211. The facilitating role of library environments in the rehabilitation of patients with mild to moderate mental disorders

Abstract Background Patients with mild to moderate mental disorders often face distractibility, emotional instability, social withdrawal, and low engagement in rehabilitation. Although traditional rehabilitation includes medication management and psychoeducation, it remains limited in improving environmental adaptability, sustained attention, and social participation. In recent years, some rehabilitation institutions have attempted to incorporate libraries—quiet, orderly public spaces with a strong cultural atmosphere—into psychiatric rehabilitation, based on the assumption that their stable sensory stimulation and structured activities may help regulate emotions and promote functional recovery. However, quantitative evidence supporting this approach is still lacking. Therefore, this study developed a structured “library-based rehabilitation program” to evaluate the facilitating effects of library environments and their associated activities on the rehabilitation process of patients with mild to moderate mental disorders, with a particular focus on emotional improvement, enhancement of cognitive focus, and increased social participation. Methods A total of 160 patients with mild or moderate mental disorders diagnosed according to the Tenth Revision of the International Classification of Diseases were included and randomly assigned to a library-intervention group (n = 80) or a standard-rehabilitation group (n = 80). Both groups received routine rehabilitation care, including medication management and basic psychoeducation. The library-intervention group additionally participated in a 6-week library-based rehabilitation program consisting of three 90-minute sessions per week. The activities included structured reading tasks, group reading discussions, focused-attention training, and cultural-context experience sessions. The primary outcome was the Rehabilitation Function Scale (RFS). Secondary outcomes included the Hospital Anxiety and Depression Scale (HADS), the Continuous Performance Test (CPT), and observational ratings of social participation. All outcomes were assessed at baseline and Week 6. Paired t-tests, independent t-tests, and multiple regression analyses were conducted. Results After 6 weeks, the library-intervention group demonstrated a significant improvement in RFS scores from 42.6 ± 5.8 to 55.4 ± 6.2 (t = 13.91, p<.001), which was notably greater than the 4.1-point increase in the standard-rehabilitation group (effect size d = 0.82). For emotional indicators, HADS-anxiety scores in the library-intervention group decreased by 5.7 ± 2.4, compared with a reduction of 1.6 ± 1.3 in the standard-rehabilitation group (t = 10.22, p<.001). HADS-depression scores decreased by 6.2 ± 2.9, significantly greater than the 2.0 ± 1.8 reduction in the standard-rehabilitation group (t = 9.84, p<.001). In attention testing, the library-intervention group showed an 18.5% improvement in CPT reaction time (p=.006), whereas the standard-rehabilitation group did not show a significant change (p=.118). Social-participation scores increased by 27.9% (p=.003), while changes in the standard-rehabilitation group were not significant (p=.274). Regression analysis indicated that the library-based intervention independently predicted improvements in rehabilitation function (β = 0.38, p<.001). Discussion The findings demonstrate that rehabilitation activities conducted in a library environment significantly improve emotional well-being, attention performance, and social functioning among patients with mild to moderate mental disorders. The stability, cultural atmosphere, and interactive tasks characteristic of library environments may jointly reduce anxiety levels, enhance attentional engagement, and increase willingness to participate in social interactions within a safe context. These results support the incorporation of library environments as an auxiliary intervention in psychiatric rehabilitation. Future research may further explore how spatial design, activity frequency, and patient characteristics influence intervention outcomes.