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.

 
 
 
 

“Stop worrying about hairdressers”: The UK government has misdiagnosed its productivity problem

We’re going as fast as we can, here. Image: Getty.

Gonna level with you here, I have mixed feelings about this one. On the one hand, I’m a huge fan of schadenfreude, so learning that it the government has messed up in a previously unsuspected way gives me this sort of warm glow inside. On the other hand, the way it’s been screwing up is probably making the country poorer, and exacerbating the north south divide. So, mixed reviews really.

Here’s the story. This week the Centre for Cities (CfC) published a major report on Britain’s productivity problem. For the last 200 years, ever since the industrial revolution, this country has got steadily richer. Since the financial crash, though, that seems to have stopped.

The standard narrative on this has it that the problem lies in the ‘long tail’ of unproductive businesses – that is, those that produce less value per hour. Get those guys humming, the thinking goes, and the productivity problem is sorted.

But the CfC’s new report says that this is exactly wrong. The wrong tail: Why Britain’s ‘long tail’ is not the cause of its productivity problems (excellent pun, there) delves into the data on productivity in different types of businesses and different cities, to demonstrate two big points.

The first is that the long tail is the wrong place to look for productivity gains. Many low productivity businesses are low productivity for a reason:

The ability of manufacturing to automate certain processes, or the development of ever more sophisticated computer software in information and communications have greatly increased the output that a worker produces in these industries. But while a fitness instructor may use a smartphone today in place of a ghetto blaster in 1990, he or she can still only instruct one class at a time. And a waiter or waitress can only serve so many tables. Of course, improvements such as the introduction of handheld electronic devices allow orders to be sent to the kitchen more efficiently, will bring benefits, but this improvements won’t radically increase the output of the waiter.

I’d add to that: there is only so fast that people want to eat. There’s a physical limit on the number of diners any restaurant can actually feed.

At any rate, the result of this is that it’s stupid to expect local service businesses to make step changes in productivity. If we actually want to improve productivity we should focus on those which are exporting services to a bigger market.  There are fewer of these, but the potential gains are much bigger. Here’s a chart:

The y-axis reflects number of businesses at different productivities, shown on the x-axis. So bigger numbers on the left are bad; bigger numbers on the right are good. 

The question of which exporting businesses are struggling to expand productivity is what leads to the report’s second insight:

Specifically it is the underperformance of exporting businesses in cities outside of the Greater South East that causes not only divergences across the country in wages and standards of living, but also hampers national productivity. These cities in particular should be of greatest concern to policy makers attempting to improve UK productivity overall.

In other words, it turned out, again, to the north-south divide that did it. I’m shocked. Are you shocked? This is my shocked face.

The best way to demonstrate this shocking insight is with some more graphs. This first one shows the distribution of productivity in local services business in four different types of place: cities in the south east (GSE) in light green, cities in the rest of the country (RoGB) in dark green, non-urban areas in the south east in purple, non-urban areas everywhere else in turquoise.

The four lines are fairly consistent. The light green, representing south eastern cities has a lower peak on the left, meaning slightly fewer low productivity businesses, but is slightly higher on the right, meaning slightly more high productivity businesses. In other words, local services businesses in the south eastern cities are more productive than those elsewhere – but the gap is pretty narrow. 

Now check out the same graph for exporting businesses:

The differences are much more pronounced. Areas outside those south eastern cities have many more lower productivity businesses (the peaks on the left) and significantly fewer high productivity ones (the lower numbers on the right).

In fact, outside the south east, cities are actually less productive than non-urban areas. This is really not what you’d expect to see, and no a good sign for the health of the economy:

The report also uses a few specific examples to illustrate this point. Compare Reading, one of Britain’s richest medium sized cities, with Hull, one of its poorest:

Or, looking to bigger cities, here’s Bristol and Sheffield:

In both cases, the poorer northern cities are clearly lacking in high-value exporting businesses. This is a problem because these don’t just provide well-paying jobs now: they’re also the ones that have the potential to make productivity gains that can lead to even better jobs. The report concludes:

This is a major cause for concern for the national economy – the underperformance of these cities goes a long way to explain both why the rest of Britain lags behind the Greater South East and why it performs poorly on a

European level. To illustrate the impact, if all cities were as productive as those in the Greater South East, the British economy would be 15 per cent more productive and £225bn larger. This is equivalent to Britain being home to four extra city economies the size of Birmingham.

In other words, the lesson here is: stop worrying about the productivity of hairdressers. Start worrying about the productivity of Hull.


You can read the Centre for Cities’ full report here.

Jonn Elledge is the editor of CityMetric. He is on Twitter as @jonnelledge and on Facebook as JonnElledgeWrites

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