Designing Relief: A Mixed-Methods Experiment to Inform Crisis Room Design and Intervention in Acute Psychiatric Care

Abstract Background: The design of psychiatric environments influences patient experience, especially in acute crisis settings where perception is altered and emotional vulnerability is heightened. This also applies to crisis rooms, which are often used for seclusion—a practice increasingly criticized for its psychological impact. While guidelines call for de-escalating designs, the perspectives of patients with lived experience of seclusion have rarely informed such efforts. Methods: This mixed-methods study explored how individuals with lived experience of psychiatric seclusion (N=30) perceive different visual design elements in simulated crisis room settings. Participants viewed nine digitally rendered room scenarios that varied by wall design (various nature-themed images and cool, pale colors) and furniture form (curved vs. angular) vs. an empty white control room (psychiatric paradigm of no stimulation). They rated each room on perceived restorativeness, stress, liking, and overwhelm and answered qualitative questions about crisis rooms and needs. Results: Nature-themed wallpapers—especially an image depicting dunes and water—and blue and green walls, were rated as more restorative and less stressful than both the control and a beige-painted comparison room. Furniture form showed no significant effects. Qualitative responses emphasized the importance of calmness, orientation, positive social interactions, recreational activities, selfcare, and environmental control. Conclusions: Design interventions in psychiatric crisis rooms—particularly those incorporating natural wall imagery and color— improve both the aesthetic and, more importantly, the emotional experiences of patients. The study underscores the feasibility and value of participatory approaches in healthcare design, guiding the decisions needed to co-create spaces that promote better mental health. Trial registration: The study and main analyses were pre-registered 2024/08/22 at aspredicted.org (#187275) https://aspredicted.org/9ht9-ckwn.pdf