Building for Mental Wellness: A Case for Mindful Cities Part I
To what extent do urban landscapes represent a threat to our wellbeing?
This report explores the interaction between mental health and the physical quality of our built environment. In Part I, we look at the ways in which urban life can have detrimental effects on our mental health, and discuss the barriers to creating healthy places. In Part II, we present the ideal city, one that meets the psychological needs of its inhabitants, and discover current spaces that are prioritizing residents’ wellbeing. In Part III, we consider how to overcome some of the obstacles to healthy placemaking, discussing the potential of collaboration and innovation in order to create resilient urban ecosystems.
Social interaction, mobility, production, and entertainment make cities places of intense stimulation and excitement. But how exactly does this stimulation affect the emotional wellbeing of urban dwellers? Given the rapidly rising urbanisation and worsening mental health of its inhabitants, a stronger focus needs to be placed on better understanding the psychological impact of our built environment.
Today, more than half of the world’s population lives in urban areas. As people continue to seek improved social and economic services and benefits, the UN estimates that by 2050 this number will increase to two-thirds¹. Considering the current shift in urbanization and the natural increase of population, it is essential for us to ensure that our cities are designed for healthy living with a thriving population.
Although urbanization allows for important economic, cultural, and educational opportunities, we know today that the impact is not all positive. Living in an urban environment can have harmful effects on people’s mental health, as big cities tend to strip away protective factors that foster wellbeing such as green spaces, physical activity, and social connection. Mental health causes more disability than any other noncommunicable disease and is estimated to cost the economy $16 trillion by 2030². This is especially true in cities where the risk of depression increases by 40%, the risk of anxiety by 20% and the risk of schizophrenia doubles³.
Millions of people worldwide suffer from mental health conditions and no country or city is immune. Globally, 1 in 4 people will experience a mental disorder in their lifetime potentially impacting aspects of their life such as education, employment, economic opportunities as well as diminishing their relationships, coping skills, enjoyment, and even prompting suicide. Poor mental health impedes an individual’s capacity to live up to their unique potential and contribute to their community.
Research has repeatedly demonstrated that our psychological wellbeing is influenced by everything from diet and exercise to culture and relationships, and our built environment is no exception. Today’s densely packed cities are filled with monochrome skyscrapers, oversized billboards, and polluting traffic. We have created a shared urban environment that fails to prioritise the human experience over other capitalistic concerns. However, multiple studies have begun to link psychological issues to different urban conditions urging us to pay attention to how the external built environment greatly impacts our sense of wellbeing.
Socialisation — The need to connect
Human beings are inherently social creatures. Connection with others is a natural part of our life — we have spent thousands of years living in closely-tied communities enabling us to survive and thrive. Harvard’s 75-year-long study on human development proved that close relationships are the biggest driver to long, healthy, and happy lives⁴. Although cities are often vibrant and buzzing with people, large urban spaces tend to remove our sense of community, making us feel lonely and isolated rather than connected and united. Social isolation and loneliness have been linked to higher risks for a variety of physical and mental conditions including heart disease, anxiety, depression, cognitive decline, Alzheimer’s disease, schizophrenia, and premature mortality⁵.
Our urban environment presents us with physical barriers to fostering those much needed connections. Favouring highways and high-rises over pedestrian zones and pro-social places, cities contribute to the social isolation felt by many. Vulnerable populations are particularly at risk as they are often left out in urban planning. Built environments pose challenges to people with disabilities and the elderly as they often lack the ramps and elevators needed for transportation. These obstacles hinder a person’s experience of autonomy, disrupting not only their mobility, but their psychological wellbeing too.
Overstimulation — Bustling streets
On the other hand, our brains are not well designed for living in densely and overpopulated metropolises either. Population density is a constant threat to the social order we live in and overcrowding leads to stress and illness in a variety of species ranging from insects to rodents and primates, humans included. Studies have linked regions of the brain involved in processing negative emotion, environmental threat, and stress regulation with time spent in a big city⁶. The more dense a city, the more activation was found in those regions.
Cities can indeed be harsh on the senses. Overstimulation that our brains and bodies endure from navigating densely packed spaces can have damaging effects on a person’s mental health. Increased cognitive load, a product of heightened stimuli, depletes our attention capacity and weakens functions such as self-control. From constantly being fatigued due to high-demanding urban scenarios, our brains can become inattentive, socially withdrawn, irritable, and impulsive. Our built environment is conducive to a fast-paced urban life, but our cognitive processes have not advanced nearly as fast as the pace of urbanization.
Pollution — Even in your sleep
It has now long been considered that air pollution is detrimental to our physical health. Recent literature seems to link exposure to certain air pollutants with brain health, showing an increased incidence of psychiatric and neurological disorders such as developmental disorders and dementia⁷. However, noise and light pollution also impact our mental health and are of growing environmental concern. Today, 20% of the EU population live in areas where noise levels are considered harmful to health. As our brains are constantly monitoring sounds for signs of danger, even as we sleep, loud and frequent noise from traffic, nightlife, or construction can trigger anxiety, irritability, lack of focus, and increase a person’s sensitivity to stress.
Excessive light exposure during the nighttime produces an increase in cortisol, the stress hormone, during a time when our bodies are biologically conditioned to sleep. The secretion of cortisol blocks the production of melatonin, the sleep hormone, disrupting our natural circadian rhythm. A deficit in sleep leads to deficits in health and often precipitates or exacerbates affective symptoms in susceptible individuals.
Deprivation — The concrete jungle
Not only are densely-populated cities inflicting unpleasant experiences onto us, they are also depriving us of certain protective factors against mental illness such as regular access to nature and physical activity. Grey, concrete roads, and an excessive amount of cars has driven us away from nature, and towards a more sedentary lifestyle. This limited contact with green space can have long-term consequences. A recent study discovered that children who lived in areas with the lowest levels of green space had a 55% greater risk of developing psychiatric disorders as adults⁸.
There is now substantial evidence that physical activity is not only good for your body, but also for your mind, and increasingly so if you are able to get active outdoors. A walk through nature is restorative for the body and mind and has been found to be a potent stress reliever⁹. Research suggests that spending time in green space and bringing nature into everyday life can benefit our mental health, making us feel happier, and even reducing our levels of depression and anxiety¹⁰. As these benefits seem to increase with the diversity of plants and animals we encounter¹¹, we should all be looking for less concrete and more jungle.
Barriers to Progress — Why can’t we move forward?
If evidence for healthy placemaking is so clear, why haven’t the changes been prioritised? What are the major barriers preventing the design of mindful urban spaces?
The Design Council, an independent charity and the UK Government’s advisor on design, led a survey in 2018 that set out to answer some of these questions. The results highlighted a number of obstacles which inhibit environment practitioners across the UK from creating places that reduce cases of preventable illnesses and positively impact people’s wellbeing¹².
Overall, practitioners who completed the survey had a strong understanding of the wider issues impacting health and wellbeing within the built environment. However, they generally felt that they needed to convince clients and other professionals to invest in creating healthy environments, as there was a lack of understanding amongst the general public and politicians regarding the effect of the built environment on health. Although increasing physical activity was often high on the agenda, other important components of healthy spaces such as pedestrian priority or convivial spaces to encourage social interaction were overlooked. A lack of knowledge seems to underpin the lack of support from the policies and processes of urban planning towards creating healthy places.
We know that a wide range of disciplines are involved in developing healthy environments, which is probably why these issues are lagging to be addressed. Practitioners acknowledged that some collaborations do exist, but the overall results revealed that it is not common practice to work as a multi-disciplinary team. Respondents deemed it necessary and wished to see more cross-sector cooperation. They also stated that while they are able to use local data to justify certain interventions, access to and usage of this type of data was very limited. Practitioners lack a framework in order to measure the impact of their decisions but recognise the value in local insights from residents admitting that this is rarely part of the process. Imagine the possibilities with abundant data and information, differing points of views and knowledge, and measurement tools to support and help shape decisions on healthy spaces.
Finally, one of the most important barriers mentioned was cost. Economic value is the driver of most current systems, urban development included. Practitioners mentioned having to be conscious of finances as their main priority influencing their work. Developers tend to focus on commercial priorities and short-term objectives which can inhibit the development of healthy spaces. Similarly, a common hurdle seems to be financial viability. Planners and architects stated that they repeatedly get questioned if something is deemed too costly and is not the most efficient use of resources. Certainly, good urban design may be expensive, but the cost of bad design impacts the wellbeing and health of millions, leading to long-term consequences with its own steep costs attached, and significant knock-on economic effects. The direct and indirect costs of mental ill health can amount to over 4% of global GDP. Reducing the rate of mental illness in urban areas by 20% could save the world $250 billion yearly.
Cities are the places where we work, live, and play. They provide us with great opportunities, but our health seems to pay the price. We’ve seen how our external world impacts our internal world, how the very places that are created for us to live in can actually hinder us from leading happy and healthy lives. Although mental health figures are generally worse in cities than in rural areas, they are by no means the problem — cities are part of the solution, they just need some mindful adjusting.
Can we imagine urban environments that enhance, rather than detract from our wellbeing?
What would an ideal city look like? Read Building for Mental Wellness: A Case for Mindful Cities Part II to find out!
At Masawa, Tiff focuses on Nurture Capital. Before that, she has tried her hand in the fashion industry, co-managing a business, teams, photoshoot production, and digital transformation. Tiff’s cultural experience is just as diverse — she speaks 4 languages and lives in a multicultural city of Geneva.
¹ https://www.un.org/development/desa/publications/2018-revision-of-world-urbanization-prospects.html
² https://www.thelancet.com/commissions/global-mental-health
³ Peen J, Schoevers RA, Beekman AT, Dekker J (2010) The current status of urban-rural differences in psychiatric disorders. Acta Psychiatr Scand 121:84
⁵ Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspectives on psychological science, 10(2), 227–237.
⁶ Krämer, B., Diekhof, E. K., & Gruber, O. (2017). Effects of city living on the mesolimbic reward system-An fmri study. Human brain mapping, 38(7), 3444–3453. https://doi.org/10.1002/hbm.23600
⁷ Peeples, L. (2020). News Feature: How air pollution threatens brain health. Proceedings of the National Academy of Sciences, 117(25), 13856–13860.
⁸ Engemann, K., Pedersen, C. B., Arge, L., Tsirogiannis, C., Mortensen, P. B., & Svenning, J. C. (2019). Residential green space in childhood is associated with lower risk of psychiatric disorders from adolescence into adulthood. Proceedings of the national academy of sciences, 116(11), 5188–5193.
⁹ Olafsdottir, G., Cloke, P., Schulz, A., Van Dyck, Z., Eysteinsson, T., Thorleifsdottir, B., & Vögele, C. (2020). Health benefits of walking in nature: A randomized controlled study under conditions of real-life stress. Environment and Behavior, 52(3), 248–274.
¹⁰ Roe, J. (2016). Cities, green space, and mental wellbeing. In Oxford research encyclopedia of environmental science.
¹¹ Fuller, R. A., Irvine, K. N., Devine-Wright, P., Warren, P. H., & Gaston, K. J. (2007). Psychological benefits of greenspace increase with biodiversity. Biology letters, 3(4), 390–394.
¹² https://www.designcouncil.org.uk/what-we-do/built-environment/creating-healthy-places
