The lead female role of of Deborah Blake in this picture was previously intended for Natalie Wood who had unrealized plans to both produce and star in the movie. Wood once had planned to produce the picture as well as star in it in the role of Deborah Blake but those plans never materialized. The part in the end was played in the film by Kathleen Quinlan.
The lead character of Deborah Blake was offered to actress Patty Duke during the late 1960s. But she turned it down because she wanted to be married and not work at the time.
The movie's producer Roger Corman says of this film on its DVD sleeve notes: ''While Vol au-dessus d'un nid de coucou (1975) offered a subversive and satirical look at a psychiatric institution, 'Rose Garden' delivered a dramatic, emotionally compelling portrait of a young woman's experience of psychiatric treatment. This Oscar®-nominated screenplay was adapted from the best-selling novel by Hannah Green. It features a critically acclaimed performance by a young Kathleen Quinlan in an extremely challenging role. Shot with stark realism, the film pulls no punches in its depiction of a psychiatric ward, while maintaining individual and sensitive portrayals of the hospital's residents.''
Barbara Steele is billed as part of the cast in the closing credits for the film but it appears any of her scenes never reached the final cut.