We should think more about the link between urban design and mental health

Some spaces can be good for the psyche. Image: Layla McCay.

With an increasing majority of the global population living in cities, the question of urban public health is expanding far beyond its traditional practitioners.

Urban planners, designers and developers are increasingly being asked how their plans and projects actively improve people’s health and wellbeing. But when answering that question, many currently overlook the very category of urban health that they might most effectively impact: mental health.

Much of the focus at the nexus of health and design at the moment is on the physical health risks – most especially those associated with our often-sedentary lifestyle, which can contribute to non-communicable diseases (NCDs) like heart disease and diabetes. This often means designing built environments that nudge people to be more physically active. But opportunities for health promotion extend beyond physical activity: the World Health Organisation defines health as a state of physical, mental and social wellbeing.

Most of us will experience symptoms of mental health problems in our life, and one in every four of us will have a mental disorder. From stress and sadness to attention deficit-hyperactivity disorder (ADHD), depression, biopolar affective disorder, schizophrenia, addictions, and dementia – mental health problems can affect every part of our lives. They can diminish our enjoyment of life, our coping skills, and our relationships; they can reduce our education, employment, housing and economic opportunities, incur healthcare and social care costs, and prompt suicide.

In fact globally mental health disorders cause more disability than any other NCD. This is particularly true in cities, where our risk of having depression increases by 40 per cent, an anxiety disorder by 20 per cent, and the risk of schizophrenia doubles.

With the huge impact of mental disorders on people’s health and wellbeing, and the increased mental health risk of that comes simply from living in a city, you might think that mental health would be an urban health priority. In fact, few policies or recommendations for healthy urban environments address mental health in any depth.

If the low prioritisation of urban mental health isn’t due to lack of need, or lack of opportunity, what is the reason? It seems to me that there are three main barriers.

The first is stigma, which can be a powerful barrier to achieving mental health impact in a wide range of fields. It may be deterring people from becoming vocal advocates for mental health, and from addressing it properly in their work. People often feel embarrassed or ashamed about having mental health problems, and may worry that discussing this will make people judge them more negatively than they would physical health problems.


This anticipation and reaction associated with mental illness stigma doesn’t just impact people with mental illnesses: concern about stigma by affiliation can influence decisions made by anyone from potential advocates to researchers, journalists, funders of healthcare or research, and even urban planners, designers and developers. Advocates for mental health can be reticent, and wonder: “By prioritising mental health in my work, will people make stigmatising assumptions about own my mental health?”

Another barrier is that the failure to recognise mental health as a priority is a self-fulfilling prophecy. Currently urban planners, designers and developers focus more on physical health than mental health. They showcase their designs, win prizes, and talk at conferences – and in doing so, create an impression that physical health is the health area of most opportunity in their field.

Even if this is not the case, the zeitgeist is inspiring urban design innovation around physical health. Without a similar movement for mental health, we inevitably hear much less about mental health in urban design plans, policies and projects, delivering less inspiration and motivation around mental health, despite the need and opportunity.

The third barrier is that mental health disorders sound complex – so we need to clearly understand and articulate how to improve mental health through urban design. Mental disorders have a wide range of contributing factors, like genetics, early experiences, family relationships, and social settings.

But physical health disorders are often just as complicated, and we don’t shy away from them. Perhaps it is simply easier for urban planners, designers and developers to access clear practical recommendations that help translate physical health research into practical urban design actions. That happens less for mental health.

There are many opportunities to improve population mental health through urban design. We can create places where people feel safe and confident. We can reduce noise to improve sleep. We can develop neighbourhoods that promote social interaction and belonging, while delivering privacy and security. We can reduce stress associated with commuting. We can design daily encounters with nature.  And there are many more options currently being explored.

Clearly mental disorders constitute an urban health issue that needs to be addressed, and offer an exciting opportunity for innovation in urban design. But how to overcome the challenges in translating research into urban design projects that genuinely improve people’s mental health?

The Centre for Urban Design & Mental Health is a new think tank aiming to harness and translate academic research alongside the ideas and experience of urban planners, designers and developers to help all of us better understand how to design better mental health into our cities. It is time to move beyond stigma, to clarify the opportunities, and start designing for urban mental health.

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

 
 
 
 

“You don’t look like a train buff”: on sexism in the trainspotting community

A female guard on London’s former Metropolitan Railway. Image: Getty.

I am a railway enthusiast. I like looking at trains, I like travelling by train and I like the quirks of the vast number of different train units, transit maps and train operating companies.

I get goosebumps standing on a platform watching my train approach, eyeballing the names of the destinations on the dot matrix display over and over again, straining to hear the tinny departure announcements on the tannoy.  I’m fortunate enough to work on the site of a former railway station that not only houses beautiful old goods sheds, but still has an active railway line running alongside it. You can imagine my colleagues’ elation as I exclaim: “Wow! Look at that one!” for the sixth time that day, as another brilliantly gaudy freight train trundles past.

I am also a woman in my twenties. A few weeks my request to join a railway-related Facebook group was declined because I – and I quote here – “don’t look like a train buff”.

After posting about this exchange on Twitter, my outrage was widely shared. “They should be thrilled to have you!” said one. “What does a train buff look like?!” many others asked.

The answer, of course, is a middle-aged white man with an anorak and notebook. Supposedly, anyway. That’s the ancient stereotype of a “trainspotter”, which sadly shows no sign of waning.

I’m not alone in feeling marginalised in the railway community. Sarah, a railway enthusiast from Bournemouth, says she is used to funny looks when she tells people that she is not only into trains, but an engineer.

She speaks of her annoyance at seeing a poster bearing the phrase: “Beware Rail Enthusiasts Disease: Highly Infectious To Males Of All Ages”. “That did bug me,” she says, “because women can enjoy trains just as much as men.”


Vicki Pipe is best known as being one half of the YouTube sensation All The Stations, which saw her and her partner Geoff Marshall spend 2017 visiting every railway station in Great Britain.

“During our 2017 adventure I was often asked ‘How did your boyfriend persuade you to come along?’” she says. “I think some found it unusual that a woman might be independently interested or excited enough about the railways to spend sixteen weeks travelling to every station on the network.”

Pipe, who earlier this year travelled to all the stations in Ireland and Northern Ireland, is passionate about changing the way in which people think of the railways, including the perception of women in the industry.

“For me it’s the people that make the railways such an exciting place to explore – and many of these are women,” she explains. “Women have historically and continue to play an important part in the railway industry – throughout our journey we met female train drivers, conductors, station staff, signallers and engineers. I feel it is important that more female voices are heard so that women of the future recognise the railways as a place they too can be part of.”

Despite the progress being made, it’s clear there is still a long way to go in challenging stereotypes and proving that girls can like trains, too.

I’m appalled that in 2019 our life choices are still subjected to critique. This is why I want to encourage women to embrace their interests and aspirations – however “nerdy”, or unusual, or untraditionally “female” they may be – and to speak up for things that I was worried to speak about for so long.

We might not change the world by doing so but, one by one, we’ll let others know that we’ll do what we want – because we can.