Urban Green Spaces and Mental Health: what does WHO recommend?

UD/MH Associate Charlotte Collins from Freie Universität Berlin and University College London summarises the mental health implications of the recent World Health Organisation report on Urban Green Spaces and Health.

Policy makers, planners, researchers and urban dwellers are beginning to understand that health issues in cities are increasingly found in the ‘noncommunicable disease’ realm of mental health. The recent (2016) report by the World Health Organisation aims to address the link between this public health issue and the potential of open, green spaces to have a remedying effect.

There has been sustained historical interest in the links between green spaces and improved health, but the mechanisms and reasons behind such links have not always grounded in empirical evidence. Interest in how green spaces can improve health has recently encountered a resurgence, especially in the context of finding practical urban approaches. Rather than explicitly offering solutions, the new WHO report gathers evidence from studies that have been conducted all over the world to establish similarities and patterns and set the groundwork for a new research toolkit to update this field of study in the context of the 21st century – and importantly, to influence policy and practice.
 
What does the report say about mental health in cities?
The report identifies the potential for the urban environment to engender mental health problems and a lack of general wellbeing as a ‘major public health issue’. Mental health problems can affect anyone in society, at any time in their life, with effects that can be short-lived or have a life-long impact. While it is clearly important to ensure people can receive support and treatment for mental health problems, this is not the only approach, and nor should it necessarily be the first approach. We should look to providing sustainable, preventative measures that reduce the risk of developing mental illness and help maintain good mental health. As Morris et al. (2006) suggests, at the personal level this approach not only improves people's wellbeing; it also reduces the strain placed on healthcare facilities in cities. Furthermore, the report recognises wider socio-economic benefits of good mental health such as a healthier, more productive workforce needing less sick leave due to disorders like depression or anxiety.

Green space in the centre of Tokyo. Photograph by Layla McCay, UD/MH.

The role of green spaces in cities
The UN Sustainable Development Goals aim to provide “universal access to safe, inclusive and accessible, green and public spaces, in particular for women and children, older persons and persons with disabilities” by 2030. This recognises the substantial link between green spaces and the improvement of general health - but what exactly are ‘green spaces’ and what qualities lead them to have an ameliorating effect on mental wellbeing?

In reality, urban green space is highly variable in its definition and can range from trees planted in the street, to children’s play areas and even extends to ‘blue spaces’ such as water features. The WHO report describes how these natural spaces facilitate improved mental health through a series of pathways:
 
Enhanced Physical Activity

• Physical activity is particularly beneficial for those with mental health illnesses in urban areas (Roe and Aspinall, 2011).

 
Stress Reduction

• Contact with nature can have restorative benefits by alleviating high stress levels, and promoting mental relaxation (Hartig, 2007).
• Several medical studies carried out to analyse the effects of exposure to green, natural spaces on cognitive function have found reduced levels of cortisol (a blood marker of chronic stress) in people participating in activities in green spaces.
• Soundscapes in the urban environment can also play a role in psychological stress. Certain practical methods have been implemented and tested to try and mitigate unpleasant, loud and harsh sounds such as; bird calls, water sounds and noise buffering through vegetation barriers.

 
Social Contact/Cohesion

• Green spaces like parks may affect mental health by facilitating an improved sense of social cohesion, community, trust, acceptance/belonging and friendship, contributing to a reduction in feelings of loneliness, isolation and a lack of social support. 
• Green spaces can provide critical spatial frameworks for social integration and networking, especially in children and adolescents; they “can play an important role in fostering social interactions and promoting a sense of community” (Kim and Kaplan, 2004). 
• Rather than being a purely spatial entity, when located in urban communities green spaces can foster strong ties to place, identity and belonging. An issue that is intimately bound up with notions of place is safety – the perception of a space as unsafe or antisocial can have damaging and lasting psychological imprints, influencing one’s sense of feeling ‘at home’ or ‘at ease’.

 
Quantity or Quality?
The report stresses that quality of green spaces is preferential to quantity. Parks in particular can have certain sensory dimensions that greatly affect emotion and mood. As Grahn and Stigsdottir (2010) note, parks can have connotations of serenity: “a holy and safe place, which is a calm environment, undisturbed and silent” that can lead to feelings of calmness and reduced stress. Alcock et al. (2014) meanwhile conducted studies in the UK, which found that overall surrounding ‘greenness’ is more beneficial than proximity to green spaces. In a practical sense this means that even the visibility of nearby trees and vegetation from urban dwellings has the potential to lower levels of mental fatigue, aggression and stress. Contrastingly, the mismanagement of vegetation can connote feelings of neglect, and increase anxiety levels due to fear of crime. Therefore the initial design and sustained upkeep of open spaces is a crucial factor.

Green space in a busy thoroughfare in Nakameguro, Tokyo. Photograph by Layla McCay, UD/MH.

Key mental health-specific recommendations for architects and urban planners
Urban planners are faced with conflicting demands to accommodate an ever-growing population density in cities, whilst maintaining the provision of urban green spaces. The WHO report calls for greater interaction between urban planners, policy makers and public health specialists, and aims to inform them on the “benefits of providing urban residents with green space access”. Emphasis is placed on the need for small-scale, local green spaces that can be a point of encounter for urban dwellers on a daily basis, alongside larger green areas such as parks to offer a space for recreation, physical exercise, and solitude, through contact with nature. At the same time, their design should be sympathetic and scale-appropriate to local contexts, as well as take a dimensional approach to look at potential needs and vulnerabilities of certain groups in society, in order to promote health benefits on a universal basis.
 
Conclusion
The report provides a reassuring reminder of the broadening field of interest and research in the field of urban design and mental health. The call for greater co-working between public health workers and urban planners provides an opportunity to inform urban policy, as well as to implement practical mechanisms into the urban environment to prevent the continued increase of mental health problems in cities.

Read the full Report
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About the Author

Charlotte Collins is a UD/MH Associate. She is studying for a BA Geography at UCL, and is currently on an exchange year at the Freie Universität Berlin. Her main interests are in the architecture and regeneration of urban housing estates and its link to wellbeing, which she is currently researching for her undergraduate dissertation.