Built Environment and Mental Health
The values of a healthy community are reflected through the built environment. The built environment impacts every facet of our daily lives. Humans place a great deal of importance on their home surroundings, investing time, money, and emotional energy into their neighborhoods. This creates a strong correlation between our mental health and our surrounding built environment. Mental health is a basic human right. It is essential for individual, community and socio-economic development and physical and social well-being.
According to the Centers for Disease Control and Prevention (CDC), mental health is the state of our emotional, psychological, and social well-being. It influences our thoughts, feelings, and actions as well as how we interact with people, manage stress, and make healthy choices. Mental health is more than the absence of mental illness, it is a complex interplay of individual, social, and structural stresses and vulnerabilities.
Mental health is a state of mental wellness that enables individuals to cope with life stressors, realize their full potential, learn, work, and contribute to their community. It is an integral component of health and well-being that supports both our individual and collective abilities to make decisions, build relationships and shape the world we live in. Throughout our lives, multiple individuals, social and structural determinants may combine to protect or undermine our mental health. The physical landscapes and social context of our communities directly and indirectly impact mental wellness.
The built environment impacts a person's quality of life, determining travel times, pollution exposure, and access to parks and green spaces. Additionally, poor housing quality, including neglected maintenance and overcrowding, worsen psychological distress and cause anxiety, panic, and fatalism. Furthermore, certain architectural styles in distressed neighborhoods can cause cognitive tiredness attributable to what are termed as "stress-design features," particularly in low-income mothers of young children. For example, stress design features allow large buildings to cast shadows on someone’s home, limiting sunlight exposure and increasing feelings of loneliness.
The Relationship Between Mental Health & The Built Environment
Many communities in the United States are visibly segregated by land use, and low-income residents often live closer to hazardous facilities than their more affluent counterparts. Acute or long-term exposure to air pollutants can have an impact on mental health and well-being. According to a study by Hoisington et al., outdoor air pollutant exposure during pregnancy may increase the risk of autistic spectrum disorder (ASD) in children. Similarly, indoor air pollution causes chronic low-grade inflammation and could increase the risk of trauma- and stress-related diseases, including PTSD (Post Traumatic Stress Disorder) and depression. Pollution is an issue in Tennessee because there are still coal-fired power plants running. The worst coal ash spill in American history occurred in 2008, not far from Knoxville. According to a study, it was found that people living in the county where the spill occurred suffered considerably more psychosocial stress as a result of the disaster.
Though health policy often addresses the negative effects of waste management facility and incinerator emissions, we should also consider the mental health impacts of these chemicals. Thus, healthy design and land use policy that avoids hazardous chemical exposures can increase both physical and mental well-being.
The vast majority of U.S cities are designed for driving and prioritize cars. Studies reveal that people who live in communities that require a dependence on cars have lower levels of physical activity and higher rates of obesity. Physical activity has also been demonstrated to have a powerful and favorable impact on mental health. Also, poorly planned and unclear development patterns typically lead to longer daily commutes and stress inducing drives.
In mainstream western countries, the majority of health-related and many mental disorders are lifestyle-related, including diabetes, substance misuse, some cancers, and heart disease. For example, if you can comfortably and safely walk to nearby work, shops, and schools, you are more likely to be physically active and less likely to get diabetes. Also, quick and easy access to bike lanes, walking trails, parks, and outdoor spaces enables residents to easily incorporate physical activity into their daily lives, leading to increased mental wellness and improved quality of life.
Housing quality may impact a person's identity and self-worth (Evans et al 2003). Over time, worries about structural risks, frustration with one's lack of control over maintenance and management procedures, and fear of criminality create a heavy mental and emotional load. Urban planning frequently prioritizes maximizing profitability at the expense of residential welfare. But healthy planning designs have a powerful impact on residential well-being. They give people access to daylight, which can result in better sleep. View of nature from indoor buildings creates peaceful feelings. Healthy designs can lessen crime, eliminating a source of trauma. Planning buildings with enough flexibility to accommodate both prevents social isolation and provides adequate privacy.
The Covid-19 lockdown forcibly highlighted the importance of every day social connection. Individuals are happier in and around beautiful buildings. Although depression can affect anyone, people are more likely to feel depressed in depressing surroundings. Planners and architects can design buildings to be beautiful, to allow for privacy, to limit noise while allowing social interaction to provide access to nature and natural light, and to promote healthy lifestyles. As stated by Guha and Channon in Mental health in the built environment, “it is possible to design buildings that are socially inclusive."
Parks and green spaces encourage physical activity, a connection to nature, and opportunities for community involvement, all of which have positive effects on mental health. Spending more time outside improves cognitive capabilities and attention and reduces stress levels. Additionally, those who spend more time outside are more likely to report high levels of happiness and well-being and less likely to have depression and anxiety disorders. Those who live near parks and greenspaces are more likely to be physically active, which strengthens mental health and decreases risk of obesity and related diseases.
Parks and greenspaces also improve air quality, control temperature, and mitigate the effects of extreme weather. They are associated with lower health care spending and improved levels of financial security and well-being. According to National Recreation and Park Association (NRPA), neighborhoods with more greenspaces had a 33 percent lower rate of depression than those with less greenspace.
Being social creatures, we depend on one another’s support to survive. This dependence begins in our families and spreads to our communities, neighborhoods, and cities. A strong sense of community and belonging allow people to live to their fullest potential. It encourages people who misuse substances or live with depression or anxiety to engage and talk about their struggles with supportive peers, a vital step on the road to recovery. Neighborhoods, cities, and states can incorporate healthy design principles into their policies and master plans that foster community, gathering, and involvement. This includes providing places and spaces for the community to assemble and socialize. A third place to call home beyond home and work deepens feelings of belonging and fosters social interaction.
To better serve the communities and the population at large, it is necessary to reinvent the approach that we take to mental health. We often take a very individualized approach where we can only treat once a diagnosis has been made, but this method is often difficult and inaccessible. A population health approach offers a higher standard for promoting mental health from the start and focuses on prevention. Furthermore, incorporating mental health as a consideration in funding and planning will better provide resources to individuals to support mental health practices. The “Residency incentive Program” illustrates such intervention strategies in which the state of Tennessee provides incentives for practitioners and residents to work in underserved communities that lack mental health professionals.
Also, community-centered interventions focused on improving public mental health demonstrate a positive effect on mental health outcomes and decrease stigmatization of mental disorders. Therefore, for an effective outcome, there must also be community support and involvement. Common components of community-based activities and tools incorporated to ensure better mental health outcomes include using lay health workers from within the community, focus-group discussion on tackling social isolation, signposting and overcoming structural barriers to access.
In addition, telehealth can provide a greater range of support. Since most people have difficulty accessing mental health services, telehealth is a valuable resource. This was an incredibly useful tool during Covid-19 and is still being used.
Guha, M., & Channon, B. (2020). Mental health in the built environment. Journal of Mental Health, 29(6), 611–613. https://doi.org/10.1080/09638237.2020.1836559
Zumelzu, A., & Herrmann-Lunecke, M. G. (2021). Mental Well-Being and the Influence of Place: Conceptual Approaches for the Built Environment for Planning Healthy and Walkable Cities. Sustainability, 13(11), 6395. https://doi.org/10.3390/su13116395
Larson, L. R., & Hipp, J. A. (2022). Nature-based Pathways to Health Promotion: The Value of Parks and Greenspace. North Carolina Medical Journal, 83(2), 99–102. https://doi.org/10.18043/ncm.83.2.99
Hoisington, A. J., Stearns-Yoder, K. A., Schuldt, S. J., Beemer, C. J., Maestre, J. P., Kinney, K. A., Postolache, T. T., Lowry, C. A., & Brenner, L. A. (2019). Ten questions concerning the built environment and mental health. Building and Environment, 155, 58–69. https://doi.org/10.1016/j.buildenv.2019.03.036