How Outdoor Spaces Heal Mind, Body and Spirit
When we design for the built environment, we don’t tend to think of healing landscapes.
However, outdoor spaces can serve a therapeutic purpose and become spaces for healing.
Contemporary urban landscape design shifts increasingly from grey to green, with the development of green infrastructure, rain gardens, green corridors, bio-swales and engineered wetlands. This re-greening of our city spaces presents a potential solution to a serious emerging issue.
Cancer, diabetes, hormonal imbalances, heart disease, IBS – public health is deteriorating at an accelerating rate. Cutting edge research shows that immersion in natural spaces, sunlight and greenery can have a profound effect on our mental and physical health. In a world full of microplastics, pollution and artificial light, the solution might be as simple as reconnecting with nature.
Outdoor Spaces for Healing and the Effect of Stress on Health
Maggie’s Cancer Charity designs its centres with a core concept: the space in which cancer support is provided can be as powerful as the support itself. In fact, for them the building, and especially the garden is part of the team.
Before she died in 1995, Maggie Keswick Jencks, with her husband, landscape architect Charles Jencks developed the blueprint for a new kind of cancer support space. They emphasised greenery and nonclinical environments that prioritise emotional well-being alongside medical care.
Maggie’s Centres are places of refuge on hospital grounds. Their outside spaces are designed to help people feel comfortable, relaxed, and connected to nature. Far from the stress of the hospital, these centres are positioned close to the oncology ward. The intention is that patients step out of consultation and into a winding garden, immersed in passing of seasons, lush plant life, dappled light and calming scents. Water features and trees create shelter from external noise, wildlife and birdsong create space for pause and reflection.
Simply looking at a natural view or open landscape can boost Vagus nerve activity. The Vagus nerve is a key part of your parasympathetic nervous system, that controls fight or flight, stress response and relaxation. Vagus nerve stimulation leads to faster relaxation, decreased anxiety, lower heart rate and a greater overall stress resilience. Spending time in nature can do a lot to lower anxiety and stress, allowing people to relax and feel present.
This principle is reflected in the Japanese practice of forest bathing (shinrin-yoku): intentionally spending time in nature to lower stress and promote relaxation. Even just 20 – 30 minutes can lower cortisol and ramp up parasympathetic activity.
Trees also release phytoncides, powerful anti-microbial essential oils that have direct benefits to human health. They can boost immune function, lower stress and have even been shown to have anti-cancer benefits. Pine, cedar, fir and spruce are rich sources.
So, how far do landscapes affect health and healing?
Encouraging relaxation is fundamental for health and healing. Physical and mental health are interdependent at every level. Physical stress and mental/ emotional stress have the same effect on the body. Hormones like cortisol and adrenaline raise heart rate, blood pressure and alertness. Chronic stress keeps these systems over-activated leading to dysregulation, and persistent inflammation.
Stress can cause a variety of health problems:
- Cardiovascular issues – high blood pressure and increased risk of heart attack and stroke
- Metabolic issues – increased insulin resistance, weight gain and diabetes risk
- Slowed digestion, leading to gut inflammation and IBS
- Sleep disturbance, starting a vicious cycle of rising stress
Stress also impacts healing and recovery:
- Chronic inflammation slows wound healing and tissue repair, affecting recoveries from injury and surgery.
- Immune system suppression (cortisol lowers immune response over time)
- Prolonged inflammation disrupts tissue remodelling
Studies have shown that higher perceived stress correlates with slower healing.
By designing environments to stimulate parasympathetic activity, offer respite, pause and relaxation, we address health issues and actively promote healing. In hospitals, care centres and recovery programme, the incorporation of nature into designs can make a significant difference.
Roger Ulrich’s 1984 study found that patients assigned to rooms with windows overlooking a natural view (trees and greenery) recovered better than patients with views of asphalt and concrete:
- They had shorter hospital stays; an average of 7.9 days compared to 8.7 days.
- They required less pain medication following surgery.
- They had fewer negative comments in nurses’ notes (indicating fewer complications).
Shorter hospital stays and lower medication costs translate directly to savings. While therapeutic landscapes pose high upfront costs, the return on investment means they quickly pay for themselves.
Therapeutic spaces on hospital grounds are found in schemes like the Queen’s Centre for Oncology and Haematology in Hull, where HLM Architects created a healing garden that provides access to nature and greenery while offering enclosure, privacy and safety.
At Maggie’s West London (designed by Dan Pearson) a winding path takes you through a green transitional space. Separating Maggie’s from the hospital’s clinical intensity, letting people process their experiences and find calm in the greenery.
Emerging evidence underscores the value of therapeutic gardens in modern healthcare. A 2024 study found that adults suffering from dementia with access to greenery showed significantly reduced agitation.
Historical examples of healing landscapes
If a fish is sick, don’t just medicate it, clean the tank.
The idea that your environment can have significant health implications is not a new one. Hippocrates, the father of modern medicine famously said, “Nature is the physician of the diseases”. He stressed that air and water quality directly affect disease patterns and recovery. Hippocrates advocated diet, exercise and fresh air over “medicine” alone.
Similarly, Florence Nightingale linked healing to pure water, light, warmth quiet and beautiful surroundings as essential for recovery.
In fact, famed neurological Oliver Sacks in his essays on gardens tells us:
“I have seen in my patients the restorative and healing powers of nature and gardens, even for those who are deeply disabled neurologically. In many cases, gardens and nature are more powerful than any medication.”
Healing Light
Today, we’re coming full circle with healing landscapes. There are famous black and white photos of hospitals with healing sun decks and solariums for their patients – an idea coming back into vogue in projects like the King’s College Hospital Critical Care Unit Roof Garden.
Sunlight for healing is becoming popular in response to undeniable links between vitamin D and health. This is as well as cutting edge research – that we’re photosensitive beings, and our cells are stimulated in response to light.
More recently, emerging research demonstrates that bodies work as light receptors. When light hits the skin it penetrates tissues and stimulates cellular activity and mitochondrial energy production. Red and near infrared light (abundant in sunlight) reaches deep into muscles, organs and joints where it boosts ATP, reduces oxidative stress and promotes repair processes. Known as photo-biomodulation, these effects accelerate healing, decrease inflammation, balance hormones and improve overall recovery. Sunlight also triggers melatonin production, a potent antioxidant that further protects tissues.
Key features for a healing landscape
When designing a healing landscape, here are just a few options to keep in mind. These features can be incorporated individually or in combination depending on project scale, budget, and therapeutic objectives:
For physiological restoration:
- Biologically friendly lighting – Warm colour lighting (2700k or lower) can support the body’s natural circadian rhythm. Minimising blue light exposure helps boost melatonin production, promoting better sleep quality and avoiding health problems like disrupted mood, poor metabolism, and fatigue from chronic circadian disruption.
- Grounding areas – Direct skin contact with the earth (walking barefoot or sitting on grass) allows electron transfer that can reduce inflammation, lower free radicals, improve sleep and balance stress levels. Landscape architects should consider having lawns where people can kick off their shoes and connect barefoot to the earth!
- Biodiversity and wildlife-friendly planting – Emerging concept of “Antivirus Parks”, encouraging trees and plants that produce phytoncides. Inhaling these airborne chemicals boosts immune function while reducing stress and inflammation.
- Nature gazing areas – Directed attention to trees and nature reduces anxiety (2024 Bangor University study). Nature gazing areas can be framed vistas, or window like openings in hedges, creating elevated overlooks, or pathways that draw your eye to tree lines and greenery.
Sensory engagement
- Water features – Fountains, streams and small waterfalls release negatively charged ions into the air via the Lenard effect. These ions purify air, reduce stress, elevate serotonin levels and promote relaxation. The sounds of water features can also encourage mindfulness and calm.
- Therapeutic planting – Aromatic herbs and sensory plants that engage the sense of smell. Fragrant species like lavender, chamomile and rosemary have powerful aromatic properties for things like focus, calm and relaxation.
- Edible planting – Herbs, fruit and vegetables to eat, stimulating taste buds, drawing people from their headspace into a grounded experience of the garden.
Social and emotional wellbeing
- Public seating – Comfortable and accessible for older adults and people with reduced mobility. Along pathways and in secluded nooks, screened by hedges to create privacy for contemplation and rest. Natural material seating made from timber, wood or stone for grounding.
- Areas for community – Open lawns, decks, communal seating areas, areas for activities: yoga and games. These promote social support, shared purpose, and a sense of belonging, hugely important for mental and physical health.
- Encourage hands-on horticulture – This can boost mood, microbiome, cognitive function, social interaction and lets people connect with the earth in a hands-on and productive way!
Environmental quality
- Plant life for air purification – Plants act as natural air purifiers, absorbing pollutants and improving oxygen levels and humidity. They can be incorporated in borders and vertical gardens to create cleaner, fresh air environments. Trees add phytoncide benefits.
- Resilient infrastructure – Consider permeable paving, rain gardens, engineered wetlands and climate-adapted natives to manage water and support ecological health, for enduring restorative spaces.
- EMF considerations – Electromagnetic fields from electronic equipment and wireless networks are becoming increasingly prevalent. As evidence is starting to pile up that they can have effects on our health. Landscape architects can incorporate dense plantings of trees and shrubs, living barriers to absorb and scatter electromagnetic waves while contributing to biodiversity and privacy screening.
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