Walking is a meaningful occupation known to benefit both physical and mental wellbeing. Research suggests it can reduce symptoms of anxiety and depression whilst improving confidence, social connectedness and overall wellbeing. Walking in natural environments may also support stress reduction, mood enhancement and mindfulness, a core skill within Dialectical Behaviour Therapy (DBT).

At Cygnet Hospital Derby, growing interest in our therapeutic walking group led the Occupational Therapy team to develop a six week graded hiking programme. Initially established on the Male Low Secure Ward, the programme expanded to include the Female Personality Disorder Service and the Male high-dependency ward.

Using activity analysis and grading principles, the programme progressively increased physical and psychological demands whilst remaining achievable and safe. Alongside participation, service users learned about hiking preparation, including equipment, safety, route planning, pacing strategies and endurance building.

Participants completed a series of increasingly challenging hikes at Dovedale, Tissington trail, Carsington water, Lud's Church/The Roaches, Kinder Scout and finally Snowdon. Each location introduced greater distances, steeper inclines and more complex terrain, enabling participants to build confidence, resilience and self-belief through meaningful occupation.

Seven service users initially enrolled. As demands increased, some chose not to progress further, demonstrating increased self-awareness of their strengths and limitations, which in itself was viewed as a positive therapeutic outcome.

As enthusiasm for the programme grew, the final hike became a sponsored challenge raising funds for The Fire Fighters Charity. This provided participants with an additional sense of purpose and social contribution, raising £225.

Of the seven service users who began the programme, one successfully completed every stage and reached the summit of Snowdon. However, success was measured by individual progress rather than completion alone.

Baseline and post-programme reflections explored confidence, self-perceived fitness, personal abilities and sense of achievement. Early feedback suggested improved confidence, greater awareness of physical capability and pride in achieving goals previously thought unattainable.

This project demonstrates how Occupational Therapy can transform a simple occupation into a powerful vehicle for recovery, resilience and hope within secure mental health services.