Joining the team in 2019, Neil Barker, Head of Occupational Therapy, saw the potential within the grounds and wanted to create a space that enabled service users and staff to enjoy activities in a therapeutic and purposeful way.
Now in 2024, the grounds have been transformed into an idyllic outdoor space to support patients to spend more time away from the clinical environment and improve their health and wellbeing.
Cygnet Hospital Maidstone is a state-of-the-art, 63 bed mental health facility for adults situated in the Kent Medical Campus in Maidstone. Work completed over a 5 year period by occupational therapy staff and patients has completely revamped the outdoor space.
Neil explained the idea behind the project. He said: “I wanted to support service users to improve their health and wellbeing, and having a suitable outdoor space is really important, particularly because it harnesses the healing power of nature. And occupation helps you regain a sense of control in your life.”
The gardens have been totally redesigned, with a circular route to guide visitors to different locations, each with their own unique purpose and look. At the entrance is a stone gabion wall, and hedgerows surrounding a central meeting point and circular bench. A meandering resin path makes its way from the bottom to the top of the gardens. These were all original features upon opening of the hospital. A shelter was created by the estates team a few years later, followed by fencing completed by contracted gardeners to section off the back as an allotment space.
Neil began initial work in 2020 with service users to dig flower beds and add new hedgerows and trees. Work continued in bursts over the next 4 years to shape the landscape into an environment that encourages exploration.
He explained: “I had a vision of what the space should do, it needed to be somewhere that you could walk, run, do gardening and enjoy nature. I just had this persistent thought that service users were walking up the path up to the top, then turning round and walking back down again. We didn’t have the funds to build another path, so I had to think creatively.”
He added: “In the first year I asked the gardeners to leave sections of the lawns to grow into meadows, so that it could open up walking routes around the grounds. But this didn’t bring the desired effect. So the next year we got working on replanting hedgerows leading off the path, forming a route leading around the edges and returning back to the entrance.”
After entering the gardens, a pallet wood sign directs you left to a picnic area and allotment, going up the winding path past rosemary, smoke bush and red roses. It says ‘150 metres, 10 laps ~ 1 mile’, encouraging visitors to increase their walking.
Going up the path, wildflowers are allowed to grow and establish, taking advantage of the farmland on which the hospital resides. At the picnic area there are two benches, lavender, flowery shrubs, and established trees, as well as two pear trees and a single apple tree. Staff recently enjoyed an afternoon having lunch outside together during their break, then completed a nature trail.
At the end of the path is an allotment, featuring a poly tunnel and raised beds. Neil explained: “We received feedback from funders and service users to add a poly tunnel so that service users could engage in growing fruit and vegetables. Hospital management has been really supportive with investment, and by giving me the reins to make things happen.”
Within the allotment space, a typical occupational therapy session looks like this: Growing multiple trays of flower seeds, filling each section with soil and a couple of seeds so they do not become overcrowded, then covering with a thin layer of soil and grit, and watering well. Depending on the level of support needed, service users are shown visually what to do, then the task is broken down into steps, and guidance is given to make corrections. Neil said: “The purpose is to create a product, because it brings with it achievement and confidence in your abilities.” A service user giving feedback said: “I’m very impressed with the allotment and the poly tunnel. I’m pleased they are growing some fruit. I’d like to help tidy it up, cutting the grass and making some more planting beds.”
Service users attend a weekly ‘green walking group’, which focuses upon physical exercise and social participation by exploring nature. They are supported to set a goal for the session, for example to walk a number of laps of the gardens, or to explore the natural environment, smelling and tasting fruits and herbs for their relaxing effects.
Neil said: “It is really nice to complete some laps around the garden as a form of exercise, and then enjoy some raspberries and strawberries from the allotment.
“We’ve also been growing herbs like rosemary, rhubarb and fennel. You really get to see the patients get in touch with nature and appreciate what is around them.”
“Having a chat is the other benefit too. Patients tend to open up more when away from the clinical environment. Conversations happen and that staff-patient rapport is allowed to flourish a little better.”
Turning right off the main path takes you through an eighty metre bark chip trail, leading you through hedgerows and trees, then you can take a short break on the benches, then veer off back to the start in a figure of eight, or go straight down to the wildlife garden.
Starting in autumn 2023, service users worked over a period of six months to complete the new path. One service user said: “Doing this kind of work in a mental health placement helps a lot, I’m very happy to do this and see the progression of what we do.”
Neil added: “Having gardens creates an enjoyable distraction, but it also allows for the undertaking of gardening jobs and learning of skills, which better prepares you for independent living.”
The wildlife garden is a secluded and tranquil environment in which to enjoy spending time. It takes advantage of the plants that are naturalised within the area, such as white primroses and yellow birds-foot trefoil. Added features are a notice board with information about the featured plants, and a bug hotel which doubles as a sitting spot. One service user said: “I think we should focus on sowing more wildflowers to support local insect life, we should also participate in no mow May.” After receiving this feedback, the wildlife garden was designated a ‘no mow’ area, and grass is only cut back seasonally.
Last year the hospital held a sponsored run to raise money for charity, taking place within the gardens and car park. The course was measured to 12 laps making 5km. Service users and staff took part by walking or running whatever distance they felt comfortable, and they were very proud of their achievements. A second run was held this spring, and another sponsored run will go ahead this autumn.
Next on the agenda is to establish the wildflower garden, improve the information board, and add a squirrel proof bird feeder. A welcome board is also planned, to feature a map and guidance about what occupations you can engage in here.
Overall the project has been extremely successful. Neil said the feedback from patients has been overwhelmingly positive. “The feedback we’re getting from patients now is that they really enjoy spending time outside and it is benefitting their mental and emotional state”, Neil added. “The fact they’ve played a huge part in helping to transform the area themselves means they have a real sense of ownership and satisfaction. You can’t recognise the garden as it was from the beginning.”
“It comes down to basic human needs, having access to the outdoors and having that freedom is something that we all take for granted. When you are in hospital having been sectioned, just having the ability to go outside can have a massive effect. It gives you a sense of freedom.”
