Are You Happy with Your City?

“How can I change my son’s room to help his ADHD symptoms?” A mother asked me for her child with Attention Deficit Hyperactivity Disorder (ADHD) when I was working as a clinical psychologist. That was the first time anyone questioned about the built environment and mental health to me as I remember. I used to give my patients some therapeutic recommendations in the aspects of psychology/psychiatry, including stress coping strategies, Cognitive Behavior Therapy (CBT), or psychotherapy. But I could not offer good answers for the mother since I had never thought about how built environment would impact ADHD. From that day on, I started to look up information on helpful housing conditions for ADHD children. Some that I still remember are to make homes organized; not to pile up unnecessary stuff at homes and in the children’s rooms; and to minimize clothes, toys, and other furnishing items. Those tips make sense because messy homes and rooms could make children distracted more, and children would more likely get in accidents at home. I realized that the housing conditions and the built environment can worsen an existing mental illness or improve our mental health.

Many of my patients also complained about how they suffered from noise between floors and how the noise made them annoyed. Some patients expressed that they felt harassed by having too many family members in a small house. A social worker who worked on a mentally retarded mother and her new born daughter in a local community reported me how messy her house was. Three years later, her daughter was also diagnosed with mental retardation, and her house was still messy according to the social worker. I was not sure about the causal relationship between their messy house and mental retardation, but I couldn’t stop paying attention to influences of patients’ home conditions to their mental health.

I’m glad to revisit the subject since I have worked on the relationship between housing and mental health while I was a summer research associate at the Center for Urban Design and Mental Health (UD/MH). I borrowed the housing concepts from Le Corbuiser, a Swiss-French architect, and defined three functions of a house as: 1) “a shelter against heat, cold, rain, thieves and the inquisitive,” 2) “a receptacle for light and sun,” and 3) “a certain number of cells appropriated for cooking, work, and personal life” (De Botton, 2006). These concepts are directly and indirectly related to our health, both physical and mental health. For example, if a house can’t play a role of protecting us from cold, we might not be able to survive in winter, which would directly affect our physical health. We might get stressed and anxious when we are exposed to the risk of being robbed and attacked. It is no exaggeration to say that the desire to design a building is the desire to bring happiness.

Based on my research about housing and mental health, some features of housing were closely associated with mental health (To read more about the built environment and mental health, visit our website, the Center forUrban Design and Mental Health. http://www.urbandesignmentalhealth.com). For instance, the more green space we live with, the better mental health we can have regardless of whether we live in urban or rural area (White, Alcock, Wheeler & Depledge, 2013; Alcock et al., 2014; Wells & Evans, 2003). The adverse effect on fetus’ cognitive development when pregnant women are exposed to secondhand smoking at home is well documented. Impacted children later showed impaired cognitive functions such as lower scores on intelligence tests and poor school performance (Weitzman et al., 2013). Environmental noise can also influence academic achievement as well as psychological distress for children (Weitzman et al., 2013). The issue of environmental noise is not just a problem of children, but a problem of all people in the community. Recently, there was a homicidal case in South Korea. A neighbor who lived in the same apartment killed another because of noise between floors (Kang, 2013).

The Korean government has tried to regulate the level of noise, but the experts criticize that “making floors thicker is simply not enough” (Kang, 2013). The conflicts among neighbors in these apartment buildings are more related to “individualism, miscommunication and lack of understanding” than just noise (Kang, 2013). I think these three elements are the characteristics of ‘urbanization’: we are more individualized and more disconnected with neighbors, which can take away the chance to communicate with and understand them. We still don’t know the connection between noise and mental health: people with poor mental health could easily be bothered even by a very low level of noise. The bottom line is that mental health appears to be associated with environmental noise in some level, and it should be considered when designing buildings and planning urban cities.

There are many factors related to urban design and mental health including office environment, transportations and streetscapes. In order to make better cities for mental health, it is imperative to take an interdisciplinary approach. For example, poor housing conditions and homelessness are related to poverty and socioeconomic issue. To bring the issue into the policy, social consensus of how to improve a community or city is required: does our community consider mental health of the public as a priority? The cooperation and collaboration with architecture, environmental engineering, psychiatry and psychology are also critical to design healthy buildings and cities. I would ask you: are you happy with your city?

References

1. Alcock, I., White, M.P., Wheeler, B.W., Fleming, L.E. & Deplege, M.H. (2014). Longitudinal effects on mental health of moving to greener and less green urban areas. Environmental Science & Technology, 48, 1247–1255.
2. De Botton, A. (2006). The Architecture of Happiness (1st American ed.). New York: Pantheon Books.
3. Kang, H.K. (17 Feb 2013). “Apartment noise hard to handle.” Korea Times.
4. Weitzman, M., Baten, A., Rosenthal, D.G., Hoshino, R., Tohn, E. & Jacobs, D.E. (2013). Housing and child health. Current Problems in Pediatric and Adolescent Health Care, 43(8), 187–224.
5. Wells, N.M. & Evans, G.W. (2003). Nearby nature: A buffer of life stress among rural children. Environment and Behavior, 35(3), 311–330.
6. White, M.P., Alcock, I., Wheeler, B.W. & Depledge, M.H. (2013). Would you be happier living in a greener urban area? A fixed-effects analysis of panel data. Psychological Science, 24(6), 920–928.