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.

 
 
 
 

What’s behind the rise of the ornamental restaurant toilet?

Toilets at Sketch restaurant, London. Image: Nik Stanbridge/Flickr.

A few weeks ago, I found myself in the toilets of a zeitgeisty new Italian restaurant in east London called Gloria. As with so many contemporary restaurant toilets, those in question were an aesthetic extension of the establishment’s soul. The inventive menu was matched by two-way mirrored toilet doors.

The setup was this: cubicle occupants could see out while the unisex crowd milling around the taps could check their outfits on the exterior mirrors. All fun and games, I thought. But then I found myself mid toilet with a guy peering into my door to change his contact lens. Either he had spectacularly bad manners or he was unaware of the two-way door thing. (Let’s hope it’s the latter.)

Gloria’s toilets aren’t unique in their attempt to be distinctive. The loos at nearby Mr Fogg’s Maritime Club & Distillery are adorned with specimen boards of dead spiders. Meanwhile, Edinburgh’s The Sun Inn invites patrons to pee in buckets, and trumpets double as urinals in The Bell Inn in East Sussex. Men can wee into the vista if they’re dining in the Shard. And Sketch’s ovum shaped loos are the stuff of urban legend.

Further afield, transparent doors become frosted only after they’re locked at Brussels’ Belga Queen. In Otto’s Bierhalle in Toronto, diners can press a button to activate their own private rave. And the toilets in Robot Restaurant in Tokyo have gold-plated interiors and dancing robots.

What’s behind this trend? Are quirky toilets just a bit of fun – or an unnecessary complication to the simple act of going for a wee and checking you don’t have tomato sauce on your chin?

Yotam Ottolenghi’s London flagship restaurant Nopi crops up often in conversations about restaurant bathrooms. A hall of mirrors glitters enticingly ahead of loo-bound diners. “The bathroom needs to be the nicest part [of] the whole place because that’s where you’re on your own,” says Alex Meitlis, the designer behind the space.

But no one is truly alone in 2019. If surveys are to be believed, nearly 65 per cent of millennials take their phone to the bathroom with them. Mike Gibson, who edits the London food and drink magazine Foodism agrees that the bathroom selfie – searches for which, incidentally, yield over 1.5m results on Instagram – is part of the reason that contemporary lavatory design is so attention seeking.


“Any new venue that's opening will be super aware that there's probably not an inch of their restaurant that won't be photographed or filmed at some point”, he says. But bathrooms like Nopi’s predate this trend. Indeed, Meitlis believes he has created a haven from the smartphone obsession; Nopi’s mirrors are angled in such a way that means you have to seek out your reflection. “You can choose whether to look for yourself in the mirror or not.”

Another driving force is the increasingly competitive restaurant landscape. “It’s almost like there’s some sort of ever-escalating competition going on amongst new openings, which makes every visit a faintly terrifying experience”, says food writer and New Statesman contributor Felicity Cloake. Gibson agrees. “Restaurants want an edge wherever possible, and design definitely comes into that.”

So novelty bathrooms get you noticed, promote social media engagement and entertain diners who are momentarily without the distraction of company. (Although, it must be said, quirky bathrooms tend to make the loo trip a more sociable experience; a Gloria spokesperson described the restaurant’s toilets as somewhere you can “have a good laugh and meet people along the way.”)

Nevertheless, I’m not the only one who finds bathroom surprises disconcerting.  One TripAdvisor user thought the Belga Queen loos were “scary”. And a friend reports that her wonderment at the Nopi bathroom was laced with mirror maze induced nausea – and mild panic when she realised she didn’t know the way out. Should restaurants save the thrills for the food?

“I think it's important not to be too snarky about these things – restaurants are meant to playful,” says Gibson. Cloake agrees that novelty is fine, but adds: “my favourite are places like Zelman Meats in Soho that have somewhere in the dining room where you can easily wash your hands before sitting down and tucking in.”

So perhaps we should leave toilets unadorned and instead ramp up the ornamentation elsewhere. Until then, I’ll be erecting a makeshift curtain in all mirrored toilets I encounter in future. An extreme reaction, you might say. But, as I wish I could have told the rogue contact lens inserter, it’s not nice to pry into someone else’s business.