Important new report on how urban design can help improve urban mental health

by Layla McCay, UD/MH Director

An important new report on urban design and mental health, Urban Sanity: Understanding Urban Mental Health Impacts and How to Create Saner, Happier Cities, has just been published by the Victoria Transport Institute in Canada. The report evaluates the evidence that links urban design and mental health, and uses these specific links to propose policy recommendations. 

The report author, Todd Litman,  asserts that cities generally provide good opportunities for people to thrive - yet research tells us that people who live in cities have an increased risk of  psychosis, mood disorders, cocaine and heroin addiction and unhappiness (though a lower risk of dementia, alcohol abuse and suicide) compared to rural dwellers. Why? And what can we do about it?

The premise of the report is that urban living in itself does not cause mental disorders or even make people unhappy - rather, city life seems to be associated with increased mental health problems for two principal reasons:

1. People who happen to be at increased risk for developing mental illnesses tend to gravitate to cities, often attracted by  economic and social opportunities and services, creating a concentrated, self-reinforcing cycle of mental illness risk (this is also known as 'social drift'). 
   
2. Various specific factors that are particularly associated with city living seem to exacerbate people's risk of developing some mental illnesses.
   

The report identifies  factors that are particularly associated with the increased risk of mental illness in the city:

• Pre-existing risk factors for mental illness including: poverty, disability, minority status, drug addiction, unmarried
  
• Social isolation and loneliness (particularly as city dwellers have often migrated from afar)
• Excessive stimulation and stress
• Crime
• Economic stress
• Transport conditions
• Inadequate interaction with nature
• Noise and light pollution
• Toxin pollution (eg  via vehicle emissions)

Design and Policy recommendations from the report
The report makes specific design and policy recommendations to address the urban risk factors for mental illness identified in the report, replicated here:

Targeted social service: Recognize that cities tend to attract people with elevated mental illness risks, and provide appropriate mental health, housing and substance abuse treatment services.

Affordability: Improve affordable urban housing and transportation options (walking, cycling, public transit, taxi, etc.) to reduce residents’ financial stress.

Independent mobility: Provide independent mobility options for diverse community members,
including those who are poor, have disabilities or impairments, adolescents or seniors.

Pro-social places: Create public spaces that promote community and encourage positive interactions among residents. Involve residents in creating public places and activities that meet their needs.

Community safety: Create communities that minimize urban dangers including traffic, crime and
harassment, and pollution exposure. This can involve traffic safety programs, crime prevention
though environmental design, appropriate lighting, passive surveillance by nearby residents and bypassers, and other community safety programs.

Design for physical activity: Integrate physical activity by providing good walking and cycling
conditions, high quality public transit, compact and mixed neighborhoods, local parks and
recreational facilities, plus appropriate community sports and recreation programs.

Pollution reductions: Implement noise, air, light and toxic pollution reduction programs.

Greenspace: Design cities with appropriate greenspaces, including local and regional parks, green
infrastructure, and out-of-city wilderness access programs.

What this report makes clear is that improving mental health through urban design is not a nebulous aspiration: practical architecture and urban planning approaches that target specific risk factors are likely to yield results. Better population mental health is an essential contributor to a thriving, sustainable city, and this report contributes an important analysis that will be helpful to citymakers.

Read the report

Summary at Planetizen  (by Todd Litman)

Read the full report here