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.

 
 
 
 

The IPPC report on the melting ice caps makes for terrifying reading

A Greeland iceberg, 2007. Image: Getty.

Earlier this year, the Intergovernmental Panel on Climate Change (IPCC) – the UN body responsible for communicating the science of climate breakdown – released its long-awaited Special Report on the Ocean and Cryosphere in a Changing Climate.

Based on almost 7,000 peer-reviewed research articles, the report is a cutting-edge crash course in how human-caused climate breakdown is changing our ice and oceans and what it means for humanity and the living planet. In a nutshell, the news isn’t good.

Cryosphere in decline

Most of us rarely come into contact with the cryosphere, but it is a critical part of our climate system. The term refers to the frozen parts of our planet – the great ice sheets of Greenland and Antarctica, the icebergs that break off and drift in the oceans, the glaciers on our high mountain ranges, our winter snow, the ice on lakes and the polar oceans, and the frozen ground in much of the Arctic landscape called permafrost.

The cryosphere is shrinking. Snow cover is reducing, glaciers and ice sheets are melting and permafrost is thawing. We’ve known this for most of my 25-year career, but the report highlights that melting is accelerating, with potentially disastrous consequences for humanity and marine and high mountain ecosystems.

At the moment, we’re on track to lose more than half of all the permafrost by the end of the century. Thousands of roads and buildings sit on this frozen soil – and their foundations are slowly transitioning to mud. Permafrost also stores almost twice the amount of carbon as is present in the atmosphere. While increased plant growth may be able to offset some of the release of carbon from newly thawed soils, much will be released to the atmosphere, significantly accelerating the pace of global heating.

Sea ice is declining rapidly, and an ice-free Arctic ocean will become a regular summer occurrence as things stand. Indigenous peoples who live in the Arctic are already having to change how they hunt and travel, and some coastal communities are already planning for relocation. Populations of seals, walruses, polar bears, whales and other mammals and sea birds who depend on the ice may crash if sea ice is regularly absent. And as water in its bright-white solid form is much more effective at reflecting heat from the sun, its rapid loss is also accelerating global heating.

Glaciers are also melting. If emissions continue on their current trajectory, smaller glaciers will shrink by more than 80 per cent by the end of the century. This retreat will place increasing strain on the hundreds of millions of people globally who rely on glaciers for water, agriculture, and power. Dangerous landslides, avalanches, rockfalls and floods will become increasingly normal in mountain areas.


Rising oceans, rising problems

All this melting ice means that sea levels are rising. While seas rose globally by around 15cm during the 20th century, they’re now rising more than twice as fast –- and this rate is accelerating.

Thanks to research from myself and others, we now better understand how Antarctica and Greenland’s ice sheets interact with the oceans. As a result, the latest report has upgraded its long-term estimates for how much sea level is expected to rise. Uncertainties still remain, but we’re headed for a rise of between 60 and 110cm by 2100.

Of course, sea level isn’t static. Intense rainfall and cyclones – themselves exacerbated by climate breakdown – can cause water to surge metres above the normal level. The IPCC’s report is very clear: these extreme storm surges we used to expect once per century will now be expected every year by mid-century. In addition to rapidly curbing emissions, we must invest millions to protect at-risk coastal and low-lying areas from flooding and loss of life.

Ocean ecosystems

Up to now, the ocean has taken up more than 90 per cent of the excess heat in the global climate system. Warming to date has already reduced the mixing between water layers and, as a consequence, has reduced the supply of oxygen and nutrients for marine life. By 2100 the ocean will take up five to seven times more heat than it has done in the past 50 years if we don’t change our emissions trajectory. Marine heatwaves are also projected to be more intense, last longer and occur 50 times more often. To top it off, the ocean is becoming more acidic as it continues to absorb a proportion of the carbon dioxide we emit.

Collectively, these pressures place marine life across the globe under unprecedented threat. Some species may move to new waters, but others less able to adapt will decline or even die out. This could cause major problems for communities that depend on local seafood. As it stands, coral reefs – beautiful ecosystems that support thousands of species – will be nearly totally wiped out by the end of the century.

Between the lines

While the document makes some striking statements, it is actually relatively conservative with its conclusions – perhaps because it had to be approved by the 195 nations that ratify the IPCC’s reports. Right now, I would expect that sea level rise and ice melt will occur faster than the report predicts. Ten years ago, I might have said the opposite. But the latest science is painting an increasingly grave picture for the future of our oceans and cryosphere – particularly if we carry on with “business as usual”.

The difference between 1.5°C and 2°C of heating is especially important for the icy poles, which warm much faster than the global average. At 1.5°C of warming, the probability of an ice-free September in the Arctic ocean is one in 100. But at 2°C, we’d expect to see this happening about one-third of the time. Rising sea levels, ocean warming and acidification, melting glaciers, and permafrost also will also happen faster – and with it, the risks to humanity and the living planet increase. It’s up to us and the leaders we choose to stem the rising tide of climate and ecological breakdown.

Mark Brandon, Professor of Polar Oceanography, The Open University.

This article is republished from The Conversation under a Creative Commons license. Read the original article.