Planning a Healing Garden in a Psychiatric Hospital in Hungary

This blog post was contributed by PLUS Change Ambassador Katalin Rethy and Bea Pántya, and is part of our series featuring personal accounts from our Ambassadors. These blogs offer first-hand reflections on the challenges and opportunities shaping land use planning across Europe and beyond.

Ambassadors contribute to PLUS Change discussions on equitable land use, representing the interests of groups that may be excluded from or underrepresented in land use planning and decision-making in Europe. These individuals bring valuable perspectives rooted in their experiences and lived realities, helping to shed light on how land use change impacts different communities.

Participatory design with human and more-than-human voices

Healing gardens are more than just green spaces, they are nature-based solutions that can support both human well-being and ecological health. Exposure to natural environments and nature related activities can reduce stress, improve recovery outcomes, and foster resilience, which are beneficial in a hospital setting. But beyond human benefits, gardens provide habitat for plants, animals, and other beings. When including them in the design process, a healing garden can become a place of mutual healing, supporting both people and ecosystems.

At the Healing Garden Living Lab in Hungary, we have been working with the Boldog Gellért Hospital to co-create such a space. Our approach is rooted in participatory action research with the goal of including the voices of all stakeholders: patients, coworkers, experts, and the more-than-human beings who live in the garden. Over the past three years we have tested different methods to bring these diverse perspectives into the design process.

Human voices in the planning process

Human voices were included through in-depth interviews with hospital staff, observations and group meetings. These conversations explored how staff and patients currently use the garden, their visions for recreation and therapy, and how they interact with the natural world. They also revealed tensions and conflicts between people and between humans and non-humans; helping us understand where design might support smoother coexistence. In a hospital setting, especially when working with people living with mental disorders, privacy is of utmost importance. For this reason, patients were not interviewed directly; their insights were collected anonymously and indirectly, through eco-art and music-therapy sessions and voluntary storytelling in group settings.

Listening to more-than-human voices

Not all non-human beings are equally visible or equally appreciated by the hospital community. Birds, trees and cats on the hospital grounds seem to be awarded more affection and attention than other beings. However, these familiar creatures may serve as gateways of empathy, sparking curiosity and opening conversations about other, less familiar species. Can beloved cats or a flock of goldcrest help us broaden awareness to pollinators or the microorganisms in the soil? By acknowledging the garden as a complex, multi-species habitat co-created by many forms of life, we recognize that human well-being is inseparable from the well-being of the living environment. Healing the hospital’s landscape can become part of healing the larger web of life.

Ecological and affordance mapping

Mapping has become one of our key participatory tools for involving both humans and more-than-humans:

Botanical and zoological mapping: What began as technical surveys evolved into participatory exercises. Ornithological mapping was supplemented with bird related programmes for patients living with dementia; botanical quadrants for surveying became a spectacle in the garden for observing plants and insects; turning scientific observation into shared experience.
Affordance mapping: Our research employs Timo Maran’s Ecological Repertoire analysis (2020) to analyse the data of multispecies environments. With umwelt analysis, we explore the species’ sensory and behavioural interactions with the environment, and identify functional relationships among species, their resources, and threats. We explore ecofields—specific patches that fulfill species’ needs, such as foraging or nesting areas. Affordance mapping highlights environmental features that support species’ life functions, like surfaces for movement or shelter structures.

By integrating these methods, we reveal patterns in more-than-human interactions and map the presence or absence of affordances, especially for key species.

Sensory and audiovisual observations

To complement ecological data, we applied experiential methods that capture the garden

Sensory sitting: Participants spent 30 minutes at a chosen spot, noting smells, textures, sounds, and movements through continuous writing.
Photo diaries: Repeated walks along a fixed route documented environmental change over time.
Soundscapes and time-lapse videos: Recorded across four seasons, these revealed subtle dynamics: birdsong competing with traffic noise, the rhythm of footsteps, and the interplay of natural and mechanical sounds. The videos could also offer insight into how humans use the garden.

Together, these observations help us visualize the garden as a living system of interactions, where social, ecological, and material processes intertwine. The recordings also identify disturbing factors such as heavy traffic, guiding both spatial design and maintenance strategies.

Creative encounters

Another interface between humans and the natural world has emerged through eco-art therapy sessions that were organized as part of art-therapy groups. Participants painted with plants, created seasonal art such as Easter egg decorations, or listened to the music of plants through a special device that translates plant signals into sound. Researchers joined these sessions as co-creators and observers, exploring how artistic engagement can deepen empathy toward non-human life and strengthen participants’ connection with the living environment.

Micro-interventions

Throughout the planning process, we have facilitated and supported micro-interventions, small, quickly implemented actions based on ideas from hospital staff and patients. These actions are low cost and small scale, often using upcycled or found materials and relying on the involvement of a group for building and planting. Examples include building raised beds, establishing a compost heap or planting fruit trees in a “recovery forest”. Each micro-intervention becomes both a therapeutic activity and a nature-human interface, where new relationships can emerge. Patients and staff see the direct results of their care, while researchers can observe how people and non-human organisms interact in these newly created niches. As researchers, we often participate in both the concept development and physical realization of these micro-interventions. This collaboration blurs the boundaries between research, design and therapy. It turns the garden into a living laboratory of co-creation, where every small act of planting or building contributes to the evolving ecosystem of care. Micro-actions also help test ideas at a manageable scale before larger investments are made. They keep the design process adaptive, allowing non-human agencies to contribute and the garden space to develop organically.

Co-creating the Master Plan

The scientific, sensory, and practical insights contributed directly into the Landscape Architecture Master Plan. The plan recognizes that a hospital garden must respond simultaneously to therapeutic, ecological, and operational needs. Permaculture principles overarch the design: building on what already exists, planting native species, creating microhabitats, and designing for realistic, shared realization of elements, as well as maintenance. Elements can serve multiple functions, such as aesthetic, therapeutic, social or ecological.

Zoning of therapeutic areas was designed for different modes of healing:
- Personal and quiet zones for reflection or one-on-one sessions.
- Perceptual zones such as barefoot paths or herbal walks emphasizing sensory experience.
- Zones of care and nurturing, where patients can exercise caring for garden areas themselves.
- Community spaces for social interaction, sports and other collective activities, and shared events.

Maps were created based on the affordance maps for specific more than human beings; such as birds, cats, soil inhabitants; both in the current state and in the planned garden. Where one group loses affordance (for example, due to new paths or parking), compensatory areas can be created elsewhere.

Institutionalizing healing with nature

This hospital healing garden design process was an invitation to rethink relationships between people and place, between patients and caregivers, and between humans and the wider community of life. By bringing together multiple voices, including those of more-than-human beings, we are seeing that healing is not unilateral: When we care for the garden, the garden cares for us in return.

As the project approaches its conclusion next year, a new challenge emerges: how to sustain this dialogue with humans and the more-than-humans once the active research phase ends. What forms of stewardship, maintenance, and community engagement can keep the garden alive as a learning ecosystem? How can the practices of listening, observing, and co-creating continue when researchers step back? These questions reach beyond the Boldog Gellért Hospital, pointing toward a broader goal of creating models for other institutional gardens that wish to integrate ecological care, therapeutic practice, and participatory design. The Healing Garden Living Lab doesn’t offer a strict blueprint, but showcases a living process; an ongoing collaboration between humans and the more-than-human world, cultivating a culture of mutual care that we hope can serve as an example for other initiatives.

A Coevolutionary approach to unlock the transformative potential of nature-based solutions for more inclusive and resilient communities (COEVOLVERS) projects has received funding from the European Union’s Horizon Europe research and innovation programme under grant agreement No101084220.

Reference

Maran, T. Ecological Repertoire Analysis: a Method of Interaction-Based Semiotic Study for Multispecies Environments. Biosemiotics 13, 63–75 (2020).