Why Doctors Are Now Recommending Gardening as Part of Treatment – Not Just as a Hobby

An elderly stroke patient is relearning how to use a trowel in a northern England hospital garden. Occupational therapy is closely monitored while the deliberate, slightly halting movement is a tiny act of planting. Previously, this type of scene was referred to as supplementary. An addition. The physiotherapy department organized something enjoyable between the important sessions. Since years, however, the framing has been changing, and these changes are becoming more pronounced. The UK, some parts of Europe, and an increasing number of clinical settings in the US are incorporating gardening into treatment plans. Instead of boosting morale, this is done as medicine.

Known as social and therapeutic horticulture, social and therapeutic horticulture is gathering peer-reviewed evidence that is becoming harder to ignore. An article published in the journal Clinical Medicine in 2018 based on 20 years of research found that gardening reduces the chances of chronic illness, improves cognitive function in older adults, decreases anxiety and depression, and improves physical health. There are more than 220 citations of the study by researcher Richard Thompson, indicating the results are taken seriously. The literature suggests that this research has been waiting for mainstream medicine to catch up for far too long.

It is startling just to look at the cortisol data. Cortisol, the stress hormone, decreases after gardening. Studies have shown that this decrease is comparable to what antidepressants do for patients with mild to moderate depression. That comparison usually raises eyebrows. It should. Researchers are careful not to suggest that lavender can replace prescriptions. Under the right circumstances, however, structured time spent in a garden affects the body through chemical pathways that medicine has spent decades trying to mimic. The fact that it works, at least in part, through mechanisms that sunlight, soil, and physical effort share with pharmaceutical treatments depends on your preconceived notions.

General practitioners in the UK have been writing what is now referred to as “green prescriptions” for several years. These are official written recommendations that encourage patients to spend time in nature, participate in community gardening initiatives, or start gardening at home. A clinical guidance document is not a suggestion made at the end of a consultation. Patients with long-term mental health conditions, dementia, and cancer have repeatedly asked the NHS to increase this practice. Some hospitals have created therapeutic gardens staffed by horticulturists who collaborate with physiotherapists and nurses. The arrangement still seems strange to some clinical staff. It probably shouldn’t.

Mental and physical health benefits complement each other in ways that enhance overall coherence. Gardening involves bending, lifting, carrying, kneeling, and walking, which are all low-impact, full-body exercises. It keeps muscle mass and dexterity without the risk of injury associated with more strenuous exercise, especially for older adults. According to research published in the British Journal of Sports Medicine, regular gardeners over 60 have a lower risk of heart attack and stroke than non-gardeners. The figure is significant, and it stands up to scrutiny better than many pharmaceutical discoveries. Moreover, working outside increases exposure to sunlight, which promotes vitamin D synthesis, which is chronically low in a large percentage of adults in northern climates. As a result, blood pressure readings appear to become healthier over time.

People with dementia are especially intrigued by the results. Dementia patients with therapeutic gardening programs have shown improved cognitive scores and reduced agitation. Structured, yet adaptable, activities provide the brain with something to track without overtaxing it with sensory stimulation, such as touch, smell, and visual variety. Many elderly dementia patients retain garden memories when other memories are no longer accessible, so the environment itself acts as a sort of orientation. It is possible that the mechanism is more complex than what is currently understood. Despite this, dementia care providers have begun treating the effect as established rather than experimental due to its consistency across studies.

There is a social component to community gardens that individual therapeutic work does not adequately address. People have been paying much more attention to the fact that isolation is a well-established risk factor for poor mental health and early mortality among aging populations since the pandemic. By bringing people together around a common goal in the open air with a natural rhythm of visiting and returning, community gardens foster loose but genuine social connections. As opposed to hard clinical data, the evidence that this reduces loneliness is primarily qualitative, based on self-reported wellbeing measures and interviews. This makes it more difficult to defend in some medical circles. The reality of it doesn’t change.

There seems to be a gradual update in medicine’s understanding of possible treatments. Most of the 20th century was characterized by medications, procedures, and structured talking therapies. From a scientific perspective, anything beyond that corridor was considered soft, incidental, or culturally pleasant. Gardening is simply too archaic, too modest, and too accessible to be considered truly therapeutic. This presumption has been subtly challenged by research for years. As the medical community waits for a more appropriate classification, it’s hard to ignore how long it’s taken and what other commonplace tasks are similarly undervalued.