Urban Life and Mental Health

Having recently moved to Washington DC, I’ve been feeling pretty fortunate to have quickly found a place to live in a convenient, vibrant part of the city. Perhaps, I thought, years of moving between different cities has finally given me enough insight to avoid the pitfalls I’d made in the past. Pride comes before a fall though, so I probably should have seen it coming when a new study was published recently that found DC to have the highest proportion of psychopaths of any state in the rest of the US – more than twice as high, in fact, as the next state. I mean, it’s not as bad as finding out that you’re living downwind of the sewage treatment plant, but it certainly paints a place in a new light…!

In reality, this isn’t all that surprising. Even though the press coverage of the study honed in on the potential link to the high density of politicians living and working in DC, the other explanation the study authors proffer is more mundane. While there’s plenty of anecdotal evidence that politics tends to attract a higher proportion of people displaying psychopathic tendencies (see for example Jon Ronson’s book The Psychopath Test – well worth a read), DC differs fundamentally from other US states because it’s essentially just a city – there’s no rural and not much suburban space within the district borders, making comparisons with the other, much larger states unfair.

Cities, after all, are notorious for their ill effects on mental health. Environmental stressors like pollution and crime are more concentrated in cities, and despite the density of people living in close proximity social isolation is also rife. Schizophrenia, depression, and anxiety are common in city dwellers, and although this may reflect a tendency that those facing mental illness issues may be more likely to move to cities, city life doesn’t necessarily benefit those affected.

The building body of evidence to support this case should be a wake-up call for policy makers and city planners. As cities increase in size as rural populations around the world move into urban settings to seek economic and social opportunities, the effect on mental health is likely to become more acute, especially if steps aren’t taken to structure cities in a more open and humanist way. Rapid growth in cities like New Delhi has led to urban sprawl without significant space for parks, social spaces, or indeed anything other than accommodation.
City planners in some places are coming to grips with these questions. Research suggests that time spent in parks is of huge benefit to those dealing with mental health challenges, as is increased socialisation. I was encouraged to see Layla McCay, the director of the Center for Urban Design and Mental Health, citing the Barbican in London as a positive example for cities around the world to follow. For those who’ve never visited, the Barbican is a whole nest of buildings that fill a city block in the centre of London, with an art gallery, conservatory, museum, cinema, and other amenities situated within the warren of concrete and glass. Many in Britain think of the Barbican as a ghastly Brutalist eyesore – it’s a product of the stark concrete design style favoured by 60s architects that Prince Charles referred to as ‘monstrous carbuncles’, but it’s a masterpiece of urban planning.

The Barbican Conservatory. Image: R Emberson 2018

I lived in the Barbican for 6 months, about 2 years ago, and I loved it. I don’t object to the brutalist concrete as much as some people, but more than anything it felt like living in a community; I’ve never lived in another city where people are as friendly to their neighbours, even if they might only vaguely recognise them. The crowds of residents around the central lake reading and talking at the weekends highlighted, for me, the abundance of thought that went into the design. I’d contrast it with my experience in other cities; I’m not particularly extroverted by nature, so while I loved living in Berlin (for example), there was often a sense of personal isolation, even with so many people living nearby. Perhaps that reflects my status as a foreigner and the cultural (and, to a lesser extent, language) barriers that entails (a post for another time), but I’d argue urban design played some role.

Even while I enthuse over it, the Barbican may not be the perfect model for every new city block. But it is worth considering how cities are designed at a macro scale; parks, space for socialising, and an awareness of the risk of urban life exacerbating mental health problems are all essential building blocks for more humanist cities in the decades to come.

A bigger lesson, perhaps, is the importance of linking our nascent and evolving discussion in society about mental health with more broad social and cultural questions, like urban planning. Even as health outcomes improve for many diseases and disorders, we’re rapidly becoming more aware of the prevalence and importance of mental health crises. It’s not limited to cities, either; lack of economic opportunities and social mores changing too fast to keep up with are driving problems in rural areas, as evinced by this powerful account from Kamloops, in Western Canada. At the same time, cities are rapidly expanding all over the world as rural populations migrate, changing these dynamics. Let’s at least ensure we have these discussions openly; whether urban or rural, increased awareness should act as a rising tide to lift all ships. There are concrete steps we can take now, even as individual citizens, whether reducing pollution or supporting social events in city neighbourhoods, and we can find the impetus to make these changes from these initial discussions about our mental well-being in cities.


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