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Mental Health in the City: Five Key Takeaways

IPPO Cities convened a policy roundtable to explore insights from the pandemic for city policymakers around mental health.  The event discussed how mental health is critical for a place’s productivity, resilience, and economic development, as well as hearing examples of innovative place-based strategies to promote wellbeing.

Jeremy Williams

Here are five key takeaways from the discussion.

1. Place matters

The interface between people and the urban environment is fundamental for mental health.  Place fundamentally shapes our personalities, how we feel, and who we are.  While we have always known this, this insight was brought into sharper focus by the collective experience of the pandemic.

While policymakers, researchers, and citizens are increasingly aware of aspects of urban life which have negative consequences – poor urban planning, for example – psychology can help us define the things which are positive for us in a place, both socially and emotionally.  Living in urban environments is still relatively new in terms of the course of human evolution and psychology can help us think about what a good city “habitat” should be for humans.

Cities and the built environment help provide us with a sense of meaning and purpose.  To help promote this sense, city life needs to be oriented not just around economic value, but also around helping people be mentally healthy.

2. Good mental health is an economic issue

As well as being important socially, good mental health also makes good economic sense.  Psychology is an important facet of wellbeing, with the linkages between a populace with good mental health and economic productivity well established.

Cities can help to maximise productivity by focusing on minimising the social determinants of poor mental health and maximising the good ones.  This can involve a focus on issues like decent work and financial security, as well as on more physical determinants such as access to green space and activities.

As a happy population is a productive one, population mental health can also be framed as an economic resilience issue for the future.  This can be a compelling frame to encourage investment in the kinds of social and physical infrastructure that promotes good mental health.  Similarly, a mechanism for measuring the mental health, psychological, and wellbeing impact of policies can be a fruitful tool for cities to deploy, similar to how many do through economic or equalities impact assessments.

3. Cities should seize the opportunity for a post-pandemic urban planning

The pandemic has changed the way we think about what matters in a city with a key challenge being not to let this opportunity slip.  One important aspect of this moment can be to involve mental health and psychology in urban planning, equipped with the knowledge and new perspectives about urban life that the pandemic has given us.

Good mental health can be placed at the centre of thinking about what it means to be a successful and thriving society.  This can include thinking about the way that civic assets improve collective mental health, including the importance of neighbourhood and public realm design to facilitate this.  For example, in Coventry, the city has employed a psychotherapist in residence to participate in a project to redesign the city centre.

Similarly in Bilbao, the city has sought to define intangible elements such as values, principles, and objectives as personality traits of it as a place, and as part of its social infrastructure.  This lens involves planning the city’s future not just as a piece of infrastructure, but also through the lens of the people who live within it.

4. Empowering citizens is key

The experience of the pandemic saw unprecedented collaboration between citizens and showed that it is often communities themselves who best understand their own needs.  A key challenge for city leaders when thinking about mental health is to develop a collaborative approach which supports and facilitates this citizen agency.  It should also seek to avoid communities having the perception that ideas are being imposed upon them from the top down.

Coalitions which have found success in raising awareness of mental health as well as improving access to mental health services have involved a range of different organisations and leaders.  The Thrive approach is a good example of this model, successfully applied across cities as diverse as Glasgow, Amsterdam, and New York.  Such an approach frames mental health and wellbeing as a joined-up, participatory, and community-driven endeavour.

5. Cities are innovating to improve mental health, but local leaders need autonomy

While cities and municipalities are at the forefront of much innovative work on mental health, they require the tools to be able to make the most of their position.  This involves a degree of political autonomy at the city, municipal, or regional level to allow leaders with knowledge of their localities to deploy innovations responsive to the local context.  In the UK, the government’s Levelling Up agenda provides an opportunity to use a focus on wellbeing at the local level to help people lead stronger, healthier, and happier lives.

The pandemic saw a reduction in life satisfaction, and an associated increase in anxiety, depression, and loneliness.  Place-making work which focuses on psychology and mental health has a huge amount to offer in reversing these trends.  However, local leaders require meaningful autonomy to enable these opportunities to be seized.

Participants at the roundtable included Chris Murray of Core Cities UK, Steve Appleton of the International Initiative on Mental Health Leadership, Nancy Hey of What Works Wellbeing, and Idoia Postigo of Bilbao-Metropoli 30.