Mental Health

Building for mental wellness: A Case for Mindful Cities Part II

Urban design and development needs a new focus, and it’s mental wellbeing

Masawa

We have explored the interaction between mental health and the physical quality of the spaces we live in, we have recognised the stress that cities put on our bodies and minds, and aspire to build communities that support our wellbeing. We believe this can be done by bringing people into close and frequent contact with nature and with one another, designing for people as biological organisms and nurturing a love of place. We look at cities and spaces that have understood the importance of building for wellness in urban areas, ones that are creating restorative and nurturing spaces, and draw inspiration from what an ideal city would look like — one that meets the psychological needs of its inhabitants.

For centuries, people have been fascinated by imagining what the city of the future could look like. Contrary to what people once thought, moving sidewalks or nuclear-proof underground cities haven’t become commonplace yet. The picture they painted was one where technology ruled, where skyscrapers pierced through the heavens and flying cars made roads redundant. Quite strikingly, nature wasn’t invited to the party and inclusive community spaces were nowhere to be found. Wellbeing, it seems, was not as exciting as the technological advancements of our wildest imagination.

In light of what we know today, let’s ask that question again. What would today’s ideal city look like?

Mental health is a key asset for long-term sustainable development and nurturing this asset is critical to ensure that people can live creative and productive lives. It is clear that there is a need for urban designers and planners to help create spaces in cities that increase social capital — the links, shared values, and understandings in society that enable individuals and groups to trust each other and work together. Creating a mindful city means putting wellness at the forefront, offering a soothing atmosphere to regain strong bonds between each other and our environment, which in turn leads to happier and healthier communities.

Our neighbours and our environment can play an important role in improving psychological distress. Doctors are already “social prescribing”, encouraging patients to engage with others, often around an activity such as gardening to tackle anxiety, loneliness, and depression. Green and blue prescribing is the use of nature-based activities for improving the physical and mental health of individuals. However, all too often these remedial approaches are treating poor health. Preventative care that supports people to lead healthy lives may not only be more effective and efficient, but could prevent long-term poor health and mental distress. By designing our surroundings with a heightened awareness towards the users’ needs, we can facilitate lifestyle changes and shift the focus from mental illness and treatment to wellbeing and prevention.

Picture this: you head out of your home only to be just a few minutes away from a park where a local meet-up group is enjoying an outdoor tai-chi class. Walkers and cyclists are safe from traffic, enjoying wide roads shadowed by trees and flanked by running water in a harmonious meeting between occupants and their natural environment. Biodiversity is thriving. You wouldn’t recognise that you were in the city centre. It feels energetic and vibrant, nurturing your senses rather than overwhelming them. When you look up, you discover natural elements intertwined with the highrises on which they live. Pedestrians are prioritised, having space to wander, and traffic is no longer ubiquitous. Evening arrives and warm-coloured street lights are ephemeral, turning on when someone approaches and off when nobody is around. People feel safe and confident to engage with others and contribute to their communities.

We know that exposure to nature, whether it be spending time outside or looking out on natural landscapes, reduces anger and stress while increasing pleasant feelings. The incidence of depression within urban areas has been shown to be lower when people have access to green spaces, and some cities are leading the way. Singapore is already one of the world’s greenest cities with one third of its land covered in trees, moreover, as part of the city’s Green Plan 2030, every home will be no more than a 10 minute walk from a park and the city is setting aside an additional 10 square kilometres of green space.

© Niels Devisscher

As humans, we are genetically programmed to find these settings attractive and biophilic design, an idea already making waves across the globe, seeks to satisfy our inherent need to connect with nature. The concept aims to create architecture as an extension of nature, using natural elements of lighting, ventilation, and landscape into contemporary architecture. Biophilic design can be incorporated everywhere from our workplaces, indoor gyms, buildings, or even entire highways. The Relink project by Urban Scale Interventions, a Belfast-based multidisciplinary design studio, is using biophilic design ideas to reshape the Northern Irish city. By drawing inspiration from interventions such as the Catharijnesingel in Utrecht or the High Line in New York City, the aim is to transform the westlink motorway and bridges currently dividing and polluting the city into a massive linear park stretching North to South. Solutions such as this one where accessible spaces and inviting paths of biodiversity are created will undoubtedly make for a healthier and more prosperous city, while also caring for our planet.

With our environment and lifestyles increasingly removed from nature, we now face the attention-depleting effects of urban living. Studies have confirmed that biophilic design could in fact remedy these drawbacks by reducing stress, enhancing creativity, expediting healing, and improving our wellbeing. If spending time in nature actually replenishes the attentional and cognitive resources that are depleted by urban environments, we can only hope that more of our cities will be moving towards greater green and blue spaces in the near future.

“I cannot say exactly how nature exerts its calming and organizing effects on our brains, but I have seen in my patients the restorative and healing powers of nature and gardens.”

Oliver Sacks, Everything In Its Place

People are the heart of cities. Urban spaces have the capacity to bring people together, and therefore should be striving to create social harmony in everyday life. Social interaction increases our feeling of belonging and helps us cope with life’s challenges. Urban design should work to reinforce inclusion and foster a greater sense of community between people by facilitating natural and positive interactions. Creating pro-social spaces through walkable neighborhoods, creative public seating, and multi-use open spaces present the opportunity for cooperative community events and socialization. Breeding this sense of belonging through engaging and inclusive spaces makes people feel safe and confident in order to thrive within their community and contribute to society.

Take for example the Friendship Bench programme in Zimbabwe. Following a number of atrocities in the country and the lack of healthcare professionals, grandmothers have taken to the park benches. With no previous experience in counselling, the community volunteers offer a listening ear to anyone struggling with their mental health. Today, grandmothers are being trained in evidence-based talk therapy and have helped over 30,000 people. This unlikely solution to an enormous treatment gap has now been empirically vetted and expanded to other countries. Creating physical spaces that ignite creativity and intimacy can sometimes provide beautiful solutions.

A number of projects, organizations, and think tanks have put wellbeing at the forefront of their urban work. Jonathan Rose Companies is a mission-based real estate, urban planning, development, and investment firm with projects that support the wellbeing of communities by balancing opportunity between residents through mixed-income residential units and community spaces. Similarly, Denmark’s visionary residential project, The Future Sølund, is transforming a nursing home into a multi-generation and neurodiverse community. These projects bring together a broad range of ages and backgrounds promoting close contact and learning between groups while immersed in urban gardens and multi-purpose spaces.

At a city-level, Singapore, the world’s second-fastest ageing society, has prioritised friendlier public spaces such as community gardens where the elderly can relax and socialize, as a way to combat urban loneliness and the rising rates of suicide among older adults. Since 2017, the city has also freed-up plots of land for people to farm together, fostering closer social bonds between all age groups. The island’s Therapeutic Horticulture Programmes uses gardens filled with fragrant and edible plants to engage the senses. Suitable for people with dementia, therapeutic gardening has been shown to stimulate memory, encourage positive social interactions and connection with nature, as well as have a calming effect, lift moods, and instill hope in visitors. The horticulture intervention has proved successful in promoting psychological wellbeing of the elderly of Singapore, and not surprisingly, the success of the intervention was attributed to the positive relations that it fosters.

It is unquestionable that regular physical activity has been proven to help prevent and treat a variety of noncommunicable diseases both physical and mental. But in a world where gyms and fitness apps have become commonplace, we seem to have, paradoxically, almost entirely removed physical effort from our day-to-day lives. Whether it be walking, cycling, sports or active forms of recreation, our spaces should be promoting the pursuit of everyday physical activity, and fortunately there are limitless possibilities for designing cities that do so. Encouraging active transport has already been prioritised in many cities as an opportunity to integrate movement into the setting in which people live, work, and play. Any visitor to Copenhagen or Utrecht will agree that well-connected sidewalks and safe cycling lanes are often more attractive modes of transport than driving. Copenhagen aims to be the world’s best city for cyclists by 2025 by creating cycling routes separate from car traffic, connecting the entire city from the waterfront to the city centre with routes accessible and comfortable for all. In Utrecht, bikes now outnumber people and there are measurable benefits from their incentive; though the city spends a (whopping) 55 million dollars annually to build and improve bike facilities, the savings from reduced air pollution-related healthcare costs are estimated at 300 million dollars a year.

Studies have shown that the more greenspace available, the more physically active the people. Moreso, using the natural environment for physical activity weekly halves your risk of poor mental health. From China to Denmark, outdoor gyms have been springing up and providing opportunities for people of all ages, abilities, and incomes to exercise. There are more than 600,000 pieces of outdoor equipment in China, and Copenhagen, a city with 600,00 inhabitants, has over 60 places equipped for outdoor training. Far from the fetishization of autonomous vehicles and flying cars, the ideal city would invest in smarter (and likely less-costly) solutions to our transportation challenges, integrating those with our need for physical exercise and social inclusion where possible. Things as simple as walking loops in parks, sports fields and running routes in low-income and minority neighbourhoods, and expanded cycle-paths go a long way when it comes to wellbeing.

When was the last time you got a proper night’s sleep? Not interrupted by wailing ambulances, honking cars or glaring street lights. Although we have somewhat unconsciously grown accustomed to eroded sleep patterns, the long-term damage it causes is significant. Sleep is an extremely important protective factor for good mental health and the quality of sleep experienced by being near the soothing sound of crashing waves or in the silence of the mountains, differs drastically from the man-made noise pollution characteristic of the city.

What if sound sleep wasn’t just limited to weekend getaways? Thankfully, there are plenty of solutions for making our urban centres more friendly to sleep and rest. Noise pollution can be kept out through improved building insulation as well as the use of plants and trees to dampen and filter out sound. Imagine a city that not only replaces old roads with smoother asphalt, but improves the soundscape quality of our spaces by using pleasant noises like running water to mask the sound of traffic.

In the same way that forests can shelter our minds, the night sky has long been a source of human wonder and exploration. We shouldn’t forget the wonderful cosmic landscape just above us, and our cities should do more to protect it for the health and wellbeing of all living beings. Prioritising downward-facing street lamps and using warmer colour lighting versus blue-rich white lights would avoid poorly targeted and unnecessary glare. While some cities are already attempting to bring darker skies back, more tangible steps are needed towards protecting this vital, yet overlooked, natural resource.

As climate change has been a growing threat to our planet, it has also been a threat to our mental health. Feelings of anxiety, depression, and grief can arise from confronting the fact that the world is running out of time to limit the irreversible damage we are causing. We imagine a city that could address eco-anxiety through urban design choices — creating energy-efficient buildings, reusing and recycling waste energy and materials, and obtaining energy from cleaner sources. We should be living in a city that is not only taking action to create change, but is also providing the opportunity for its inhabitants to do their part by supporting lifestyle changes compatible with their values.

As part of Singapore’s Green Plan, the island is planting 1 million trees to cut pollution, new diesel cars will be banned and the recycling infrastructure will be improved. In line with this vision, Singapore is creating its first smart and sustainable town, Tengah, known as a new eco-development of over 40,000 homes. At surface level, its centre is entirely car-free allowing more space for cycle routes, parks, and community farms. The energy efficient town will have smart lights switching off when no one is around and house a 100-metre-wide eco-corridor for wildlife to safely pass through. Human Nature is also envisioning the sustainable city of the future. As a development company and campaigning business, they aim to build and inspire a new generation of healthy and sustainable neighborhoods where people can live life within the planet’s limits. Using investment and urban design, they are crafting places that stand the test of time while fostering diverse communities and resilient economies. These projects embody the concept of living amidst nature, as well as amongst each other, in harmony with our environment.

© Niels Devisscher

We know that cities can be taxing on our attention and can lead to cognitive overload due to constant stimulation. How could we use sensory inputs to nurture perception rather than swamp it with overload? Certain cities have cleared their streets of advertising in order to promote the health of their people and the environment. Sao Paulo was one of the first cities to ban urban billboards, digital signs, and advertising on buses, and several US states as well as the city of Chennai and Grenoble followed suit.

Although planners and urban designers mostly focus on how a place looks, sight is not the only sense through which we experience spaces. Conscious environments engage and evoke occupants at deeper levels and harmonize us with our surroundings. Through the design and placement of objects, urban form, and environmental characteristics, we can create areas of sensory stimulation that combine all our senses and impact our perception, emotion, and overall experience of wellbeing. They say smell is the garden of memory, and our memory is deeply intertwined with our emotions. Beyond the predominance of audio-vision determining practices of urban design, using smellscape to improve the sensory experience of our cities can create warm and pleasant feelings for its inhabitants. Our daily sensory encounters impact our wellbeing, and designing cities with senses in mind can enrich us in a purposeful way.

Nurturing cities would not just consider the needs of the young and dynamic — assuring their transportation and productivity, but would also consider the needs of its older adults, and particularly those with cognitive decline. As we age, we begin to exhibit substantial difficulty in our navigation abilities and memory, this is especially true for adults suffering from dementia. Alzheimer’s disease causes a degeneration of the hippocampus, the region of the brain associated with spatial and episodic memories, causing people to experience disorientation¹. We must strive to understand which aspects of our urban spaces are most important for successful orientation and how these can be best positioned in order to create a more friendly environment for all. For example, by providing wayfinding guides that point to civic destinations and activities of daily living, and preserving traditional architecture and landmarks that have defined a place for generations. We should promote urban design that reduces decision-making, reduces the need for wasted circulation, and makes streets comfortable and energetic, without being overwhelming. Advocating for roads with more right-of-way to pedestrians and features that make walking safer and more pleasant can address the needs of our aging population.

Recent studies have shown that the neurodiverse population also differs in their navigation strategies², adding to the already challenging experience of excessive crowds, lights, and noise found in cities. One project chose to create an inclusive and supportive space for convening, play, and healing to better service those with differing needs. Restorative Ground by WIP Collaborative was born from the COVID-19-related social isolation and the need for public spaces for both recreation and reconciliation. An installation in Manhattan’s Hudson Square neighborhood, the project consists of a multifaceted landscape of exploration with a range of experiences and interactions between residents and the broader public. It fosters collective engagement using research about inclusive play spaces for people of all ages, backgrounds, and spectrums of neurodiversity. Using a range of colours, shapes, materials, and textures in order to distinguish between the focused, active, and calm experiential zones, it offers both high and low stimulation. This project responded to its community’s needs and we can only hope our cities will do the same.

We tend to project emotions, thoughts, and memories onto people and places, influencing how they make us feel. Like humans, cities can bear wounds from traumatic events generating negative associations and impacting our mental map of those places. Consider sites of suffering and loss such as the Berlin Wall and the World Trade Center Site in Lower Manhattan. Although the physical scars of these places are barely visible today, the history of the trauma lives on and can remain present for its visitors. Symbolic attributes of a place are important in understanding people’s psychological response to their setting. A physically damaged environment has an emotional impact on its inhabitants and can instil feelings of insecurity, distress, horror, and vulnerability. A place that was once safe can now feel threatening.

Urban planning must strive to reconcile the city and their communities. The ideal city would consider areas where a traumatic event occurred and explore how urban design can contribute to reducing individual and public distress caused by that place. Designing with recovering features can transform a place of trauma into a place of healing. When individuals return to places with a history of pain and suffering, but which are now being cared for, the safe space can condition a new response, catalysing new memories and emotional attachments for its community. Such a designed environment provides stability and peace, finds reconciliation with the past and embraces the future, preserves sensitive memories and opens up the possibility for a new and nurturing spatial narrative to emerge. Both the Berlin Wall and Ground Zero were transformed into a memorial. These memorials are a powerful reminder that we all, individually and as a group, have the potential to recover and rebuild.

Other locations may not have been physically hurt by an event but could represent a space of distress, such as bridges or overpasses that have frequently been chosen to attempt suicide. Our Future Foyle, Urban Scale Intervention’s first public health project, understands that the spaces we use everyday affect how we feel and think, impacting our health and our perception of a place. The Foyle Reeds project in Derry, Northern Ireland will transform the river Foyle and its bridge lining it with digital “reeds” that move in the wind and change colour. The sculptural installation will not only act as an innovative physical prevention barrier, but as a dynamic and colourful art installation changing the perception of the bridge for its community.

Japan has some of the highest rates of suicide in the world, and while the subject still remains relatively taboo, the country has recently focused on suicide prevention through urban design. Installing physical platform barriers to prevent access to the train line has been shown to deter suicide attempts or draw attention to them, enabling others to press public panic buttons before the train approaches. A Japanese study suggested that installing soothing blue lights in train stations was associated with a reduction of suicides³. Today, you can find blue light installations at a train crossing in Scotland, and at Gatwick airport train station.

The cities of the future need to be healthier, adapting and responding to human needs. We have considered how to develop better person-environment interactions through urban design in order to reduce urban stress, and improve our wellbeing. Interconnected land uses, biophilic design, non-motorized modes of transportations, and plenty of public and common open spaces foster and improve social capital. Providing restorative spaces for people to cross paths, play, learn, and cooperate with each other develops a sense of community and conviviality — important ingredients for individuals to generate positive relations, feel a sense of autonomy, and reach their unique potential.

Designing such spaces presents an opportunity to improve our lives and it is imperative that we take action to do so. We have looked at the conditions in urban spaces needed for humans to thrive, and we have surveyed some of the most inventive approaches already taken to create planet- and people-friendly places. How can we implement these solutions and enable real change in order to ensure the wellbeing of future generations? How can we form better cities, so that they in turn, form better minds?


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