gms | German Medical Science

Background: The environment we live in sets our living conditions, influences behaviour and interactions, and has a profound impact on mental health and well-being. Recent studies indicate that the quality of a city’s environment significantly predicts the quality of life of its inhabitants [1]. The interaction between the built environment and mental health was the central topic in the session on urban mental health.

As more and more people move to urban areas, cities are becoming the most important living spaces of the future. While city life offers many benefits, which can act as health-contributing factors, such as improved access to medical and social care, educational opportunities, and social and cultural diversity, it also comes with the risk of being exposed to a variety of health-threats [2]. Compared to people living in rural areas, city dwellers show a higher prevalence of various mental illnesses such as depression, anxiety and other stress-related disorders [3]. In other words, living in a city can be considered a risk factor for the development of poor mental health.

This is a critical issue for urban planning and one that is becoming more and more important in the light of increasing urbanisation. As cities grow in size and population, so does the need for urban planning that favours a needs-oriented design, contributes to health and safety and fosters the well-being of its inhabitants.

Contribution:

• Inger Heine-Fuster, Javiera Mella, Casa Enjambre Foundation: “Your look tells”: young people’s expression through photography in Santiago, Chile.

Plenary discussion: In plenary and smaller group discussions, participants identified the existing state of knowledge and addressed potential approaches to incorporate mental health aspects in urban planning processes.

In the context of existing knowledge, participants named a variety of potential stressors of urban living e.g. the hectic rush of big cities, loneliness, and social isolation in the presence of overcrowding. Several physical environmental factors that pose a threat to health and well-being, such as noise or heat pollution and inadequate quality of air and water, were named as well. As counteractive measures participants mentioned green and blue spaces most frequently. Their various positive effects on mental as well as physical health were well known within the group. The participants further agreed that cities should not only meet the basic needs of their inhabitants to “have a roof over their head”, but should also provide spaces and facilities that make people feel safe, at home, and help them thrive. It was discussed that cities should preserve safe spaces for disadvantaged groups, places to relax and unwind, and places that encourage people to socialise and interact with each other.

Regarding current knowledge gaps, participants agreed that although mental health plays a key factor in subjective quality of life, it has been given far too little attention in urban planning up to now. Mental health was recognized as a stigmatized topic that needs to be addressed more openly to discuss its influences not only in the context of pathology but in daily life as well.

When talking about the need for actions and possible approaches the factor of social inequality came into play. The built environment not only reflects social inequalities but also contributes as a risk factor to maintaining and reinforcing them. People with lower socio-economic status often live in areas that have less green or blue spaces with higher exposure to health-threatening factors (e.g. noise and overcrowding) and are less likely to be involved in political planning and decision-making processes. Participants advocated for a low-threshold policy approach that aims to reach out to disadvantaged communities in particular and encourages them to point out their personal needs. A city government’s key responsibility in urban planning was deemed the fair distribution of environmental resources and health opportunities to mitigate social inequalities and create a city worth living for all.