may encourage participation of community members in a way that facilitates trust, alleviates discrimination, and promotes insight (Carney et al., 2012). Wakefield et al. (2007) highlight the role that community gardens play in the health and well-being of urban populations, while also emphasizing the interplay between the concepts of space, place, and occupational participation. In developing occupational therapy services in a community-based setting, literature such as this supports the development of client-centered programming that can impact the health and well-being of adults labeled with mental illness in a variety of ways.
The urban population that served as the setting for the study by Wakefield et al. (2007) was an area of South-East Toronto, Canada; this area is characterized by high rates of poverty and ethnic diversity, and it encompasses Regent Park, Canada’s largest social housing complex. A strength of this study was the investigation of 15 different community gardens, which allowed for a robust inclusion of 68 participants (Wakefield et al., 2007). The researchers also described triangulation of data collection methods via observations, focus groups, and interviews, as well as the use of member checking techniques to increase the credibility of interpretations of participant experiences (Wakefield et al., 2007). Researchers described that they participated with the community gardeners by “planting seeds, carrying water, and shoveling dirt” (p.93), which most likely contributed to the development of trust between the researchers and the participants, and may have allowed for richer description of experiences and feelings regarding the community gardening experience, as well as more in-depth reflection by participants when they were asked to identify research questions and provide insight into the needs of the community.
Despite the large sample size in this study, the study took place in only one area of one large city, and the number of participants was not great enough to allow for generalization of results. However, the qualitative data presented here does provide insight into the positive health implications of community gardens and illustrates the worry regarding pollution and permanence of such gardens that community members face.
Important health benefits that were identified through participation in these community gardens were better access to food, improved nutrition, increased physical activity, and improved mental health. Attributes of the gardens that contributed to these health benefits through promotion of stress relief included the opportunity to interact with nature, the gardens conveying “a sense of lushness and abundance” (p.95), and the gardens offering “spaces of retreat within densely populated neighbourhoods” (Wakefield et al., 2007, p.95). This supports Hasselkus’s (2011) position that space and place contribute to health and well-being due to certain aspects of an environment promoting healing and recovery.
Hasselkus (2011) also describes the ‘transactional unit’ which is comprised of the “dynamic relationship between people and the environments in which they carry out their everyday lives” (p.43) and which results in occupational performance. In the community gardens, the occupational performances of physical activity, social interaction, and growing fresh produce were a result of the interaction between the community members and the gardens. A crucial element in influencing the occupational choices of the community members was that the locations of the gardens were within the neighborhoods where the community members carried out their everyday lives.
This view of the person-environment interaction also supports Persson & Erlandsson’s (2014) elaboration on the concept of ecology as the “interaction between the eco-system of the doer and the environmental ecosystem” (p.16) and the supposition that this interaction, when examined from a perspective of sustainability, has the potential to contribute to the well-being of the local environment, as well as the well-being of the greater ecosystem. The gardens did promote the well-being of the community members on a personal level, while also promoting well-being on community and environmental levels. Garden-based programming benefitted the community members on an individual level by creating an opportunity to come together to share tools, ideas, food, and culture, which contributed to decreased isolation, increased self-esteem, feelings of empowerment, and skill development (Wakefield et al., 2007).
The garden-based programs benefitted the “community as a whole, by improving relationships among people, increasing community pride and in some cases by serving as an impetus for broader community improvement and mobilization” (Wakefield et al., 2007, p.97). The presence of the gardens contributed to community pride by enhancing the physical features of the neighborhoods, and working closely with the food that they were to eat, stimulated community members to think about such factors as pesticides, air pollution, and soil contamination.
While the presence of community gardens provided an opportunity for health benefits on individual, local, and planetary levels, the meaningfulness of these gardens also stimulated concerns by the community members as to the sustainability of the garden plots. Wakefield et al. (2007) allude to the idea that social exclusion and marginalization are prevalent problems in neighborhoods of low socioeconomic status (SES), such as the neighborhoods where this study took place. The community members did express concerns about lack of awareness of the gardens and lack of political will to contribute resources to sustain the gardens, by the greater community and political leaders. These concerns were preempted by the recent initiation of re-development in Regent Park. This contributes to the study of occupational justice by highlighting the importance of the perspective of the community members in determining what is most meaningful and useful for themselves, the community, and the planet.
Just as the participation of community members in the study by Wakefield et al. (2007) allowed researchers to understand what was meaningful about community gardens, the participation of community members in decisions about land development would contribute to fair allocation of resources to enable equitable distribution of rights and privileges in terms of occupational participation. However, the current state of Regent Park, with the initiation of re-development without input from those who reside in this housing complex, places the community members at risk for infringement on their freedom to participate in their valued occupation of gardening.
This situation also contributes to an understanding of how occupational marginalization often “results from informal norms and expectations within a sociocultural infrastructure” (Durocher, 2014, p.422). The greater Toronto society may view residents of low SES neighborhoods to be involved in crime, or to not be concerned with such ideas as access to fresh produce, pollution, and community well-being, and these assumptions may lead political leaders to neglect to examine their expectations of the behavior of the inhabitants of such neighborhoods when making decisions about community development.
The study of occupational science, which informs occupational therapy, has been developed through the amalgamation of perspectives from various disciplines on the study of factors affecting the participation and engagement of humans in everyday life. Due to the dynamic between the person and the environment, it is imperative that occupational science incorporates knowledge from disciplines that highlight this interaction to truly understand the meaning of occupational choices and the resulting occupational performances, as well as to appropriately promote participation and to address issues of occupational injustice and occupational marginalization. Wakefield et al. (2007), through a health promotion perspective, highlighted the importance of access to natural environments in promoting physical and mental health, contributing to social inclusion, inspiring appreciation for the natural environment, and in stimulating empowerment of community members to address larger social issues. This study also demonstrated the efficacy of a community-based approach in illuminating the client-centered perspective that is the hallmark of the occupational therapy profession.
Sharon Vincuilla, OTR/L
Occupational Therapy Doctoral Resident
Carney, P.A., Hamada, J.L., Rdesinski, R., Sprager, L., Nichols, K.R., Liu, B.Y. … Shannon, J. (2012). Impact of a community gardening project on vegetable intake, food security and family relationships: A community-based participatory research study. Journal of Community Health, 37:874-881.
Wakefield, S., Yeudall, F., Taron, C., Reynolds, J., & Skinner, A. (2007). Growing urban health: Community gardening in South-East Toronto. Health Promotion International, 22(2):92-101. doi:10.1093/heapro/dam001