Lessons in building for mental health from Tokyo and Hong Kong

The Shibuya crossing, Tokyo. Image: Getty.

Standing in the right place, deep within the density of tower blocks and the throng of crowds and the neon glow of kanji, is a snapshot of humanity’s future. We could be on the set of Blade Runner.

But sci-fi films are not the only way to envision our overcrowded, hyper-urban future. Asian megacities offer a present day glimpse of what the world’s soaring population and rising urbanisation could mean for how we will live. By doing so, these cities also hold clues about how to futureproof our sanity.

As more people flock to cities, we need solutions that balance urban density with liveability. Hong Kong and Tokyo are both super-ageing cities known for their tall buildings, long working hours, efficient underground trains, and tiny living spaces. In both cities, stress and loneliness are common complaints, suicide is not uncommon, and at least one in five people experience a serious mental illness in their lifetime. Like anywhere, many factors mediate these risks: genetics, upbringing, employment, certain physical illnesses.

But these one more factor whose impact is only now emerging as a key determinant of mental health: the built environment. Modifying the settings where we live, work and play is not just the next big public health opportunity; it is a key to the resilience that companies, cities and countries seek for their populations.

The built environment affects mental health in two important ways. First, by over-stimulation. Cities can provide social and cultural stimulation that surpasses that of rural settings. Everything we see in cities is designed to make us think, feel or act in certain ways. Many of us left our close relationships behind to move to the city, and instead of someone to confide in, every day we encounter tens of thousands of someones. All of this can result in overload: an urge to retreat from this assault on our senses.

Secondly, cities deplete the very factors that strengthen our mental health and build resilience, such as access to green, natural spaces, regular physical activity, and positive social interaction. As the population urbanises, these challenges risk escalating, to the detriment of society’s mental health and wellbeing.


This hyper-urban future is currently the present in many of Asia’s denser cities. Examining how these cities are adapting uncovers clues about our upcoming challenges and emerging solutions.

Growing density and demand for space drives up house prices unsustainably. In the quest for affordable housing solutions, some people in Hong Kong have had to live in ‘cage homes’, tiny ‘caged’ living spaces within subdivided apartments. And through the challenges of this very constrained living, it is becoming clear that affordability and quality of life can be improved through a return to social, communal facilities, from shared kitchens to shared study spaces.

Developments are encroaching on public open space, so in addition to incentivising developers to provide dedicated public spaces, Hong Kong’s population is improvising, appropriating spaces for different uses at different times. University plazas for older people to exercise at dawn before the students swarm in; the grounds of a major bank building, for migrant domestic workers to socialise at the weekends when office staff go home; and even corners of air-conditioned office lobbies have become informal day centres for older people.

Meanwhile in Tokyo, streets are being flexed as public spaces. Vehicle traffic is encouraged to stick to the bigger roads, and in many places, the smaller networks of roads inside these grids are given over largely to roadside plants (often provided and maintained by local residents), pedestrians, and mothers riding mamachari bicycles with several children strapped aboard, stopping to chat outside small and welcoming shops.

Looking at hyper-dense Asian cities also makes it clear that the future could be public transport – the key to which is seamless integration with safe and convenient pedestrian and bike links between stations and destinations. In Tokyo, hills are tackled with electric bicycles; in Hong Kong with free public outdoor escalators. In both cities, residents benefit from the regular physical activity that is naturally integrated into their daily routines.

Nature is good for our mental health, but dense development makes access to greenery challenging. Tokyo and Hong Kong both incentivise developers with tax credits to green their buildings, and invest in urban parks within new developments. But recognising the land use challenges, both cities also prioritise the provision of cheap, convenient public transport access to large swathes of greenery just outside the city. Whether they call it forest bathing (Tokyo) or simply hiking (Hong Kong), it is clear that to fully reap the mental health benefits of nature, we need both urban nature that people can access in the course of their daily routines, and immersive nature that delivers a bigger respite from the city.

What these solutions have in common is the design of settings that facilitate positive social interactions within dense neighbourhoods, enabling participation of people of all ages in shared spaces. These uses of space enable residents to physically see each other. In doing so, they build their social capital and a sense of community belonging. This is incredibly protective for mental health.

If we look to Hong Kong and Tokyo for clues to our future, it becomes clear that while some parts of our future cities might look like Blade Runner on the surface, underneath we may find a dense collection of overlapping villages.

Layla McCay is director of the Centre for Urban Design & Mental Health.

 
 
 
 

A Century after radical leftists were elected to its city hall, Vienna’s social democratic base is slipping away

Karl Marx Hof. Image: Kagan Kaya.

Karl Marx-Hof, a kilometre-long municipal apartment block in Vienna’s wealthy 19th district, was first named after the father of the communist movement by Austria’s Social Democratic Workers’ Party (SDAP) in 1927. Its imposing structure borrows from an eclectic mix of modernist, Bauhaus, art deco, neoclassical and baroque architectural styles. In the mould of early soviet experiments, the building, nicknamed The Palace of the Proletariat, housed shared childcare services, gardens and washrooms.

The building is Vienna’s most prominent physical reminder of a period known as Red Vienna, when left-wing radicals found themselves at the helm of the Hapsburg’s former imperial capital during the aftermath of the First World War. 

After the collapse of the Austro-Hungarian dual monarchy in 1918, the SDAP won the fledgeling republic’s first elections held under universal suffrage and commenced an ambitious programme of social and economic reform. Leading intellectual lights of the party sought to unite the two great strands of the 20th-century labour movement, reconciling parliamentary socialism and revolutionary communism under their new current of non-Bolshevik “Austro-Marxism”. Karl Marx-Hof epitomised their radical ambitions. “When we are no longer here”, Mayor Karl Seitz told an assembled crowd of workers at the building’s opening in 1930, “these bricks will speak for us.”

When I visited Karl Marx-Hof on a sunny day in June, Monica and George, two of its residents, were walking their two Chihuahuas around the estate’s leafy, quiet courtyards. “We moved here last year,” Monica tells me. “It’s really nice because you’ve got a lot of green space in the middle of the city.”

The young couple are the beneficiaries of a generous system of public housing provision. Vienna has a relative abundance of high-quality municipal flats compared with most large capitals. “We weren’t waiting long for the flat – moving in here was really fast”, Monica says. Currently, 60 per cent of Vienna’s residents live in either municipally owned, subsidised housing, or in social homes run by not-for-profit cooperatives. The remaining portion of private homes is subject to strict rent controls and regulations.

The social democrats and their less radical successors have remained the dominant party in Vienna since the city’s first election, save for an 11-year hiatus of fascist dictatorship from 1934, followed by Anschluss and Nazi occupation from 1938. The city remains a red statelet in an otherwise conservative country. Indeed, Austria is now more associated with the far right than the radical left. But even Vienna is no longer immune to the trend of waning support for centre-left parties that has gripped European countries since 2008, and cracks are beginning to appear in its social democratic project.

Two exhibitions in the city – one in the former communal wash house of Karl Marx-Hof, the other in the grand Wien Museum MUSA – note the achievements of Red Vienna’s experiment in local socialism: the introduction of pensions and unemployment support; the establishment of a nascent public healthcare system; the opening of kindergartens, schools run on Montessori principles, public baths, open-air swimming pools, libraries, parks, leisure facilities, arts centres; and, of course, a programme of mass council house building, all paid for by a system of progressive income taxation coupled with duties on luxury goods, including servants, champagne, private cars and riding horses.

Unlike the Bolsheviks, (and partly because, as a provincial government, it lacked the powers to do so), the SDAP did not expropriate or nationalise factories or private industry without compensation, but instead paid former owners whenever buildings or land passed from private to public hands. The party built what it perceived to be the chrysalis of a new egalitarian society, while leaving the market and private ownership of the means of production largely intact. In many ways, its policies palliated the worst effects of early 20th century industrial capitalism like slum housing, mass unemployment and extreme poverty. Red Vienna laid the ground for the modern European welfare state, inspiring other social democratic governments across the continent to implement similar policies after the Second World War. 


“Back then the social democrats were good,” Monica tells me, attempting to calm her excitable dogs by pulling on their leads. Does she intend to vote for the social democrats in the upcoming national elections in September? “We vote for the blue ones,” she answers. Monica and George will cast their vote for the Freheitliche Partei Osterreichs (FPO), the Freedom Party, an organisation founded after the Second World War by a former Nazi minister of agriculture and high-ranking SS officer. “It’s because of all the refugees and all the violence that’s going on here,” she claims. “Shootings are more frequent in Vienna.”

Austria has one of the lowest murder rates in the world, almost half that of England and Wales, and Vienna itself is known for its relative safety compared to other European capitals. But hundreds of thousands of refugees have travelled through Austria over the last four years. Many have made the city their home, but most have transited towards Germany, at Angela Merkel’s invitation. The mass movement of people from across the Mediterranean to central and northern Europe has ruptured the country’s social-democratic pact. In 2016, Norbert Hofer of the Freedom Party narrowly missed out on victory in the presidential election, receiving 46 per cent of the vote.

“Lots of people say they’re just racists,” Monica continues, visibly uncomfortable with the idea that people would attribute malice or prejudice to voters like herself. But she hastens to add that her views, and those of her partner George, aren’t necessarily typical of Vienna’s affluent 19th district. “There are very rich people here, so they vote for the party who protects their interests… You’ll see a lot of big houses, so I think the OVP, the People’s Party, would do well.”

The OVP is the more traditional centre-right party of Austrian politics, and wins the most seats in the 19th district. Yet the city’s voting patterns are diverse. This is partly a result of the policies of successive social democratic administrations placing the integration of social classes and income levels at the heart of their municipal agenda. Subsidised housing can be found alongside wealthy private apartments in the city centre designed by Renzo Piano, and at the foot of the city’s vineyards near up-market wine taverns. Kurt Puchinger, chair of wohnfonds_wien, the city’s land and housing fund, tells me that the council “do not want to have a situation where you can identify the social status of a person by their home address.”

Despite the SDAP’s century-long efforts to promote social cohesion, recent years have seen the rise the FPO’s vote share at the expense of the left. Favoriten is a more solidly working class area of Vienna in the 10th district. There, according to Monica, “most vote for the Freedom Party because they are for stopping migration.” She pauses to consider her words. “Not stopping. Trying to find a way to filter them and control them. Every country has a problem like this.”

Monica’s feeling for the electoral preferences of each of the various Viennese districts proves accurate. After the war, Favoriten elected communists as their local representatives. The district's loyalties quickly switched to the social democrats, and until 2005 the party could comfortably expect to receive over half the votes there, consistently getting more than double the votes of both the far-right Freedom Party and the centre-right People’s Party. But in the most recent 2015 election, the Freedom Party won 24 seats and 38 per cent of the vote, only two points and one seat behind the social democrats. In Austria nationally, the People’s Party, headed by a 32-year-old leader, Sebastian Kurz, with Patrick Bateman overtones, has formed a government with the Freedom Party – but their coalition collapsed ignominiously in May.

Neither Austria as a whole, nor Favoriten in particular, are outliers. In France, Le Pen’s National Rally polls well in the Communist Party’s former “ceinture rouge” outside Paris. In Britain, Labour’s post-industrial heartlands are turning towards the Brexit Party, while blue collar workers in America’s rust belt have backed Donald Trump. And in Vienna, neither the impressive legacy of the SDAP nor the continually high standard of living (the city was rated as the world’s most liveable for the 10th time in 2018 by Mercer, the consultancy giant) is enough to stem the tide of right-wing populism.

Until he was unseated as leader following a corruption scandal in May, Heinz-Christian Strache positioned the FPO as the party of the working class, a guarantor of Austrian identity, and the protector of a generous welfare system now threatened by an influx of migrants. “We believe in our youth,” ran one of his slogans, “the [social democrats] in immigration.”

Sofia is a masseuse who has lived in Karl Marx-Hof for 19 years with her partner and his son. “People are angry with the social democrats now because of refugees,” she told me. “They should change this... They should say ‘we are on the left but we can’t accept everybody here.’” The view that the party have abandoned their traditional voters is widespread, but Sofia isn’t fond of the alternatives. “The FPO – the Nazis – you can’t vote for the Nazis… anyone who votes FPO isn’t my friend… But I won’t vote for the People’s Party because they do everything for rich people, not normal people.”

Sofia reserves her strongest criticism for the youthful Sebastian Kurz, who is likely to become head of another People’s Party-led coalition after elections in September. “I’m scared of him,” she says. “I think he’s a psychopath. I think he’s not a normal person.”

Like many Viennese, Sofia admires the legacy of Red Vienna: “The socialists did a lot of really good things. We are the only city in the world that has so much state housing. And they brought in pensions, health insurance, a lot of things.” But she’s not sure they will get her vote in 2019. In an era of polarisation and anti-establishment rhetoric, the most fertile yet unoccupied political ground seems to be for a radical, redistributive economic programme, coupled with a more conservative vision of shared responsibilities and values, national sovereignty, and sociocultural issues.

“Even in the working class areas of the city,” sighs Kurt Puchinger, the city’s housing fund chair, “less people are voting social democrat. And this is a pity.” 100 years since the old radical Social Democratic Workers’ Party was first elected by a restive, war-weary working class, the working class remains restive, but while the SDAP’s flagship Karl Marx-Hof still stands, the bricks no longer seem to be speaking for them.