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.

 
 
 
 

The media scumbag’s route of choice: A personal history of London’s C2 bus

A C2 bus at Parliament Hill. Image: David Howard/Wikimedia Commons.

London’s C2 bus route, which runs from Parliament Hill, by Hampstead Heath, down to Conduit Street, just off Regent Street, is one of the bus routes recently earmarked for the chop. It has oft been noted that, of all the routes recently pencilled in for cancellation after a consultation late last year, it was the one most likely to survive, for the simple reason that it links liberal suburban north London with BBC Broadcasting House and Soho; it’s thus the route most likely to be used by people who can convince someone to let them report on its imminent demise.

So it would come as no surprise that former Guardian editor Alan Rusbridger took to the Camden New Journal when the consultation began, arguing that it would be a disservice to the local community to discontinue a route where you can always get a seat – seemingly missing the point that the fact you can always get a seat is not a great sign of the route’s usefulness.

It wasn’t always that way. When I left university in 2000, and moved from accommodation near college to up to a rented shared house in N6, the C2 was my bus. I commuted to Soho for sixteen years: for more than a decade from flats around the Swain’s Lane roundabout, and for five years from Kentish Town. While my place of work bounced around from Golden Square to Lexington Street to Great Marlborough, it was always the most convenient way to get to, and from, work; especially given the difference between bus and tube prices.

So when it comes to the C2 I’ve seen it, I’ve done it, and bought the bus pass. And by bus pass, I mean those little paper ones that still existed at the beginning of this century. Not just before contactless, but before Oyster cards.

More importantly, it was before London buses operated a single zone. There was an outer zone, and an inner zone, with different prices. To travel from one zone to another cost £1.30, meaning an all cash commute was £2.60, whereas a paper bus pass was £2.00. That made it worth your while to divert to an early opening newsagents on your way to the bus stop (GK, in my case), even if you only got two buses a day.

It’s a measure of how greatly London’s buses have improved over the last twenty years, since first brought under control of the mayoralty, that pretty much everything about this anecdotage, including the prices, seems faintly mad. But there’s more: back when I started getting that bus down to Stop N, literally at the very end of the route, the C2 used single decker buses with a single door. It’s an appalling design for use in a crowded city, which meant most of any journey was, for most passengers, spent fighting your way up and down the middle of the bus to find a seat, and then back again to get off; or – and this was more likely – fighting your way up the bus to get into standing space the driver insisted was there, before fighting your way, etc.

Such buses – and in my former life in the English Midlands I went to school on one of these buses every day – are perfectly functional where bus stops are infrequent and buses rarely standing room only. But running through Camden Town at rush hour, they’re wholly unfit for purpose.

A Citypacer. Image: RXUYDC/Wikimedia Commons.

It could have been worse. I didn’t know this at the time, but a few years before the C2 route had been run using Optare City Pacers. Those are, let us be frank, not really buses at all, but minibuses. That’s something the reveals the C2’s origins, as a hopper route to the west end largely intended for the daytime use of Gospel Oak’s pensioners in the years immediately before bus privatisation. (The C11 has a similar origin, taking the same constituency from Archway to England’s Lane.)

Once responsibility for London Buses was moved to the newly established mayoralty, things improved dramatically. Under Ken Livingstone it went double decker in 2005, and 24 hour in 2007. Under Boris Johnson it was extended from its once, and future, terminus of Conduit Street to Victoria Station, swallowing up the cancelled sections of the 8 bus; this extension was quietly disposed of a few years later, once it was clear no one would notice. (I did.)


In those years I must have taken a C2 the best part of ten thousand times; but for all the years when I wouldn’t have been able to live without the C2, times have reduced its utility, and not just for me. I’m now a 214 sort of guy: these days the top chunk of the C2 route is duplicated exactly by that other bus, which starts up in Highgate Village and, once it gets to Swain’s Lane, follows the same path until the fork of Kentish Town Road and Royal College Street, opposite the long defunct South Kentish Town tube station.

From a few hundred metres below that point, at Camden Gardens, stop C, the 88 starts. That duplicates the rest of the C2’s route, with the exception of the run down Albany Street and onto Great Portland, for much of which the C2 is the only bus.

So the C2, old friend that it is, is pretty redundant in the age of the hopper fare, which allows you to change buses without paying a second fare. That’s even more true now the C2’s otherwise un-serviced stops are being giving over to a re-routed 88, which will pick up the C2’s most northern leg, by not finishing at Camden Gardens anymore and instead going all the way to Parliament Hill Fields. Which will be nice for it.

All this, however, ignores the best reason for getting rid of the C2 (or rather for merging it with the 88, which is what’s actually happening): that first character. The letter. Who wants a bus route with a letter in front of it when even half the night buses don’t have the N anymore? It’s relic of the route’s aforementioned origins as a ‘Camdenhopper’.

That C is twenty five years past its own utility. It’s just untidy. City Metric hates that sort of thing. Get rid.