To add context, this was not my first time in Ukraine. I had worked there several times before COVID and witnessed the effects of the conflict since the annexation of Crimea however, this was my first return since 2022, following Russia's major invasion. I knew from ongoing work remotely with the Ukrainian Society of Ergotherapists (occupational therapists in Ukraine) that whilst there are many challenges, the courage of soldiers and civilians as patients, the resilience of staff and the vision of many are changing the rehabilitation landscape in Ukraine. What I didn’t anticipate, or at least, not in the depth I experienced, was how profoundly the built environment could shape hope, motivation, and recovery.

My memories of the hospitals and facilities visited in 2017 and 2018 were often of dark, Soviet-era buildings with low ceilings and dark, narrow corridors. What I saw in 2025, however, were many recently renovated hospitals and new clinics with open-plan spaces, sunlight flooding through windows, carefully chosen colours on the walls, and artwork that seemed to speak directly to the spirit.

In these modernised hospitals and clinics, the effect of the environment felt tangible, as though hope itself was stitched into the plasterwork, and as an occupational therapist, I shouldn’t have been surprised.

The Environment as an Occupation Enabler

Occupational therapists have long recognised that the environment is not a neutral backdrop. The PEOP model (Person–Environment–Occupation–Performance) (Baum, et al, 2015), teaches us that the environment interacts dynamically with the person and their occupations, influencing performance and participation. In mental health especially, this interplay is critical.

My memories of the old dark hospitals, whilst clean and functioning, did not fill me with motivation. By contrast, in the new and renovated facilities, the environment actively facilitated therapy. Daylight streamed into rehabilitation rooms, naturally boosting mood and circadian rhythm regulation. Veterans, soldiers, friends and families sat in communal areas where soft chairs and warm colours created a small sense of calm. I witnessed spontaneous conversations between people; moments of human connection that are, in themselves, therapeutic occupations.

The Power of Art in Healing Spaces

What struck me most was how intentionally art was used in these modern spaces. In one children’s facility, there were animal murals lining corridors encouraging discussion and straighter postures as children walked or wheeled past them. In another clinic, a series of calm, abstract, and nature-inspired paintings lined the corridors and therapeutic spaces. The occupational therapist repeated a conversation with service users when they had been asked for their permission to be photographed so posters could be made showing their recovery, then displayed on the walls to motivate and inspire others; the service users specifically asked them not to remove the artwork, stating they appreciated the calm space they provided.

In an adult rehabilitation wing, where some service users were learning to live with multiple prosthetics, vibrant murals told stories of resilience and community: a surfer with a prosthetic leg carrying his board on a beach, a basketball player with a prosthetic limb, a hiker walking on his prosthetic leg through a sunny landscape. These weren’t random decorations. They were carefully chosen occupational narratives, visual reminders of what life could hold after injury.

From a PEOP perspective, this artwork wasn’t merely aesthetic. It was a bridge between “person” and “occupation,” sparking memories, prompting conversation, and reinforcing identity beyond injury and disability. Those images have the ability to become part of rehabilitation plans, concrete goals in visual form.

Lessons for Our Practice

As occupational therapists, we are educated to look at the whole person, their occupations, and the environments in which they live and heal. Whilst the descriptions of the centres I describe above may not seem alien in the UK for me experiencing them in Ukraine reinforced several truths to myself personally and professionally:

• The physical environment is not a luxury — it’s a clinical tool. Light, colour, noise, air quality, and spatial design all influence occupational performance and mental well-being.
• Art is occupation. Whether creating, viewing, or being inspired by it, art can reinforce identity, foster hope, and connect people to life beyond the hospital walls.
• Environments can either perpetuate illness or nurture recovery. Especially in mental health, the difference between a dim, cold corridor and a sunlit, art-filled communal space can be the difference between isolation and engagement.

Moving Forward

It is important to note that the hospitals and clinics I refer to are in western Ukraine, a relatively safer part of the country. Ukraine’s hospitals are still in transition, with a large number of clinics destroyed or damaged throughout the country, and the environment of most healthcare settings still poses significant accessibility barriers. Renovations take time and resources, and many ergotherapists continue to work in challenging physical settings. Yet, even in the older buildings and when working with individuals with catastrophic injuries, there are sparks of creativity, such as patient-led art sessions and small indoor plants around the occupational therapy rooms. These small changes are worth noting because they echo the larger principle: the environment is modifiable, and even small modifications can have a significant impact.

Back home, I find myself looking more critically at my own environments. How much natural light reaches our therapy spaces? What messages are our walls sending? Are our spaces telling stories of hope and possibility?

I’m looking forward to attending the OT Show in November to further my reflections, discussing with the exhibitors and fellow occupational therapists how we work together with our clients to adapt and enable the environment.

As occupational therapists, we should be aware that the environment isn’t just where healing happens — it is part of the healing process. We cannot separate the bricks and mortar from the human spirit. In the right space, light doesn’t just enter the room; it enters the person.

Thank you to Olya Mangusheva and Alina Tereshchenko for assisting with my reflective process.

Reference

Baum, C. M., Christiansen, C. H., & Bass, J. D. (2015). The Person-Environment-Occupation-Performance (PEOP) model. In C. H. Christiansen, C. M. Baum, & J. D. Bass (Eds.), Occupational therapy: Performance, participation, and well-being (4th ed., pp. 49-56). Thorofare, NJ: SLACK Incorporated.