Oxford psychiatric unit space transformed into garden

The University of Oxford and Oxford Health NHS Foundation Trust project created a therapeutic horticulture garden at the Meadow Unit, a Tier 4 Child and Adolescent Mental Health Services (CAMHS) psychiatric intensive care unit.

Designed for young people in acute mental health crisis who need intensive, highly supervised care, the unit featured an outdoor area that staff described as ‘barren’ and ‘depressing’.

The project was part of a broader study into how nature can support recovery and benefit wellbeing for both patients and staff, funded by the National Institute for Health and Care Research (NIHR) Oxford Health Biomedical Research Centre.

One co-researcher reflected: “It was so barren out there and depressing… so actually having some wildlife there, some plants, some bees, it adds some humanity.”

The scheme was developed through co-production, with medical and non-medical staff, ex-service users, estates colleagues, researchers, and a therapeutic horticulturalist collaborating over seven sessions between January and July 2024.

They discussed all aspects of the garden, prioritising colour, scent, herbs for cooking, places to sit, things to touch while ensuring every plant met strict safety requirements.

Estates staff improved topsoil and installed a cladded path for safe, mud-free access.

A layered planting design was selected to encourage biodiversity and attract pollinators while remaining safe and manageable.

On planting days, team members – including consultants, nurses, ex-service users, and receptionists – worked side by side in the soil, sparking discussions about where to put the lavender.

As the garden took shape, staff reported seeing more worms and bees.

The sensory engagement with the space was seen as a small but meaningful improvement to the environment.

Even patients unable to access the garden directly benefited from the view.

One staff member recalled how a patient in longer-term segregation quietly watched a flowerbed grow throughout the summer.

The garden became a ‘different horizon’ within the unit’s secure architecture.

Staff described the space as ‘a way out of the pressure cooker,’ while the project itself softened workplace hierarchies by encouraging collective, non-clinical activity.

Researchers named the approach ‘Hybrid Green Spaces’ – therapeutic environments that blur the boundaries between built and natural, inside and outside, patient and staff.

The team now advocates for treating green spaces as core therapeutic infrastructure within NHS care, not just peripheral amenities.

They believe that by supporting ‘ecological collective flourishing,’ it’s possible to create systems that care for both people and the environment.

The project was shaped by contributions from PICU staff, ex-service users, estate services, and Patient and Public Involvement (PPI) contributors, whose lived experiences enriched the development of the project.