SWK Community Gardening Interventions for Reducing Schizophrenia Stigma
Research Paper
Orion Schmidt-Libby
Ethelyn R.Strong School of Social Work, Norfolk State University
SWK:
Dr. Wade
May 1, 2025
Introduction
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Combating Stigma: Social Work and Schizophrenia, Study Guides, Projects, Research of Advanced Education
This explores the stigma surrounding schizophrenia and social workers' role in combating it. It examines stigma's impact on self-esteem, social inclusion, and well-being. Synthesizing literature and guidelines, it addresses how social workers can tackle internalized and externalized stigma while promoting inclusion. It highlights practical applications across macro, mezzo, and micro settings, including horticulture as a micro-intervention and social workers' influence on policy. The document emphasizes education, dialogue, and positive interactions to break stereotypes and foster inclusion. It also touches on universities' and social workers' roles in promoting understanding of mental illness and ethical decision-making in challenging negative representations.
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SWK Community Gardening Interventions for Reducing Schizophrenia Stigma Research Paper Orion Schmidt-Libby Ethelyn R.Strong School of Social Work, Norfolk State University SWK: Dr. Wade May 1, 2025 Introduction
Schizophrenia is a severe and chronic mental illness that significantly impacts those who suffer from it. Beyond the distress caused by the symptoms, individuals with schizophrenia often face stigmatization from the public. This stigma primarily stems from the widespread belief that people with schizophrenia are unpredictably violent. Individuals with schizophrenia are frequently labeled as different from the mainstream, perceived to have undesirable characteristics, and subjected to discrimination that leads to adverse outcomes in their daily lives. This stigmatization results in low self-esteem, difficulty in maintaining friendships, and substantial barriers in social inclusion, employment and housing. Internalized stigma occurs when individuals with schizophrenia accept and internalize negative public perceptions, adversely affecting their self-esteem and mental well-being. Externalized stigma occurs when society’s negative attitudes and discriminatory behaviors can lead to exclusion, restriction of opportunities, and widespread prejudice against those diagnosed with schizophrenia. This creates a cycle of discrimination, isolation, and shame. Combating stigma surrounding schizophrenia requires a multifaceted approach, including education, open dialogue, and social contact. Raising awareness about the condition through education campaigns and personal stories can help dispel misconceptions and promote understanding. Encouraging positive social interactions and breaking down stereotypes through personal narratives and shared experiences are crucial. This research will examine three practical applications within macro, mezzo and micro settings; Can horticulture be used as widely accessible micro intervention for dispelling stigma, promoting social inclusion, and providing opportunities for connection, skill-building, and a sense of belonging? Additionally, how can communities and culture be used specifically as platforms for stakeholders to foster awareness
focus on the efficacy of educational interventions to dispel myths and alter implicit and explicit attitudes toward schizophrenia. To address this problem a contemporary educational seminar was implemented called "Maniacs and Psycho Killers: Myths and Realities of Mental Illness in Pop Culture,". This seminar aimed to reduce stigma by using popular films and other media in combination with lectures and class discussions. The study suggests that college students (an ideal test population) have more stigmatizing views of major mental illnesses than the public, due to their common feelings of low self-esteem, powerlessness, and poor locus of control. CITE To evaluate the effectiveness of this seminar the following tools were used; Attribution Questionnaire-Short Form, the Attitudes to Mental Illness Questionnaire, and the Level of Familiarity Scale. Findings from this study support that this seminar is an effective approach to reducing college students’ mental illness stigma, especially pertaining to schizophrenia. Students in the seminar had significantly lower AQ-SF scores at the posttest assessment than students in the control groupCITE. This study is relevant firstly by demonstrating the effectiveness of educational settings as a widely accessible and cost-effective platform for correcting negative perceptions. Secondly, it demonstrated how the same popular media used to disseminate negative stereotypes can also be used or repurposed to open engaging and provocative dialogue. Lastly, stigmatizing attitudes and beliefs may deter some students from pursuing careers in social work, psychology, or related helping professions. Universities and even grade schools are community cornerstones where social workers have the opportunity to foster a supportive and informed community. Educators and social workers can
observe students and interact with diverse groups of students over time to evaluate innovative educational strategies to combat mental health stigma and promote a healthier, more inclusive understanding of mental illness among the next generation. Furthermore, properly informed young people can be charismatic disseminators of information to the community at large. Social workers should facilitate students to initiate contemporary activities such as fundraisers, themed events, peer-to-peer support groups, social media takeovers, and other fun campaigns. Institutions of learning are ideal setting for social workers to inspire and educate young adults about helping professions, social entrepreneurship, and the complexities of systemic inequalities.. Social workers should engage diversity and difference in practice. Social workers understand how diversity and difference characterize and shape human experience and are critical to the formation of identity. Competency 2 guides social workers to engage clients as experts of their own experience. Young people dominate social narratives about identity in content creation e,i. film, social media, and musical platforms A study was conducted in an educational setting that involved 94 undergraduate students at a Midwestern liberal arts college where participants were exposed to educational material about the low rates of violence among people with schizophrenia. Participants' attitudes were measured using Implicit Attitude Tests (IATs) and self-reported social distance scales before and after the intervention.CITE The findings align with previous research indicating that educational interventions are effective in improving explicit attitudes towards individuals with schizophrenia, reducing self-reported stigma, and diminishing the desire for social distance.CITE In this Mid-western study educational interventions were found insufficient for altering implicit attitudes, which are crucial for actual behavioral change. Therefore, multifaceted interventions combining education, contact, and policy are essential for fostering a more
The data suggests that direct, personal engagement, such as hearing stories from people with lived experiences, may be more effective in changing stigmatizing attitudes than large-scale media campaigns. Although not directly person to person, one study involved a 90-second video featuring a young woman who shared her personal narrative on living with schizophrenia. The video significantly improved public perception and willingness to engage socially with people with schizophrenia.CITE This study substantiates the power of combining peer-to peer and the earlier explored media interventions to expand exposure and impact. Social workers are trained to apply knowledge of human behavior and the social environment, person-in environment, and other multidisciplinary theoretical frameworks in interventions with clients and constituencies. The evidence underscores that relationships are central to recovery, necessitating a shift from individualized treatment to inclusive practices involving families, peers and communities with social work skills and values playing a crucial role in this paradigm shift.CITE? In scrutinizing micro practices, an analysis of literature on therapeutic gardening or Horticultural Therapy (HT) through the lens of a Peer Support and Recovery Model Framework reveals favorable outcomes in regard to identity and stigma. Gardening is a meaningful occupation that is believed to facilitate well-being through doing (i.e., active engagement in gardening), being in nature and with others, becoming (i.e., developing a positive sense of self, developing skills and new identity), and belonging to the social group and the wider community through engagement in an ordinary occupation devoid of stigma (Armstrong et al., 2023). Horticultural Therapy (HT) has been defined as the use of plants and plant-based activity for the purpose of human healing and rehabilitation. It is a process that uses plants and gardening activities to improve individuals' physical, mental, and emotional well-being. It's a form of
therapeutic intervention where trained professionals (social workers, occupational therapist, horticultural therapist) guide participants in gardening and plant-related activities to achieve specific treatment goals (AHTA, 2025). Social work and HT intersect when practitioners use the power of nature to address social injustices, fill gaps in service, and promote client empowerment. Gardening interventions offer various benefits for individuals with schizophrenia in various settings, including stress reduction, social engagement, increased physical activity, and improved mood. These benefits can be facilitated by social work practices that prioritize individual needs, create supportive environments, leverage group dynamics, and reduce stigma. Furthermore, researchers identified that the person driven approach in HT embraces social work values such as self-determination, self-direction, and autonomy by facilitating individuals to define their own goals, lead, and exercise choice over the services that support their recovery (Armstrong et al., 2023). In a systematic review by Taiwanese researchers' multiple studies were examined that present the effects, benefits, and potential drawbacks of HT in treating schizophrenia symptoms. The Taiwanese research led by Yi-Wen Lee identified the `following: Horticultural activities, such as soil digging and planting, might enhance neurotransmitters (e.g., serotonin, dopamine) and regulate inflammatory cytokines. Daily attention to plants and extended therapeutic intervals may increase client engagement with natural elements, enhancing the therapy's efficacy. HT offers significant social benefits by reducing social isolation and fostering social interaction through therapeutic garden activities (Lee et al., 2024). This literature assessed outcomes and emotional states of adults with schizophrenia over the age 18. HT Treatments lasted 3 months and showed greater improvement in total symptoms
interventions. Qualitative outcomes revealed: Trait Hope Scale (THS): Two participants showed improvement. One participant exhibited growth across all scales. Flourishing Scale (FS): Two participants had improved scores. All four participants showed positive change in their agency scores, whereas one participant improved their pathway score (Tsotsoros et al., 2022). For social workers the community garden is an ideal place of practice. Australian social worker, Ph.D., and researcher Susan Bailey points out: If the role of social workers is to listen to people’s stories then community gardens provide a place to be, to learn, and to share. And finally, the collaborative auto- ethnography methodology has potential for social work practitioners to develop reflective communities of practice. It shares the limitations of much qualitative and constructivist research in that it is a methodology that doesn’t seek to claim a definitive truth but rather seeks to begin a dialogue (Bailey et al., 2017). Participants in HT saw the nurturing of plants as parallel to their own healing journey, providing a sense of responsibility and purpose. The research identifies three social work principles: ‘person driven,’ ‘strengths/responsibility,’ and ‘relational.’ The ‘strengths/responsibility’ aspect relates to skill acquisition, routine, and responsibility (Armstrong et al., 2023). In addressing external/internal stigma HT can support personal agency and the creation of a new sense of self encouraging clients find an effective place in greater society. Social workers are in a strong position to fight stigma and foster inclusion by applying ethical decision-making models to navigate complex situations involving stigma. Adhering to the NASW Code of Ethics, laws and regulations is fundamental. Engaging in continued education to stay updated on new technologies, practices, and strategies for addressing stigma.
Social workers must advocate for policies and practices that advance human rights by challenging negative representations about mental health. This requires understanding that marginalization, alienation, and cultural exclusion directly disrupt personal identity and therefore personal efficacy. Social workers must not only educate the layman but also translate research evidence to inform policy. This includes advocating for and implementing policies that impact social welfare. The protection and treatment of people with mental disorders is recognized by the United Nations (UN) as a fundamental human right (United Nations. United Nations General Assembly 46/119: the protection of persons with mental illness and the improvement of mental health care 1991. http://www.un.org/documents/ga/res/46/a46r119.htm Accessed August 30, 2013). Key recommendations for policy actions based on research, stakeholder consultation, and best practices were identified by Austrian researchers.CITE (Schizophrenia— Time to Commit to Policy Change) Develop and implement an evidence-based, integrated care package that addresses both mental and physical health needs of schizophrenia patients. Provide support for community reintegration, including mechanisms to navigate employment and benefit systems. Offer educational programs for families and carers to enhance the care provided to individuals with schizophrenia. Maintain ongoing consultations with stakeholders to continually improve schizophrenia management policies. Allocate proportionate funding for research and development of new treatments. Establish well-funded, ongoing awareness campaigns as part of routine action plans.