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SANITY AND URBANITY

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How Women Perceive Safety in Parks: A View from Islamabad, Pakistan

5/15/2025

 
​By: Hadiya J. Khuwaja
In the global conversation about urban parks and mental health, one dimension often remains understated: how women perceive and navigate safety in public parks.

While parks are celebrated for their restorative benefits - offering peace, stress relief, and a vital connection to nature - for many women, especially in culturally complex contexts like Islamabad, Pakistan, parks are not unconditionally accessible havens. They are contingent spaces, where the promise of well-being is unbalanced by persistent concerns about safety, visibility, and belonging.
​
Islamabad, the capital city of Pakistan, is nestled at the foothills of the Margalla Hills and offers a unique urban backdrop. It is the country’s only purpose-built city, designed by Greek architect Constantinos Doxiadis, who envisioned it as a series of zones with quadrilateral residential sectors carefully integrated with public parks and green spaces. At its heart lies Fatima Jinnah Park – commonly known as F-9 Park – a sector-wide green space envisioned as Islamabad’s central hub for public recreation and leisure.​
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Detailed map of Islamabad showcasing the city’s sector-based layout, major green spaces, and urban parks. (Source: Ontheworldmap.com (©2021))
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Illustrative map of Islamabad displaying key sectors, roads, and green zones, including parks and natural areas that shape the city’s spatial layout. (Source: Orangesmile.com)
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Aerial view of Islamabad with the iconic Faisal Mosque framed by the Margalla Hills, illustrating the city’s green urban fabric and zoning layout. (Source: Xinhua News)
Compared to other cities in Pakistan, Islamabad enjoys a relatively abundant provision of parks and natural areas. Yet, as is common across much of South Asia, public spaces remain predominantly male-dominated. The city’s formal planning, while orderly and green, cannot fully insulate women from the social and environmental dynamics that continue to shape their experiences of urban parks.

Drawing on my recent research – a mixed-methods study examining park access and mental well-being in Islamabad (part of my graduate thesis research at NUST Islamabad) – a layered reality emerges: women’s engagement with parks is deeply intertwined with spatial justice, emotional security, and the right to public space.
​
The study, conducted with 354 participants across Islamabad’s major urban development zones, revealed notable gender imbalances. Only 26% (n=91) of respondents were female, while 74% (n=263) were male (Graph 1).
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Figure 1
​Among all respondents, approx. 10% (n=34) cited safety and security concerns as barriers to park visitation. Strikingly, 70% (n=24) of those who raised safety concerns were women, compared to just 30% (n=10) men, highlighting how safety is not just a design issue, but a lived gendered experience that restricts equitable access to parks (Graph 2).
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Graph 2
​This sharp disparity underscores not only women’s heightened vulnerability within public spaces but also their limited engagement with them. The low proportion of female participants may itself reflect broader structural barriers – social norms, safety fears, and mobility restrictions – that systematically discourage women’s active presence in urban parks.
Parks as Potential Sanctuaries – If Safe
​

This tension between the potential and the reality of parks came into sharp focus in early 2023, when a woman was assaulted by two armed men in Islamabad’s Fatima Jinnah or F-9 Park - one of the largest and, ostensibly, safest public parks in the city. Despite interventions such as linking over 200 park cameras to the Safe City Authority and increasing police patrols, another deeply unsettling event occurred in early 2025. Late in the evening, a mother and daughter were assaulted and mugged in the same park. The suspects attacked the women, robbed them, and warned they “shouldn’t be in the park at this hour” - a chilling reminder of the gendered boundaries imposed in Pakistan’s male-dominated public spaces.
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Aerial view of a part of F-9 Park, Islamabad (Source: Friends of F-9 Park, Facebook page)
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Aerial image of F-9 Park, Islamabad, highlighting its expansive layout and centrality in the city. (Source: Google Earth)
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A presentation panel showcasing the layout and design of F-9 Park, Islamabad. (Source: Archnet.org)
In my study, respondents consistently emphasized that parks hold significant potential to enhance mental health – offering relaxation, optimism, and emotional restoration. Yet, this potential was not unconditional. Safety concerns were not peripheral; they were central.

Key concerns included:
  • Fear during evening hours due to inadequate lighting
  • Anxiety over harassment and mobile phone snatching, especially in dark, unpatrolled areas
  • Family-imposed restrictions, particularly for young women, reflecting broader societal anxieties about public visibility
​For many women, parks were not simply spaces of leisure, but carefully navigated environments – where each visit was weighed against perceived risks. These patterns point to a deeper structural issue: the design and governance of our cities often fail to prioritize gendered experiences.

Spatial Justice and Gendered Access

This raises a critical question:

If parks theoretically exist for all, but practically exclude women, can we truly call them equitable urban spaces?

In Islamabad, safety issues are less about isolated incidents and more about chronic structural neglect – embedded in physical design, maintenance, and governance. These gaps manifest in several ways:
​
  • Inadequate street lighting and secure pathways
Many parks lack proper lighting, especially along jogging tracks, entrances, and inner paths – a basic feature that significantly affects women’s comfort and safety after sunset.
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Kachnar Park (I-8), one of the city’s most active sector-scale parks, becomes poorly navigable at night due to non-functional light poles. (Source: TikTok/@r.akeel)
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Sunrise to sunset at Kachnar Park, I-8 – though the lamp posts add charm, their non-functionality highlights persistent safety concerns.
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Jacaranda Park (G-11) features a jogging track with no streetlights at all, raising serious safety concerns for evening visitors. (Source: Google Photos)
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Night-time scenes from G-11/1 Park reveal how poor lighting, scattered puddles, and empty benches can transform public spaces into zones of unease - amplifying feelings of vulnerability, especially for women and families. The park lacks basic security infrastructure, leaving it poorly maintained and particularly unsafe after dark. (Source: Google Photos)

​​Even larger parks like F-9 Park, often seen as vibrant in daylight, experience a dramatic shift after dusk: 
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F-9 Park. (Source: Author)
​During the day, families and individuals use its open paths and shaded walks, showcasing its potential as an inclusive public space. 
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F-9 Park. (Source: Author)
But after sunset, dim (or no) lighting and dense tree cover create poorly visible zones, making the park feel fragmented and unsafe, particularly for women and solo visitors. 

​
The central pavilion called Baradari glows in the distance as surrounding areas remain dimly lit, highlighting uneven illumination and the contrast between formal landmarks and underused open spaces at night.
​
  • Minimal or absent security personnel, signs of neglect and informal exclusion
In many neighborhood (or sector-level) parks, the lack of visible security presence – guards, community monitors, or police – amplifies the risk of isolation and assault. Structural neglect also manifests in subtle forms of exclusion – such as lack of basic amenities like greenery and shaded sitting spaces.
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A visibly neglected “Ara Park” in sector G-13/3, where the absence of greenery, street lighting, and security measures is stark - despite being surrounded by residential buildings. (Source: Author)
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A lone woman on a worn-out bench and a mother with her toddler in a sun-drenched but unshaded clearing, both underscoring the lack of care and inclusive design. (Source: Author)
  • Poor visibility due to overgrown vegetation and disconnected design​
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Overgrown vegetation and unclear sightlines in this park contribute to obstructed visibility – creating shadowed, isolated zones that can feel unsafe, particularly for women and solo visitors. (Source: Author)
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Thick, cascading vegetation in a park in sector I-10 - while visually lush - can limit sightlines and create hidden pockets within public parks, raising concerns around safety and surveillance, particularly for women. (Source: Author)
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A view of a neighborhood park in Sector I-10, Islamabad — built at a higher elevation, the terraced layout and fencing create both physical and visual barriers, subtly affecting perceptions of accessibility, especially for women and children. (Source: Author)
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I-10 Sector Parks, Islamabad – closed gates, broken benches, and poorly maintained landscapes reveal a broader pattern of neglect in public park infrastructure. These conditions not only limit accessibility but also deter women and families from feeling welcome or safe in spaces meant for community recreation. (Source: Google Photos)
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F-10/2 Park, Islamabad – a faded signboard, overgrown greenery, and a makeshift barrier reflect neglect and restricted access, diminishing the park’s usability and sense of welcome. (Source: Google Photos)
​For women, navigating parks means navigating not only the physical landscape but also the psycho-social landscape - assessing, calculating, and often retreating.
Mental Health: The Uneven Promise

When women felt safe, parks provided a multitude of mental health benefits: calmness, rejuvenation, clarity of thought, and a rare reprieve from daily pressures.
When they felt unsafe, the very same spaces became sources of anxiety, exclusion, and compounded stress.
This paradox - parks as both healing spaces and sites of tension - is not unique to Islamabad. From London’s night-time public realm debates to Mexico City's pink public transport initiatives, gendered safety concerns shape how women globally engage with urban environments.
Islamabad’s experience mirrors a broader global urban challenge: When parks are designed without a gendered understanding of safety, they risk reinforcing inequality, even as they aspire to promote public health and well-being.
 
Toward Solutions: Designing for Women's Safety and Inclusion

Several design and policy interventions are urgently needed to reclaim parks as inclusive, healing spaces:
  • Enhance lighting along pathways, entrances, and communal areas to extend safe access into evening hours.
  • Ensure clear sightlines through strategic landscaping - beauty must not compromise visibility.
  • Embed community surveillance, combining security personnel, CCTV, and participatory neighborhood watch initiatives.
  • Create women-centered spaces within parks, such as fitness zones, family-friendly gathering areas, and culturally sensitive programming that encourages women's presence without isolation.
  • Engage women directly in the design, planning, and ongoing governance of parks, ensuring they are active co-creators, not passive users.

In Islamabad - and across the Global South - reclaiming public parks as inclusive, restorative spaces for women is not a luxury. It is a long-overdue right. Parks must be places where all citizens, regardless of gender, can feel safe, seen, and free. Public parks are not just places of leisure - they are essential to mental well-being, social inclusion, and equitable urban life. Yet for many women, the simple act of walking, jogging, or sitting alone in a park remains fraught with risk and social scrutiny. Safety, dignity, and freedom of movement in public spaces must be non-negotiable. Making parks genuinely accessible to women means rethinking not just security infrastructure, but also challenging the deep-rooted norms that dictate when, where, and how women should exist in public. It is about transforming parks from contested terrains into spaces of healing, visibility, and belonging.
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F-10/2 Park, Islamabad (Source: Author)
Final Reflection

In her book Death and Life of Great American Cities, Jane Jacobs - ahead of her time - emphasized that urban safety relies not on isolated security measures but on "eyes upon the street" - organic, community-driven oversight.

Drawing from examples of several city parks, Jacobs stressed that parks must be busy, lively spaces to feel safe and inviting. Empty or poorly used parks, no matter how beautifully designed, often become areas of danger and neglect. Successful parks, Jacobs explained, share key traits: they offer a diversity of uses, are bordered by active streets and buildings, and attract a mix of users throughout the day. In contrast, parks that are isolated, monotonous, or serve a narrow demographic tend to fail, lacking the continuous, casual surveillance provided by a vibrant community.

Islamabad’s parks often lack this vibrancy, leaving safety fragile and access unequal, particularly for women. Poor lighting, disconnected layouts, and minimal passive surveillance contribute to parks becoming isolated, especially during critical evening hours. In a city where women’s presence in public spaces is already constrained by cultural and social barriers, the absence of "eyes on the park" heightens their sense of vulnerability.

To truly realize parks as safe and inclusive spaces, urban planners must move beyond installing security cameras and posting guards. Instead, they must design environments that naturally encourage diverse, everyday use - families picnicking, elderly people strolling, teenagers playing sports. It is this constant, pluralistic presence that weaves an invisible yet powerful net of safety, embodying the vision Jacobs laid out for truly vibrant and secure public spaces.
 
Public parks are powerful equalizers - but only when they are truly public.

When women must navigate these spaces with fear or restraint, the health and social benefits that parks promise become unevenly distributed, undermining their fundamental purpose.

As we reimagine healthier, more inclusive cities, the everyday safety and dignity of women must shift from being a peripheral concern to a central design priority.
​
Because the right to safety, serenity, and joy in public space should not depend on one’s gender - it should be guaranteed.
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F-9 Park, Islamabad (Source: Author)

About the Author

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Hadiya J. Khuwaja is a curious urbanist and mental health advocate who believes cities should heal, not harm. She's currently working on her graduate research in Urban and Regional Planning at NUST Islamabad. She holds an undergraduate degree in Architecture from NED University, Karachi. She is passionate about weaving health into urban planning, rethinking public spaces, and designing cities that feel a little more human. When she’s not buried in research papers, you’ll find her daydreaming about greener parks, better sidewalks, and a kinder urban future.
​

Say hello on Instagram: @thoughtfulurbanist
​​

City design and planning opportunities to enhance sleep

9/20/2018

 
City design and planning can enhance many aspects of people’s lives, but what about sleep? Sleep is easy to forget because it’s a biological necessity that cannot be avoided. However, adequate sleep impacts physical, emotional, and mental health and urban planning can contribute to the sleep health of an entire community.

Design, nature and sleep


The effects of an urban environment on the mind and body revolve around green space and its impact on overall health. In as early as 1984, physicians began to notice that patients who either had a view of or spent time in a garden area recovered faster. That led to a review published in Science, wherein hospital records from 1972 through 1981 were thoroughly examined to see if patients healed faster in rooms with a view. It was concluded that a view of nature rather than a brick wall consistently shortened recovery times.
​

At the time, it was considered groundbreaking research. Roger Ulrich, who conducted this first review, continued his research and found several key components that contributed to improved patient outcomes. Today, these findings are regularly incorporated into modern hospital design. However, the value of his findings goes well beyond a medical setting into daily use for those not recovering from medical procedures.

Three of Ulrich’s components that led to shorter recovery times can also be applied to sleep-enhancing environments.

  • Noise levels: It’s easy to understand how noise levels interfere with sleep. Residential areas with green space create distance between people and noise pollution. Trees, grass, and bushes absorb noise, creating a barrier between people and urban sounds. Whether spending time in the green space or homes and apartments built around the green space will have some protection from sleep-disrupting noise.
  • Sun exposure: Sun exposure is critical to the sleep-wake cycle. The human eye has photoreceptors that absorb the blue light that results when sunlight passes through the earth’s atmosphere. A signal travels directly from these photoreceptors to the circadian region of the brain. This region of the brain controls the circadian rhythms, which regulate everything from hormone release to metabolism. Natural light helps the body sync the sleep-wake cycle to the day/night schedule. Access to natural sunlight is absolutely necessary to keep the circadian rhythms in check. In fact, many of the sleep disorders associated with old age occur because dimming eyes don’t absorb enough light to regulate the circadian rhythms. Urban design that maximizes exposure to sunlight helps the human body stay on a regular sleep schedule.
  • Access to windows with a view of nature: A 2015 study published in the Proceedings of the National Academy of Sciences found that taking a 90-minute walk in a natural environment versus an urban one improved mental health. After spending time in nature, participants reported thinking less negatively about themselves and their situations. The results also showed lower activity in the region of the brain associated with depression and anxiety. While the effects may not be as strong as taking a walk in nature, a window view of nature can have a similar effect on mental health. Patients in Ulrich’s reviews and studies may not have been able to go outside, but even a window with a view improved their recovery times.
Nature restores mental wellbeing

The research begs the question as to why natural environments stimulate the brain differently than built-up urban environments. One answer lies in the different forms of human attention. When reading a book, driving, or writing, the brain pays direct attention to the task at hand. Urban settings require decision-making from navigating traffic to acknowledging strangers. It requires mental effort and discipline that can fatigue the mind.


On the other hand, involuntary attention happens without concentrated effort. The rustle of leaves, a bird flying by, or bright flowers involuntarily capture the mind’s attention without concentration. The restorative nature of involuntary attention is encapsulated in attention restoration theory. When boiled down to the basics, this theory implies that nature requires very little of the human brain to keep its attention. That in and of itself restores mental energy just like food and water restore physical energy. It entertains while requiring nothing of the brain, creating the right conditions for relaxation and, eventually, sleep.

The average adult needs a full seven to nine hours of sleep for complete restoration. Environments that can reduce stress and anxiety will naturally contribute to better sleep. Healthy sleep contributes to immune system health, appetite regulation, diet, and a reduced risk of diseases and illnesses such as diabetes, high blood pressure, and heart disease.  

While hospitals may have been the first to realize the value of green space, we now know it can improve more than recovery times, and this is a design factor no longer just for hospitals. In an increasingly urban society, it creates an environment that improves, sustains, and actively contributes to the mental and physical health of those who live in it. 

Designing for better sleep

Design that enhances sleep tends to both reduce noise and increase access to green space. Plans may require a combination of design techniques to achieve optimal conditions. For example, planning major roadways away from residential areas while using earth bunds and sound barriers to reduce the sound waves that reach residential areas. Noise-tolerant buildings and sound-proofing insulation can reduce noise even further.

Good planning for restorative sleep also makes room for green space. Planners must also consider the kind of green space people want to use. In general, large, open spaces that use the natural landscape attract more users than small parks. However, it might be necessary to get creative when finding green space. Transforming rooftops into gardens and old railways into trails are two common examples. Looking for unused or forgotten areas that can be used as green spaces can increase access and better utilize what’s already available. Residential areas with communal green space and walking access to parks creates a sense of community and can promote the mental health of residents. The key is to make them accessible and usable. Trail networks along with pedestrian-only walkways and bridges provide safer access.
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Planning and designing for mental health includes sleep-enhancing measures such as noise reduction and views of nature. Picture credit.

About the Author

Samantha Kent is a researcher for SleepHelp.org. Her favorite writing topic is how getting enough sleep can improve your life. Currently residing in Boise, Idaho, she sleeps in a California King bed, often with a cat on her face.  ​

Community greening interventions have a positive impact on community mental health: a summary of the first ever city-wide RCT

7/31/2018

 
by Jacob King, UD/MH Associate and junior doctor practising in the UK
Published in the prestigious Journal of the American Medical Association last week at long last those of us interested in green space and mental health have a city-wide experimental study, and it’s good news! (South, Hohl, Kondo, MacDonald, & Branas, 2018)

KEY FINDINGS
  • Creating urban green spaces reduced feelings of depression and worthlessness
  • The effect was most pronounced in people with low income
  • The effect did not involve active use of the green spaces
  • The effect of simply tidying but not greening the spaces had minimal impact
  • The effect was achieved with small-scale greening interventions

Until now, green spaces in one’s urban environment have been shown to confer a range of mental health benefits to their local populations only in observational epidemiological studies. In the most common type of these studies, snapshots of a populations’ access to green space and their mental health are measured at the same moment in time. These methodologies are of course hindered by problems for inferring causality.

The relationship between green spaces and mental health is a hugely complex one. There are a long list of ways in which the benefits are explained. The most well-evidenced mechanisms to date are: promoting exercise and socialisation, reducing exposure to air and noise pollution, reducing stress and restoring attention, and building senses of community and place attachment . These mechanisms, among many others, are hugely complex and very difficult to adjust for in observational studies despite best efforts. A common criticism which therefore arises from observational studies is whether the effect could be caused by any one of a thousand factors associated with green spaces, which could be good for mental health. Furthermore, the observational studies so far have reported widely variable results. Some have demonstrated impressive reductions in anxiety (de Vries et al., 2016) and depressive symptomatology (Triguero-Mas et al., 2015). While others have shown virtually zero impact at all (Houlden, Weich, & Jarvis, 2017). These variable results are likely in a large part due to the many confounding factors. In response, study after study, commentary after commentary, has been crying out for experimental style studies - natural experiments or randomized control trials (RCTs) – the benefits of which allow for the single issue of interest to be studied in isolation from the disruptive noise of the complex co-factors in the relationship. In RCTs of sound methodology we can be quite confident that the results we see are due to the factor we are interested in.

Step forward Eugenia South and her colleagues from the University of Pennsylvania and their RCT set in Philadelphia.
 
Green fingered Philly
 
Initially concerned with the high burden of mental health conditions, and in light of the then fledgling evidence for green space benefit, researchers extended their work which had previously shown reductions in crime rates following neighbourhood improvement projects to consider mental health outcomes (Kondo, Hohl, Han, & Branas, 2016). By early 2013 city officials in Philadelphia had identified nearly 45,000 lots of unused vacant, often derelict brownfield land across the city. Given such an opportunity authors designed their methodology to include three study arms into which randomly selected plots, grouped together into local clusters of a 0.25 mile radius, would be allocated. The first arm would be left as they were at present. The vacant plots in the second arm would be tidied up, and the third would be “greened”. The researchers would then be able to differentiate whether the “greenness” of the spruced-up space itself contributed anything to outcomes.

Random plots were selected from the master list, and random plots also from the list and within a 0.25 mile radius were included in the cluster. To be eligible for the study, lots were to be less than 5500sqft, deemed to be abandoned, and stricken with ‘blight’, for example that there was evidence of fly-tipping (dumping), abandoned cars, or numerous police reports concerning crimes associated with the lot. In total 110 clusters were formed, containing 541 lots. Over a period of two months gardeners from the Pennsylvania Horticultural Society transformed the third of these vacant plots allocated to the “greening” arm, and tidied the third in the second arm, they will continue to maintain these lots monthly for the foreseeable future.
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Before and after examples of greening the vacant lots. Used without permission of copyright holder for educational purposes. License held by JAMA network and authors.
Gardeners were instructed to follow a strict, replicable, modification process of grading the land, cleaning debris, planting grass and a small number of trees, and enclosing the space with a wooden fence with openings, in the aim of avoiding future dumping.
 
What impact on locals’ mental health?
 
In their study researchers randomly selected individuals living within the catchment areas of clusters and administered questionnaires before the intervention, and again after the intervention. There was a 77.4% success rate at interviewing the same people post-intervention at 18 months, achieving a final sample size of 342 subjects used in analysis. Questionnaires primarily consisted of key demographic information, financial status and a measure for mental health status. The short form “Kessler-6 scale” is a quick screening tool widely used for assessing poor mental health. Each question concerns a key symptom of psychological distress: nervousness, hopelessness, restlessness, depressive feelings, worthlessness, the feeling that everything is an effort, and a summary result which gives a good approximation of overall mental health and psychological distress. An annoying limitation of the short form Kessler scale is that we cannot make clinical judgments about the results: we can only identify the presence of depressive symptomatology, rather than making a diagnosis of clinical depression. However the two are of course highly related.

On to the results. Between individuals living in clusters which were greened versus those which were not, authors demonstrated significant reductions in two of the sub-categories of the K-6: depressive feelings were reduced by 41.5% and feelings of worthlessness by 50.9%(!) All other components had major drops in prevalence too. The combined figure showed impressive community wide reductions of psychological distress by 62.8% (95% CI, −86.2 to 0.4; P = 0.051). In the second arm of the study, tidying up the lots compared to no intervention produced weaker result than greening did, and while the prevalence of all psychological categories decreased, non came close to a real significance (a strong likelihood of true difference); overall psychological distress for example was reduced by 30.1% (95% CI, −74.7 to 93.2; P = 0.49).
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Adapted from South et al., 2018. A table showing pre/post intervention differences in those clusters which were greened (arm 3) and those which were not altered (arm 1).
Furthermore, and importantly, in line with other studies of green spaces in local communities and mental health outcomes (Roe, Aspinall, & Ward Thompson, 2016), evidence from this study suggests that these benefits are even more pronounced for those individuals with low incomes (in this study judged to be household income under $25,000 pa). Notably, feelings of depression dropped in this sub-group by 68.7%, (−86.5 to −27.5; P < 0.01). All other aspects dropped by large amounts, but with wide confidence intervals and without strong evidence of a true difference.

In short, authors, and readers, can conclude from this presented data, that the greening interventions conducted by these gardeners notably reduced the overall number of citizens with poor mental health, and has been especially good for reducing the number of people with depressed feelings, particularly for those with low incomes.

A call to arms for communities

The evidence presented by South and her colleagues marks an important point for green space / mental health research. For the first time, this is large scale, experimental data, which provides key, and long-needed reassurance that the work of observational studies to date is replicable when the complex web of confounding factors are evaporated away.

Furthermore this study offers much to the way in which to think about green space within urban design. Especially in conjunction with this team’s previous work on the reductions in crime rates in ‘greened’ neighbourhoods, this paper adds to the conversation about the mechanisms of action of the now-undeniable benefits of green neighbourhoods to the mental health of their residents. Recent emphasis in the debate had been placed on active use of green spaces, but this study may now shift thought back towards passive or indirect observable functions of green spaces (such as attention restoration, stress reduction and protection from nuisance environmental exposures), and promotes greenery as a key facet of improving the quality of neighbourhoods, given tidying the area alone produced only marginal benefit.

Next, we must ask environmental psychologists to consider why South’s interventions delivered improvement to rather specific facets of psychiatric symptomatology (depressive feelings and worthlessness specifically: the authors propose a renewed sense of local authorities caring about their communities as a possible explanation). Hence whether specific mechanisms of green space produce specific mental health symptom benefits? In this sense, facilitating other mechanisms with other flavours of green space interventions, perhaps larger green spaces for promoting recreation, and as community foci, other facets of psychiatric symptomatology will be addressed for an overall multifaceted tackling of community psychiatric burden.

Other important areas for consideration now should be the replication of these results across other cities, with larger sample sizes, and more rigorous, clinically validated assessments.

More than ever, we should feel renewed in a community focused approach to urban (re)design. That efforts in renewing small scale (and very small scale) blighted vacant lots in our communities (some clusters only renovating 5 lots to produce such improvements in mental health) is to be of benefit. It is highly likely that these small projects are achievable for many communities. Authors further report that these initiatives are  affordable too: in their previous work, greening improvements of this kind cost on average US$1,597, plus US$180 in yearly maintenance. Local government structures can now add “improving the mental health of my community” to the long list of reasons for revitalising derelict land that is perhaps too small and financially unappealing to property developers. Otherwise, in the spirit of work which has suggested community involvement and directorship of a community’s spaces is of multifaceted benefit through building a sense of community, of place, and of stewardship, councils might look to devolve authority of these small projects to community groups themselves. When all is said and done improving mental health is not the only outcome of improving the quality of local communities, but it is a major player in an interconnected web of community, environment and health, which the work presented here by South and colleagues could more reliably inform and encourage local and national decision makers to take a little more seriously.
READ THE STUDY HERE
References
de Vries, S., ten Have, M., van Dorsselaer, S., van Wezep, M., Hermans, T., & de Graaf, R. (2016). Local availability of green and blue space and prevalence of common mental disorders in the Netherlands. British Journal of Psychiatry Open, 2(6), 366-372. doi:10.1192/bjpo.bp.115.002469

Houlden, V., Weich, S., & Jarvis, S. (2017). A cross-sectional analysis of green space prevalence and mental wellbeing in England. BMC Public Health, 17(1), 460. doi:10.1186/s12889-017-4401-x

Kondo, M., Hohl, B., Han, S., & Branas, C. (2016). Effects of greening and community reuse of vacant lots on crime. Urban Stud, 53(15), 3279-3295. doi:10.1177/0042098015608058

Roe, J., Aspinall, P. A., & Ward Thompson, C. (2016). Understanding Relationships between Health, Ethnicity, Place and the Role of Urban Green Space in Deprived Urban Communities. Int J Environ Res Public Health, 13(7). doi:10.3390/ijerph13070681

South, E. C., Hohl, B. C., Kondo, M. C., MacDonald, J. M., & Branas, C. C. (2018). Effect of greening vacant land on mental health of community-dwelling adults: A cluster randomized trial. JAMA Network Open, 1(3), e180298. doi:10.1001/jamanetworkopen.2018.0298

Triguero-Mas, M., ., Dadvand, P., Cirach, M., Martínez, D., Medina, A., Mompart, A., . . . Nieuwenhuijsen, M. J. (2015). Natural outdoor environments and mental and physical health: Relationships and mechanisms. Environment International, 77, 35-41. doi:http://dx.doi.org/10.1016/j.envint.2015.01.012

About the Author

Jacob King is a UD/MH Associate and junior doctor practising in UK. His main interest concerns the association between green space exposure and mental health, and how we can design interventions to promote this relationship.

Urban Picnics: a Tokyo mental health opportunity that's surprisingly subversive

4/3/2017

 
by Layla McCay, UD/MH Director
Cherry blossom season is upon us in Japan. The national news is filled with cherry blossom reports: it feels like everybody is invested in the specific day that the flowers will bloom in their town. There is good reason for this interest, and not just the national appreciation of beauty, flowers and the ephemeral nature of life. Cherry blossom behavior is part of Japan’s national psyche. In a unique moment of nationwide celebration, the country’s usual work-focused culture presses pause, and a different priority is embraced: cherry blossoms viewing, known as hanami. People walk amongst cherry blossoms, admire them, photograph them… Admiring cherry blossoms is part of the pulse of Japan.
 
As the flowers fleetingly blossom, so too does another fleeting pleasure: leisurely outdoor social interaction. Everyone dashes to their nearest cherry blossom location to enjoy raucous, convivial, drunken hanami parties, crowded on blue tarpaulin sheets spread under the trees. Offices, universities, friends, and just about anyone else organises hanami parties, characterised by picnicking (with copious alcohol usually involved). Office workers are even sent to the park early in the morning to secure a good spot.
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Hanami picnics in Yoyogi Park. Photo by Stardog Champion. Used Under Creative Commons license.
But as the blossoms start to fade, so too does this particular form of social interaction. At the end of cherry blossom season, Japanese people pack up their picnic blankets and store them til next spring. This seems a missed opportunity: many people live in very small homes, particularly those in large cities like Tokyo, which inhibits their inviting others to their homes for socialising. Picnics should be an ideal solution. And yet they are not. Part of the reason may be lack of venue. Tokyo has only 5.4 m2 of green space per person; this compares to 11.8m2 in Paris, 26.9m2 in London and 29.1 m2 in New York. While picnicking takes over many public spaces during hanami season, for the rest of the time this is not appropriate, and many parks are designed to be admired, not as appropriate social dining spots for adults. But finding the right venue is not the only hurdle. Picnics do not tend to be part of Japanese culture. According to many Japanese people, picnicking outside at any non-hanami time of the year is generally considered 'bizarre', 'childish', and even 'suspicious'.
 
Hiroshi Ota, an architect, and Kaori Ito, an urban designer, helped establish the Tokyo Picnic Club in 2002. Its mission: to tempt Tokyoites to picnic outside of hanami season, socialising in natural settings year-round. They claim: ‘to picnic is the urban culture to utilize the public spaces, to make up for the deficiencies of our city life.’ The appreciation of parks is a cultural norm, but the idea of picnics is unusual. Yet they offer many benefits, not least the opportunity to promote good mental health in the city. Picnicking offers exposure to natural green spaces, encourages physical activity (at least walking to the picnic spot), and facilitates pro-social interaction, which are all urban factors associated with good mental health.
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TRY A PICNIC TALK / Illustration: Kotori NOGUCHI, Design: Wataru Noritake
The connections between picnics in the park and good mental health tends to be underappreciated. “Japanese people don’t feel the direct connection between spending time in nature and health,” Ota explains. “However, if parks are used for community activities, that can lead to improved mental health.”

The Tokyo Picnic Club helps people make that all-important but unappreciated connection between urban design and mental health by linking picnics to more commonly accepted health promotion ideas. “In Japan, people tend to think about food when it comes to health. Since the idea of the picnic is based on food, this helps with the idea that going to the park for a picnic can help enhance health.” Ito adds that in Japan, expressing creativity is another important facet of mental health, and this can be achieved by preparing elaborate picnics. “When Japanese people enjoy creativity, they tend to feel happy. Therefore, we believe that writing a poem, making food, and wearing creative costumes during the picnic may also make people feel happy.”
 
There are further benefits to socialising in the park, Ito proposes: “If you go to a shopping centre, you will notice the lack of diversity. However, parks are open for anyone. You can see all the generations, including rich, poor, elderly and young people.”
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Tokyo Picnic Club picnicking outside in Konan-ryokusei Park, Tokyo. Photo and copyright: Hajime Ishikawa
But their enthusiasm for picnics is not shared by everyone. The Tokyo Picnic Club described setting up picnics in various patches of green space around Tokyo – and measuring how long it took before their party caught the attention of the police and were reprimanded for their subversive attitude to picnicking outside the social boundaries of hanami season. It rarely takes long before they are questioned - and often asked to move on.
 
“We just want the places to have our picnic. We need neither benches nor waterworks. We simply want a spacious lawn. If Green Fields such as beautiful parks are open to us, the picnic becomes the art of encounter in our urban lifestyles. If Brown Fields such as ex-industrial sites or abandoned harbors are open to our picnic, we can develop meals, tools, manners and conversations to fit in the new atmosphere of the modern cityscape.”
 
The Tokyo Picnic Club hopes that by raising awareness, the value of year-round picnicking will be better understood and appreciated in Japan. Their efforts have included portable lawns, and Grass on Vacation, an art show where they remove aeroplane-shaped pieces of turf from locations where people do not sit on the grass, and take them on ‘vacation’ to other locations where the grass can 'enjoy' its intended use: people are encouraged to sit, lie, socialise, eat and generally enjoy the experience of nature in the city.
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Grass On Vacation ANGYANG (2005)
Design: Hiroshi OTA + Kaori ITO + Toru KASHIHARA + Wataru KASHIHARA, Illustration: Kenji KITAMURA

The Tokyo Picnic Club smilingly insist that the "Right to Picnic" should be a basic human right for urban dwellers. Given the normality of picnicking in other cities all over the world, in Tokyo, this is a surprisingly subversive demand.

In time, the Picnic Club hope for proper observation of one of the 15 rules of Tokyo Picnic Club: every day is a picnic day. By encouraging people’s access to green space and positive, natural social interaction, this is also an apt mantra for mental health promotion in the city.
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Illustration: Kotori NOGUCHI

About the Author

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Layla McCay is Director of the Centre for Urban Design and Mental Health. A psychiatrist, international public health and health systems specialist, she holds academic positions at Georgetown University (US), London School of Hygiene and Tropical Medicine (UK) and Tokyo Medical and Dental University (Japan).

The Case for Trees in Urban Design: 5 Tools to Support Better Planning

7/17/2016

 
By Eva Adler, Geospatial Information Specialist at the United States Agency for International Development (USAID), Washington DC.
Trees present an excellent opportunity for planners to help enhance urban mental health and wellbeing. But choosing the wrong trees can be more detrimental to urban communities than having none at all. To make the most of urban green spaces, both tree characteristics and spatial thinking need be considered early on in the planning process. In this article, we will explore common challenges in choosing trees in urban design and how five tools can better support planning and build more vibrant, healthy urban communities.

The ‘wrong trees’ can do more harm than good

These tools are important because despite the best of intentions, implementation problems often occur at the neighborhood scale when the ‘wrong trees’,  or trees unsuitable for a place’s specific urban variables, are brought into the built environment. For example, city planners plant beautiful Ginko bilboa trees along local roads to contribute to the city’s beautification project. The intention is to increase shade, safety, health and happiness across the local community - all laudable aims. However, over time the trees grow too large for the city’s infrastructure and budget. The branches begin to destroy electrical lines, crack underground water pipes, fall onto cars during winter storms, and litter pounds of smelly fruit every spring. The city  becomes frustrated and cut down the trees... only to replace them with smaller, younger Ginko trees. So where did they go wrong?

How to choose the ‘right tree’ for mental health, wellbeing… and for tax dollars

In the US, the Arbor Day Foundation advocates The Right Tree in the Right Place framework, emphasizing that proper planning is vital to achieve the outcome of healthy urban green spaces. They describe trees that will “cool your home in summer and tame the winter winds… grow well in the soil and moisture of your neighborhood… be properly placed to avoid collisions with powerlines and buildings.” Furthermore, thousands of city tax dollars can be prevented in sidewalk and electrical repairs if planners match trees to the urban locations in which they will be planted.

Tree characteristics to consider for sustainable urban design:
  • Height, canopy spread, form, and shape
  • Growth rate
  • Soil, sun, and moisture
  • Fruit
  • Temperature extremes in your region - hardiness zone
  • Urban variables (soil compact, road salt, contained space, toxicity to pets, etc.)
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Organizations like Casey Trees strive to prevent planning issues associated with tree planting and restore the urban forest of the Washington DC through education and outreach, policy advocacy, and private and public partnerships. Source: Casey Trees website
Tool 1: Tree Finder Wizard (for the US)

But how to identify the right tree for a particular location? For instance, a local coffee shop in New York City wants to plant a few trees above the front patio to give customers shade. But there are electrical lines 50 feet above ground, there’s limited planting space for roots, partial shade, and the northeast winters are harsh. So what should they do?

One helpful tool they can use is the Tree Finder Wizard tool, developed by the American Arbor Day Foundation. This tool identifies the right tree species for any community in the US based on the variables of zip-code, soil, height, growth rate, spread, and aesthetics desired (fruit, evergreen, deciduous, etc.) | website
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Source: Arbor Day Foundation, website
Tool 2: National Tree Benefit Calculator (for the US)

The Right Tree Right Place framework is an important first step towards using trees to help achieve healthier communities and more impactful outcomes. However, getting the information and facts to the right people is another challenge. Evidence of economic improvement can form a persuasive argument that helps turn ideas into action. Whether it’s city officials, policy makers, neighborhood HOAs, or school principals who need to be persuaded, the free National Tree Benefit Calculator is an effective tool to communicate specific economic benefits of urban trees and diversity of tree populations. While it does not yet consider health benefits, it calculates the monetary benefit of trees based on tree species, age, and size based on potential improvements in stormwater, property value, energy usage, and air quality |  website
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Source: Arbor Day Foundation, website
Tool 3: Google’s SketchUp

However, city planning doesn’t only mean city effort. Local non-profits, businesses, and homeowners can too create designs for public spaces, backyards, and community gardens using the right tree right place framework and free 3D spatial design tools.

SketchUp is Google's free design software. It incorporates a few landscape templates to help get a project started. In SketchUp, one can upload a photo and create objects from scratch easily on a laptop to help plan tree design within a given landscape. | website
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Sources: SketchUp, website | Bēhance City Architecture, website
Tool 4: Garden Visualizer

The Marshalls Garden Visualizer lets a beginner user design a garden or small public space with stunning 3D quality. Photos of community structures and buildings can also be uploaded and displayed in the backdrop | website
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Sources: The Self Sufficient Living Blog, website | Landscaping Visualizer, website
Tool 5: Mappler K2

Predicting future trends and integrating community input early on into the design process are challenges that city and regional planners encounter regularly. Where do community members want more trees? In what areas do we need more trees to improve safety, mental health, and healing? How can a city streamline input and provide effective solutions? Mappler is a free crowdsource mapping tool and a mobile data collector app to easily conduct assessments and identify community needs across a city scale. It is a tried and true tool to collect diverse inputs on a large scale to help identify community issues, needs, and successes. | website | community asset mapping
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Asset Mapping using Mappler, website |
A prime example of the use of Mappler was in New Jersey where local residents entered the location of road potholes. Local officials then used this input to prioritize areas of operation and improve road conditions. When each road was fixed, they were able to input a comment to notify the public that the issue they identified had been fixed.
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Source: Mappler Mobile, website
This same process can be used for identifying other community needs, for instance the tracking and maintaining of urban forests as demonstrated by Casey Trees in Washington DC (online map).

These tools can contribute to smarter urban planning that will achieve the wide range of positive impacts - and help avoid the unintended pitfalls - of planting trees to improve community life.

Do you have a great tool to suggest? Please add a link and description in the comments section.

About the Author

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Eva Adler is a passionate advocate for green spaces as it relates to public health, social equity, and GIS. She uses maps to ask deeper questions and uncover hidden truths. She is a Geospatial Information Specialist at the United States Agency for International Development (USAID) in Washington, DC. Prior to her current role, she facilitated a Mapping for Social Good online course, collected geospatial data across a 50-acre botanical garden, and conducted community health surveys in Nepal. Ms. Adler studied at the University of Colorado at Boulder in Ecology and Geography, with plenty of time to enjoy her outdoor hobbies. In her free time she hikes, rock climbs, makes jewelry, and explores new places.

Applying Eastern Medicine Concepts in Urban Design for Mental Health

2/2/2016

 
by Tracy A Marciano
Urban Planning as a means to organize people, places, concepts and practices has an interesting history. As civilization progressed, urban planning followed a parallel trajectory,  reacting to practices that outlived their usefulness. With each era, large scale redesign was at the forefront of change with small pockets of improvement on the periphery.

Contemporary discourse about urban health is primarily focused on green spaces and walkability. While both are important in the urban fabric, they are not absolute measures of ideal public health and their results are hard to quantify against the variations in symptoms and treatments for mental disorders. Introducing concepts from other fields and recalibrating them into plausible urban design initiatives is a potentially interesting approach to improve mental health in cities. In particular, as urban areas gain momentum, exploring concepts from eastern medicine such as acupuncture, aromatherapy (or horticulture therapy), directional alignment with the sun and the moon, nocturnal gardens, botanical soundscapes and energy balancing might be applied to exert a positive impact on mental health in modern cities.

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Map developed by Sir Ebenezer Howard, urban planner, 1850 - 1928. This shows his vision for improving the conditions of the poor through combining the best aspects of town and country and allocating space carefully. Read more here.

As populations migrate towards urban centers at an accelerated rate, advancing improved health strategies - rather than utopia - is often being achieved through incremental improvements.

A recent movement is New Urbanism, or tactile urbanism, which seeks to align with sustainability, preservation of existing buildings and walkability.  However, as with past attempts at planning perfect cities, such as The Garden City movement, individual experience, public mental health and most importantly, the causation and impact of mental health problems have been largely excluded from the dialog.

Jamie Lerner, who served three terms as the mayor of Curitiba, Brazil uses urban acupuncture as the philosophy behind his successful initiatives.  Urban acupuncture is the mature cousin to tactical urbanism, which has suffered a bit of backlash lately as a trendy, high-concept practice of questionable long-term impact. Lerner writes in his book “Industrious mediocrity is gaining ground, along with merchants of complexity: the bean-counters and the inconclusive, never-ending researchers. But sometimes, just one stroke of creativity is acupuncture powerful enough to make progress.”

In 2007 University of Minnesota published a paper about their collaboration with Blue Cross and Blue Shield of Minnesota. This paper highlighted key findings about how to increase accessibility to nature to address mental health problems. Their research also found that social networks are important and that mental health is connected to fundamental public health issues but did not offer developed solutions with measurable results.

In most cities, areas that create tension and erratic energy and areas that can exacerbate anxiety, depression and isolation are evident. If cities are viewed as a biological system and receptive to holistic wellness plans, the philosophy of urban acupuncture may be an ideal platform to improve heath. For example, if obstructed walkways and clogged streets create tension and anxiety, a small area, such as an acupressure point along a vertical meridian line, could be addressed rather than attempting a complete urban redesign.  

Green space is prevalent in urban planning. However, an actual plan for the green space is often missing. Green space can mean a small strip of grass, or a few trees added as an afterthought. Applying other eastern principles, such as aromatherapy would be a progressive addition to the design phase. For example, if there is a lack of people using a public space where there is ample seating, adding a vertical garden with aromatic herbs may draw people to the area. Aromatherapy, or a fragrance garden, on a large scale could enhance individual experiences while reducing stress and anxiety. It also gives purpose to a vertical garden aside from aesthetics.

Incorporating vespertine gardens (night blooming) would help understand that urban areas have enormous potential after sunset; and would also align with solar and lunar lighting during the design phase. Nocturnal plants are more fragrant and assist visually impaired individuals when combined with other sensory plantings. Using balance between day/night, light/dark can create enough stability to reduce tension and anxiety.

Urban acupuncture is an intriguing starting point to reconsider conventional urban planning and design. It highlights that we are at a critical moment in time when all stakeholders can think about long term plans and how those plans will have a positive impact on mental and public health in urban centers.
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Caixa Forum Museum employing concepts of urban acupuncture and aromatherapy to urban design. More details.

About the author

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Tracy A Marciano holds a Masters degree in Sustainable Planning and Development from Pratt Institute of Architecture and attended Columbia University for graduate studies in landscape design for urban environments. The concept of using “urban acupuncture”, or small pockets of improvements in design and planning to promote wellness, is at the forefront of her current research. She is currently a UD/MH Fellow. Find her on Twitter @NewPreservation

Greening Our Cities - Towards a Biophilic Built Environment

10/13/2015

 
Clair Wholean, an architect with DLR Group| Sorg in Washington DC, on biophilia, the urban environment, and mental health.
Biophila, our innate love of nature, is an obvious way to enhance our cities into environments promoting mental health. The word was first coined by the social psychologist Eric Fromm to describe the positive feelings we obtain from interaction with natural systems and species. This describes everything from the joy we experience in seeing a family of ducklings swimming in a pond, to the beauty of an old growth forest, and the harmonious sound of crickets on a summer night.

Biophila was originally explored as a niche area of psychology and neuroscience research.  Books such as The Biophila Hypothesis, The Last Child in the Woods, and Healing Spaces have done much to spread the concept of biophilia to other fields, and it is now beginning to gain traction in design circles, influencing architecture, interior design and urbanism.

When one thinks of nature and cities, the first thought that comes to mind is likely a tree-lined street with a beautiful canopy. Trees are one of the best ways to start with enhancing the natural environment in a city because of their myriad of benefits, from creating summer shade havens to ecosystems for birds that calm us with their song.  Much work is already being done to green our cities; planting more trees is a top priority for stormwater management, reducing the heat island effect, and the health benefits they bring for urban dwellers.  Organizations such as the Sustainable Urban Forests Coalition and Million Trees NYC are non-profits that have grown recently, dedicated to planting and maintaining our urban forests. Washington DC, for instance, has proudly made tree planting and protection a priority by having an Urban Forestry Administration as part of the District's Department of Transportation. 

But beyond greening our urban landscape, biophilia has a wider focus: to bring more of the natural world in contact with our day to day lives. The Biophilic Cities Project and Partnership for Sustainable Communities are two non-profits working to bring biophila to urban environments. Terrapin Bright Green, a sustainable research & development consultant based in New York, has published several recent white papers on the topic of special interest to the built environment. The 14 Patterns of Biophilic Design and the Economics of Biophilia make the case for incorporating natural systems into our built environment for both financial reasons and to support our wellbeing. Design strategies such as incorporating natural patterns and analogues, creating a visual connection with nature, stochastic sensory stimuli, dynamic lighting, complexity, and the concepts of spatial prospect and refuge explain that creating a biophilic environment is the next step beyond planting trees.  

Research on the physiological effects of natural environments has revealed tangible benefits in stress reduction, concentration, memory, creativity, comfort, healing, and emotion and mood regulation. A few empirical results specific to mental health include:
  • Spatial forms evoking mystery and risk result in a strong dopamine or pleasure response
  • Prospect, or long range views, result in improved comfort, perceived safety and reduced boredom and fatigue
  • Presence of water results in improved concentration, memory, enhanced perception and psychological responsiveness

This is the first in a series of posts where I will explore specific examples of biophilia in urban environments and its relation to mental health, which can be seen as a reflection of our strength and fragility as a species. As humans, we are highly sensitive to our environment. Surrounding ourselves with nature reaffirms that we live in a connected world.
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Clair Wholean, AIA, LEED GA is an architect with DLR Group| Sorg in Washington DC. Her work covers a broad range of project types, from hospitals to schools and community centers. A graduate of Cooper Union, Clair sees architecture as a vehicle for humanitarian and environmental change – health, wellness and sustainability are core principles driving design of a better world. Clair joins UD/MH as a regular contributor to Sanity and Urbanity.

What does Green Building have to do with Mental Health?

10/5/2015

 
Dora Jihyun Yi is a clinical psychologist from South Korea, currently undertaking a Masters degree in global health at Georgetown University. As a UD/MH research associate she has been starting to think about how to leverage links between green building and mental health. 
Have you ever heard of green building? According to the US Green Building Council, green building is defined as ‘a holistic concept that starts with the understanding that the built environment can have profound effects, both positive and negative, on the natural environment, as well as the people who inhabit buildings every day’ and ‘an effort to amplify the positive and mitigate the negative of these effects throughout the entire life cycle of a building’ (Kriss, J., 2014). Green building, which is also called ‘sustainable building,’ is ‘the practice of creating and using healthier and more resource-efficient models of construction, renovation, operation, maintenance and demolition’ (US EPA: Green Building, 2014). Its aims are to reduce the adverse effects of the built environment which impacts on both human and the nature by maximizing the efficiency of energy, water and other resources, minimizing waste and environmental pollution, and improving health and productivity (US EPA: Green Building, 2014). 

The USGBC created Leadership in Energy and Environmental Design (LEED) certification, a rating system to assess how the built environment meets the requirements of green building (Concrete Thinking, 2015). Nationals Park in Washington, D.C. is the first Major League Baseball stadium with LEED certification (USGBC, 2014). It uses energy-efficient field lighting, which anticipates savings of $440,000 over 25 years (USGBC, 2014). The ballpark does not only encourage visitors to use public transportation but also provides parking areas and valet services for bicycles, promoting environmentally friendly transportation without using fossil fuel (USGBC, 2014). The USGB reported that the stadium could save over 4 million gallons of water a year thanks to low-flow faucets and dual-flush toilets as well as air-cooled chillers instead of water-cooled chillers (USGBC, 2014). 

But how about the impact on human health? A literature review article identified that green buildings can benefit both physical and mental health (Allen et al., 2015). For instance, green buildings designed to improve indoor air quality can reduce the incidence of workers’ asthma and allergies, which in turn, can enhance their productivity (Allen et al., 2015). Compared to a conventional hospital, a LEED-certified green hospital indicated a reduced mortality rate of patients, higher satisfaction of employees, and improved quality of care indicating a lower rate of blood stream infections (Allen et al., 2015). According to the Indian Green Building Council, green hospitals designed to maximize daylight and optimize the artificial light can reduce seasonal affective disorder, sometimes referred to as 'winter depression' (Indian Green Building Council, 2015). They found that green hospitals with more gardens and landscape are associated with positive feelings such as pleasantness and calmness for both patients and employees (Indian Green Building Council, 2015). In particular, environmental noise can lead to cognitive dysfunction as well as psychological distress for both adults and children (Stansfeld & Matheson, 2003; Weitzman et al., 2013). Green space can provide buffer to block or reduce environmental noise. 

Living in an environment that incorporates green space is certainly better for our mental health. However, it can be a challenge to create large open spaces or green spaces in highly populated and small land areas such as New York City in the US, Tokyo in Japan, or Seoul in South Korea. Using innovative solutions like green roofs or rooftop gardens are one way not only to reduce environmental noises but also to make it easier to access the natural environment. The initial cost of installing a green roof may be more costly than a conventional roof, but tangible and intangible benefits of a green roof can soon offset the expenses (US EPA: Green Roofs, 2013). These roofs can reduce energy use of cooling and heating; reduce air pollution and greenhouse gas emission; slow storm-water runoff; and improve the quality of life and human health (US EPA: Green Roofs, 2013). 
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Green building is a fascinating and rapidly emerging concept, but its relationship with mental health, especially for specific mental illnesses, is not well documented yet. Interdisciplinary studies to find out the impacts of green buildings on mental health and multi-sectoral interventions to make our environment greener and healthier are needed for the better future.

Questions for further thought

  • What are the most effective ways of achieving exposure to the natural environment in different settings?
  • What is the minimum 'dose' of natural environment exposure needed to achieve mental health benefits? 
  • Do particular countries/cultures build nature into their urban environment in ways that offer lessons for others?

If you have research or ideas about these questions or any others pertaining to the question of green building and mental health, please send us an op-ed to be considered for publication in Sanity and Urbanity. 
References 

1. Allen, J.G., MacNaughton, P., Laurent, J.G.C., Flanigan, S.S., Eitland, E.S. & Spengler, J.D. (2015). Green buildings and health. Current Environmental Health Reports, 2(3), 250-258. 

2. Concrete Thinking. (2015). Benefits > LEED. Retrieved from http://www.concretethinker.com/solutions/LEED-Certification.aspx 

3. Indian Green Building Council. Green Hospitals. (2014). Technical Bulletin. Retrieved from https://igbc.in/igbc/html_pdfs/technical/Green%20Hospitals.pdf 

4. Kriss, J. (2014). What is green building? The US Green Building Council (USGBC). Retrieved from http://www.usgbc.org/articles/what-green-building 

5. Stansfeld, S.A. & Matheson, M.P. (2003). Noise pollution: non-auditory effects on health. British Medical Bulletin, 68, 243-257. 

6. The US Green Building Council (USGBC). (2014). Nationals Stadium. Retrieved from http://www.usgbc.org/projects/nationals-stadium 

7. US Environmental Protection Agency (EPA). (2013). Green Roofs. Retrieved from http://www.epa.gov/heatisld/mitigation/greenroofs.htm 

8. US Environmental Protection Agency (EPA). (2014). Green Building. Retrieved from http://archive.epa.gov/greenbuilding/web/html/ 

9. Weitzman, M., Baten, A., Rosenthal, D.G., Hoshino, R., Tohn, E. & Jacobs, D.E. (2013). Housing and child health. Current Problems in Pediatric and Adolescent Health Care, 43(8), 187-224.

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Dora Jihyun Yi is a clinical psychologist with over 10 years of experience in South Korea. She is currently a graduate student in Global Health at Georgetown University. She is interested in mental health and environmental psychology in architecture and urban design. She was a UD/MH summer research associate, focusing on housing. Read more from Dora here.  

Psychogeography: exploring the brain's reactions to urban design

9/22/2015

 
Colin Ellard
Urban Realities Laboratory, University of Waterloo, Canada

There’s no shortage of research suggesting that cities can be bad for our mental health.  The incidence of depression and psychosis is higher in cities, and though the reasons for this are not yet completely worked out, some simple explanations such as exposure to toxins and pollutants that might be found in greater abundance in cities have been more or less ruled out—most of the clues point to more psychological explanations for the malaise that some experience in dense urban environments.  Some studies have suggested that the stresses that arise in dense settings may be to blame for producing psychopathologies in vulnerable individuals, and some have pointed to the problems of loneliness and isolation that can arise in cities.  City dwellers have to contend with the general problem of living among thousands of strangers, and considered across the broad sweep of human history, this is a recent turn of events and one for which we are not necessarily neurologically equipped.  Early humans, like the more social of our primate cousins, would have lived in small groups where everyone knew everyone and could see and understand what was happening in their small social circle most of the time.  


Urban design can exert a strong influence on our patterns of behaviour and our stress levels.  Both the anonymity of life in a high-rise and the isolation of automobile-centric suburban life can exact a heavy toll on urban residents.  Astonishingly, a recent survey showed that one-third of Americans have never interacted with the people who live next-door to them.


But it isn’t just the maladaptive social pressures exerted on us by city environments that cause undue stress and challenges to our well-being.  What some might think of as the simple aesthetic of an urban environment—the look and feel of a neighbourhood—also produces a measurable effect on our mental health.  One simple and now well-studied example has to do with natural environments.  We no longer think of a city’s green-space as an aesthetic bauble or as the “dessert” of city planning that should be parachuted into place as an afterthought.  In the past, all too often, public places with natural landscapes were squeezed into a setting wherever they could be afforded and made to work.  Now, entire urban landscapes are being dramatically transformed by the careful planning of park areas.  For examples of this, one need only look at the Millennium Park Project in Chicago or the spectacular Highline in New York City. Along with the overwhelmingly positive public response to such spaces, there is plenty of hard-nosed science suggesting that exposure to scenes of nature, even very modest ones, can have a dramatic impact on public health.  In one recent study, a link was made between the density of urban trees on boulevards and a host of public health variables including rates of heart disease and diabetes.

To flesh out our understanding of the critical connections between urban design and mental health, the Urban Realities Laboratory at the University of Waterloo is taking advantage of a new generation of tools to conduct psychological research in the settings that matter—right on the streets of cities.  From 2011 to 2013, as a part of the BMW-Guggenheim Laboratory, we conducted studies in New York City, Berlin, and Mumbai in which we led participants through city streets while we monitored their psychological and physiological states with smart phones and a simple wristband sensor that could measure their stress levels.  We showed participants a variety of different styles of urban aesthetic while we measured their stress levels and their emotional states.
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Ellard's urban walk study in Mumbai
Beyond the well-documented restorative effects of green-spaces, we showed that many aspects of the urban surround can exert a strong effect on our moods, our levels of arousal, and our attraction to particular areas of the city.  For example, we showed that long, unbroken, featureless facades cause passersby to become unhappy, bored, and perhaps even a little angry.  In our studies of urban psychogeography in Mumbai, we discovered that in a hyper-dense city, respite from the crowding and noise of city streets in an empty place (like a quiet churchyard) can produce as much psychological restoration as a refreshing oasis of green might do in a less dense environment.  We’ve also been able to show that although different types of green-spaces might have entirely different contexts and meanings (cemeteries, community gardens, traditional parks) all can produce a profound health-giving restorative response.  Although we don’t yet know how these fleeting changes in thoughts and feelings that correlate with our movements through a city might translate into long-term health measures, it would be surprising if there weren’t such connections, and the current work in our laboratory is devoted to finding them.

In our most recent study, Psychology on the Street, currently underway in the city of Toronto’s downtown core, we are conducting similar studies using walks through a set of carefully curated locations.  In addition to the measures that we used with our previous work, we are now also able to measure brain-waves and eye movements while participants walk the streets.  We will be able to tell precisely what features of the urban surround are attracting the attention of our participants and what effects the sights and sounds of a bustling city street are having on the activity of their brains.  Our hope is that by incorporating such a wide battery of tests and measurements on ordinary people walking through a typical urban streetscape, we can work towards a more complete understanding of more of the psychological connections between person and place in a dense urban environment. 
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Ellard's Psychology on the Street study, Toronto
There has never been a more pressing time for us to understand the psychological impact of urban development on the human brain.  

More than half of the world’s population now live in large cities, and the construction of hyper-dense cores is taxing the abilities of city planners to provide the infrastructure that is needed to provide services and transportation to those who live and work in these dense clusters.  But just as important as such bread-and-butter concerns as the provision of good public transport, power grids and sanitation are the psychological affordances of these teeming centers of human activity.  With projects such as our Psychology on the Street, we are hoping to contribute to the most important discussion of all:  how can urban design contribute to the mental health and resilience of a large population of overtaxed and stressed citizens?  How can psychology help to make successful cities possible?

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Colin Ellard is a cognitive neuroscientist at the University of Waterloo in Canada, and director of its Urban Realities Laboratory.  He works at the intersection of neuroscience and architectural and environmental design.  His recent book Places of the Heart: The Psychogeography of Everyday Life (2015) is published by Bellevue Literary Press.

Meet Greg Bratman, researcher at the nexus of mental health and nature experience

9/8/2015

 
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Greg Bratman is a PhD Candidate in the Emmett Interdisciplinary Program in Environment and Resources at Stanford University. He is working to define and study “psychological ecosystem services” by examining the impact of nature experience on human cognitive function and mental health. He is exploring approaches for evaluating the psychological impacts of nature, and how these can best be incorporated into the paradigm of ecosystem services.
What are your research interests, Greg?

I work in the nexus of biology and psychology, studying the impacts of nature experience on human cognitive function, mood, and emotion regulation.
 
You've just published a research study that looks at the links between nature and mental health. What got you interested in this subject?

My interest in this area comes from a desire to investigate the value that natural landscapes may provide for people with respect to mental health.  Following in the footsteps of the compelling work before me in environmental psychology, I set out to determine whether I would obtain empirical evidence for the impact of nature experience on cognitive function, mood, and emotion regulation, using the tools of psychology.   I also want to explore ways of incorporating this evidence into urban design and decision making.


Briefly, can you describe what your study involved?

38 people came into the lab and filled out a questionnaire on their current levels of rumination (repetitive thought focused on negative aspects of the self). They also underwent a brain scan. They were randomly assigned to a 90-min walk in either a natural setting (a park near Stanford) or an urban setting (beside a busy street in Palo Alto).  Upon completion of the walk, participants filled out the rumination questionnaire again, and underwent a second, follow-up scan.  We analyzed whether there was a differential change in nature vs. urban walkers in both self-reported rumination (the questionnaire) and in a part of the brain that has been shown to be active during rumination (the subgenual prefrontal cortex). 

What did your study find?

Participants who went on a 90-min walk through a natural environment reported lower levels of rumination and showed reduced neural activity in an area of the brain linked to risk for mental illness compared with those who walked through an urban environment.

How do you believe that exposure to nature achieves this impact on people's mental health?

This is an active area of exploration for us — and we hope to publish some findings on this soon.

Given that your study involved healthy participants, do you think the nature exposure is more likely to help prevent depression, or could it also be helpful for people who are already depressed?

We do not know the answer to how nature experience will impact rumination in depressed individuals, as our study focused on healthy participants.

What are the practical implications of your study's findings for urban planners, designers and developers?

More work needs to be done in this arena, but our work, along with the work of others, is helping to contribute to an overall body of evidence that nature experience provides benefits to human cognitive function and mood.  This knowledge can inform the ways in which urban planners incorporate nature into cities, and provide accessible natural landscapes for urban and suburban residents.  It can also provide support for conservation of open space and wilderness areas in policy design.

What's next for you in your research? (And what would you like to see other researchers address on this topic?)

We are exploring our hypothesis that emotion regulation shifts are a possible causal mechanism for the cognitive function and mood benefits that we have observed to be resultant from nature vs. urban experience.  I hope that other researchers continue to explore both the characteristics of the impacts of nature experience, possible causal mechanisms, and how these impacts may or may not be moderated by individual differences.

For people who want to learn more about the links between nature, urban design, and impact on mental health, what other research studies or other resources do you recommend they might like to read?

There is more to list here than room allows, but I would start with a great textbook which was recently published entitled Environmental Psychology by Linda Steg (Editor), Agnes E. van den Berg (Editor), Judith I. M. de Groot (Editor)— it includes a great overview of theory and some of the classic studies in this area.

Learn more about Greg Bratman's study:

Read the original research paper in the Proceedings of the National Academy of Sciences of the United States of America.

Read about the research in the New York Times. 

Watch Greg talk about his research in this video:


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