Journal of Urban Design and Mental Health 2018;4:3
Editorial
Taking into account young people’s mental wellbeing and rights with large scale urban developments
Emilios Lemoniatis (1) and Andre Schott (2)
(1) The Tavistock and Portman NHS Foundation Trust
(2) Fitzrovia Youth in Action
(1) The Tavistock and Portman NHS Foundation Trust
(2) Fitzrovia Youth in Action
The HS2 project aims to deliver increased rail connectivity between London and cities of the Midlands and the north of England. It may be one of the largest-scale building and regeneration projects of our lifetime. As part of the project, many buildings and areas have been requisitioned, either to rebuild housing or as part of the new structures that are required. One of the affected areas is Fitzrovia, around Euston in London.
This 2 minute video, made with young people who live in the Fitzrovia area, explores the real-life impact of urban development on young people’s lives and mental wellbeing:
This 2 minute video, made with young people who live in the Fitzrovia area, explores the real-life impact of urban development on young people’s lives and mental wellbeing:
Young people speak about about the effects of urbanisation on their mental wellbeing and their community
Two reflections on the film and its relevance for both developers and mental health services:
The loss of open spaces caused by the HS2 project, including the loss of a playground and sports pitch, is quite worrying. Regular physical exercise and access to nature and greenery have positive influences on mental health and wellbeing. Many young people do not exercise enough and could benefit from more access to nature and green spaces. We know that young people are less likely to travel around and visit places they are not familiar with or are outside of their daily travel routines. It would be interesting to see this mapped out more properly but I have a strong feeling that the loss of green spaces around their homes could have a bigger impact on them than on adults who are more likely to travel to visit parks or go out of town.
I think people are only just starting to realise what the impact of HS2 might be. Remember this project will last for many years and works have only just began. The real impact will be felt when families have to move home, when buildings start to come down, roads are closed off and local people witness the on-going disruption caused by construction works. While the impact on those who are forced out of their homes and their community are most worrying and obvious, there are also concerns about the impact on those who will remain. There is a real danger that the HS2 works may cause a deterioration of both the environmental and social conditions around the Regents Park Estate, which already has high levels of poverty and obesity, with many of our young people living in overcrowded households.
I think people are only just starting to realise what the impact of HS2 might be. Remember this project will last for many years and works have only just began. The real impact will be felt when families have to move home, when buildings start to come down, roads are closed off and local people witness the on-going disruption caused by construction works. While the impact on those who are forced out of their homes and their community are most worrying and obvious, there are also concerns about the impact on those who will remain. There is a real danger that the HS2 works may cause a deterioration of both the environmental and social conditions around the Regents Park Estate, which already has high levels of poverty and obesity, with many of our young people living in overcrowded households.
Over millennia, communities have had to face disruption and have had to rebuild themselves - at great cost - and resilient communities can pull through. However, this video succinctly illuminates the high amount of risk factors associated with developing mental health difficulties to which young people and their families may be exposed through a large scale building programme such as HS2. These include:
These risk factors can all be all hugely detrimental to a young person’s wellbeing, and can be potential cumulative precipitants of mental illness such as depression, anxiety or trauma.
Further consideration also needs to be given to the longer-term impact of such developments, for instance school exam results impact on college or university offers, which in turn impact on work opportunities available to these young people for the rest of their lives.
The impact of large developments for an individual and a community can be huge. For instance, the development associated with HS2 is expected to last for at least seventeen years. Architects and designers need to design for wellness both in the actual design of their products and through maintaining wellness during the duration of the development/build- particularly in consideration of children and young people. Big builds and construction need to consider the mental health consequences of their build to those around them and consider the big ethical questions that need to be raised whenever considering a new build: is there potential for harm (including mental wellbeing) to the community? And how can this authentically be mitigated?
Today, in the world we are trying to create, we have opportunities to work together and provide support with thoughtful and careful consideration to meet these challenges. For example, in the case of the HS2, identifying any particularly vulnerable young people and their families with the HS2 team would be a priority. Mental health professionals could be working with the planning teams to support the young people and the community of an area that is impacted upon by a large scale build such as HS2. For instance, mental health teams have a responsibility for the populations of affected areas, such as Fitzrovia.
Unicef has attempted to develop a guide for city planners and developers called The Child Friendly Cities and Communities Initiative. This is based on the principles and rights of the United Nations Convention of the Rights of the Child (UNCRC-1989) signed up-to by almost every single state in the world. The principles of the Child Friendly Cities and Communities Initiative are designed to be adaptable to suit different cultures and contexts worldwide. Indeed, one of the London boroughs Barnet, adjoining Camden, is a signatory. The seven principles of this rights based approach are:
Considering children and young people holistically, within their family, school and environmental context is fundamental to considering and maintaining their mental wellbeing:
“Every child has a right to life and each child and young person should enjoy the same opportunities to flourish as to be safe, healthy, grow and develop. From birth to adulthood, children and young people develop in many different ways – physically, emotionally, socially, spiritually and educationally – and different professionals should work together to help make this happen.”
In terms of considering the principal of Life, survival and development, recently, there was a sudden evacuation of The Chalcots Estate blocks of flats in Swiss Cottage, London, due to cladding on the multi-story buildings failing fire safety checks. This was just after the Grenfell Tower Disaster where many people dies following a tower block fire considered to be due to faulty cladding. When the Chalcots blocks were evacuated a Children and Families mental health team was on-hand to manage any potential urgent mental health needs for children, young people and families. How can local Child and Adolescent Mental Health teams provide for the ongoing needs of a longer term urban development which could span years? Can the specific mental health needs be identified and resourced? We could be using the particular situation with HS2 as a process from which to learn how to manage large scale developments in the future more intelligently. From a public health perspective, we could take a data driven approach that helps us both monitor and review the situation. I wonder what the health needs of this community group of young people will be like over this seventeen-year period and beyond.
- Stress
- Sudden loss of home
- Sudden loss of community
- Disruption in the middle of exams
- Uncertainty
- Poor air quality
- Reduced urban green recreational spaces for families and young people
- Pollution, noise and traffic
These risk factors can all be all hugely detrimental to a young person’s wellbeing, and can be potential cumulative precipitants of mental illness such as depression, anxiety or trauma.
Further consideration also needs to be given to the longer-term impact of such developments, for instance school exam results impact on college or university offers, which in turn impact on work opportunities available to these young people for the rest of their lives.
The impact of large developments for an individual and a community can be huge. For instance, the development associated with HS2 is expected to last for at least seventeen years. Architects and designers need to design for wellness both in the actual design of their products and through maintaining wellness during the duration of the development/build- particularly in consideration of children and young people. Big builds and construction need to consider the mental health consequences of their build to those around them and consider the big ethical questions that need to be raised whenever considering a new build: is there potential for harm (including mental wellbeing) to the community? And how can this authentically be mitigated?
Today, in the world we are trying to create, we have opportunities to work together and provide support with thoughtful and careful consideration to meet these challenges. For example, in the case of the HS2, identifying any particularly vulnerable young people and their families with the HS2 team would be a priority. Mental health professionals could be working with the planning teams to support the young people and the community of an area that is impacted upon by a large scale build such as HS2. For instance, mental health teams have a responsibility for the populations of affected areas, such as Fitzrovia.
Unicef has attempted to develop a guide for city planners and developers called The Child Friendly Cities and Communities Initiative. This is based on the principles and rights of the United Nations Convention of the Rights of the Child (UNCRC-1989) signed up-to by almost every single state in the world. The principles of the Child Friendly Cities and Communities Initiative are designed to be adaptable to suit different cultures and contexts worldwide. Indeed, one of the London boroughs Barnet, adjoining Camden, is a signatory. The seven principles of this rights based approach are:
- Dignity
- Interdependence and indivisibility
- Best interests
- Participation
- Non-discrimination
- Transparency and accountability
- Life, survival and development
Considering children and young people holistically, within their family, school and environmental context is fundamental to considering and maintaining their mental wellbeing:
“Every child has a right to life and each child and young person should enjoy the same opportunities to flourish as to be safe, healthy, grow and develop. From birth to adulthood, children and young people develop in many different ways – physically, emotionally, socially, spiritually and educationally – and different professionals should work together to help make this happen.”
In terms of considering the principal of Life, survival and development, recently, there was a sudden evacuation of The Chalcots Estate blocks of flats in Swiss Cottage, London, due to cladding on the multi-story buildings failing fire safety checks. This was just after the Grenfell Tower Disaster where many people dies following a tower block fire considered to be due to faulty cladding. When the Chalcots blocks were evacuated a Children and Families mental health team was on-hand to manage any potential urgent mental health needs for children, young people and families. How can local Child and Adolescent Mental Health teams provide for the ongoing needs of a longer term urban development which could span years? Can the specific mental health needs be identified and resourced? We could be using the particular situation with HS2 as a process from which to learn how to manage large scale developments in the future more intelligently. From a public health perspective, we could take a data driven approach that helps us both monitor and review the situation. I wonder what the health needs of this community group of young people will be like over this seventeen-year period and beyond.
Overview of HS2 impact
Construction of the HS2 scheme in Camden is set to last 17 years.
Expected impacts on Camden include:
HS2 Residents Charter
No 6: Respect the wellbeing of our communities, minimising disruption to their lives with local mitigation plans and activities, ensuring we meet the standards set out in the Code of Construction Practice.
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/629939/hs2_residents_charter.pdf
Construction of the HS2 scheme in Camden is set to last 17 years.
Expected impacts on Camden include:
- Homes: 220 homes will be demolished (including 136 council homes), meaning up to 1,000 people could lose their homes.
- Noise: 1,300 homes will be affected by noise that requires mitigating measures. Measures are already in place to consider up to another 750 homes.
- Traffic: 1.2 million tonnes of demolition, construction and waste material will need to be removed from the Euston station site and its approach during redevelopment. The net effect is up to 800 daily two-way lorry movements in the Euston area during busiest periods, and 90% of those lorries will be heavy goods vehicles.
- Air pollution: An adverse impact on air pollution levels at 78% of 198 of locations modelled by HS2 in the Euston area as a result of the scheme.
- Open space, trees and facilities: St James’s Gardens next to Euston station will be lost forever. Euston Square Gardens will be closed for the duration of construction. 504 trees are expected to be removed. Community facilities will also be lost.
- Schools: Seven schools and one children’s centre are in the Euston impact area.
- Businesses: 73 businesses will be directly impacted by demolition. 145 businesses are located within the safeguarding area (including those to be demolished). Over 300 further businesses are located in close proximity to major construction works. 2,915 jobs are at risk of loss or displacement.
- Cost: In 2013 the immediate ‘bricks and mortar’ cost to Camden was estimated to be just over £1 billion, to compensate costs such as housing, displacement of businesses, education and transport.
HS2 Residents Charter
No 6: Respect the wellbeing of our communities, minimising disruption to their lives with local mitigation plans and activities, ensuring we meet the standards set out in the Code of Construction Practice.
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/629939/hs2_residents_charter.pdf
Further reading
Child Friendly Cities - a website resource
About the Authors
Emilios Lemoniatis is a Consultant Child and Adolescent Psychiatrist with over 10 years of experience working with communities and mental health issues. Emilios has been in a lead role for Public and Patient Involvement in Child and Adolescent Mental Health at The Tavistock and Portman NHS Foundation Trust where he also trained. The role includes listening to the voices of service users and working with marginalised communities to ensure that their needs are considered and responded to. Emilios has a particular interest in design thinking and its use in mental health services: both for creating services that de-stigmatise metal illness as well as enhancing mental wellbeing.
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Andre Schott is Chief Executive and Founder of Fitzrovia Youth in Action. This is a ground up charity, which aims to amplify the voice of young people. It was started in 1997 by a group of volunteers in the Fitzrovia area of Camden, London, and has since grown to become a large team. The charity helps young people share their views and opinions through a variety of creative and active projects, including exceptional videos made by young people.
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