A farming program for people with mental health disabilities provides horticulture therapy, honey and a place to heal.
By Hyun Namkoong
People who experience some combination of substance abuse, developmental disability and mental illness are often subjected to what is sometimes known as “ping-pong” therapy, meaning they’re bounced from one clinic to the next.
Thava Mahadevan, executive director of XDS Inc., has long recognized that providing these services separately can pose significant challenges for people with co-occurring disorders. XDS specializes in offering a wide range of integrated services for these individuals.
Mahadevan said that a person living with both substance-abuse and mental health issues is often told to “go get yourself clean” before being allowed to receive mental health treatment.
This, he said, tends to render poor outcomes. “We must work simultaneously with both diseases,” Mahadevan said.
That’s the impetus behind XDS Inc.’s Farm at Penny Lane, where produce and honey are integral to the therapeutic process. The farm offers horticulture therapy to individuals with behavioral health issues that have traditionally been difficult to treat.
On a recent chilly Friday morning, David, who declined to give his last name, was busy mixing up the organic material in the compost bin.
“I enjoy being outside, in nature,” he said. “[We] take home kale, collards, cabbage. [We grow] pretty much anything that starts with a ‘K’ or ‘C’ right now.”
Ariel Reynolds, a social work intern from UNC-Chapel Hill, said the approach has been enlightening. She’s appreciated the opportunity it allows to work with clients as equals.
“Spending time together in the sunshine, getting dirty, it’s really beautiful,” Reynolds said.
Hospital without walls
People with co-occurring disorders often require the most treatment and suffer the poorest quality of life, Mahadevan said, but most health care systems are not designed to serve their needs.
“There is a lack of integrated care,” he said, “and I saw in my work that many people had serious mental illnesses and substance abuse, and around 25 percent of those patients [also] had developmental disabilities.”
“But,” Mahadevan said, “there was still a silo style of care for mental health, substance abuse and developmental disabilities.”
“There was a need for a one-stop shop,” he said. “So we decided we wanted to do it ourselves.”
In 2004, that “one-stop shop” was born as XDS Inc. XDS stands for Cross Disability Services, which merged with the UNC Center for Excellence in Community Mental Health in 2011, part of the psychiatry department at the UNC medical school. But Mahadevan and his colleagues chose to keep XDS as an acronym to protect the privacy of their clients seeking mental health or substance-abuse treatment.
With some financial backing from local and state government, a multi-disciplinary team that Mahadevan refers to as a “hospital without walls” was formed.
More than 90 percent of XDS’s client meetings are held outside of the traditional office setting. This outreach component is an important feature of the Assertive Community Treatment (ACT) model. Mahadevan explained that ACT is often the last resort for people with severe and persistent mental illnesses who have struggled with traditional health care methods.
The success of the ACT model has been largely attributed to its nontraditional, highly individualized and integrated approach to supporting the needs of people with co-occurring disabilities.
“No matter the cost, we will make it work,” Mahadevan said. “We have a really good, committed group of people.”
Always thinking outside the box, Mahadevan saw an opportunity to integrate wellness and health at XDS when he began the organic farm project in Chatham County. The Farm at Penny Lane was started as a way to get people outside and interacting with others to improve their overall well-being.
“Horticulture therapy is a very low-tech solution to very complicated health problems” he said.
Horticulture therapy has been used to help people with mental illnesses in different settings, such as prisons or camps for troubled youth. Studies have shown that gardening reduces stress and promotes social interaction.
Everybody is a volunteer in the garden, Mahadevan said. “Nobody knows who is staff or client, so there is an empowering thing to people to work as part of a team.”
The Farm at Penny Lane strives to bring people together in learning to work the land. And at the end of the harvest, everyone gets to take vegetables home.
The sky’s the limit
The XDS staff knew that their clients wanted to work, but the typical 9-to-5 office job wasn’t well suited for most of them.
Chickens, bees, shiitake mushrooms and more help fill the void. Several micro-enterprises are now in their pilot phases at Penny Lane. The goal is to have clients managing them to generate income for themselves and their families.
They’ve already sold hundreds of bottles of honey and plan on selling even more in the next year. “We have 40,000 bees,” said Mahadevan, beaming. And they hope to sell produce at the farmers’ market in the spring.
The mushrooms, donated by Pickards Mountain Eco Institute, grow in a large woodpile. “These are expensive;” Mahadevan said, carefully lifting a log. “They’re, like, $5 a pound!”
There’s also a greenhouse that’s home to an aquaponics project, still in its early phases. The plan is to sell tilapia to local restaurants.
Then in March, 80 chickens will take up residence on Penny Lane, soon, hopefully, to be producing eggs.
“The mindset is, the sky is the limit,” said UNC’s Ariel Reynolds.
Many organizations only have ideas about how they can help those most in need, she said, while XDS actually makes things happen.