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Monday, 7 May 2012

Healthy Built Environment Part 4 – Mental Health and wellbeing

It could be speculated that second to obesity reduction, improvements in mental health and wellbeing are the most sensitive to built environment manipulation. 

From a mental wellbeing perspective, integration and blurring of socioeconomic gradients arms future adults with social skills, competence, relations that will contribute to their success and reduce the likelihood of maladaptive behaviours like truancy, delinquency, education incompletion, addictions, teen pregnancy amongst a whole range of less healthy choices that can put individuals are risk.  Mental health promotion starts in infancy and should be focused on younger school age settings. 

Community design can support a sense of collegiality through encouraging the likelihood of inclusion and reducing the possibility of social isolation.   Precluding drive through services may sound like a good way to improve air quality, but likely also has the potential to increase socialization.  It is not sufficient, but is an enabling mechanism.

Planning for the 1-3% of persons with major psychotic disorders who are challenged to be integrated requires strategically placing group home settings where positive socialization will occur.  We will all be surprised about how housing that supports the socially disabled aggregates in areas poverty, addiction and crime – only to wonder why current approaches are not successful.

Conversely negative psychological stressor, particularly those that are repetitive have the potential to exacerbate some mental illnesses.  Crowding, noise, smells, and excessive nighttime light are known to be stressors, although their long term impacts on 12% of Canadians with mental anxiety disorders are not well determined.  Neighbourhoods challenged by these physical stressors tend to be perceived as less desirable and hence more convenient for locating subsidized housing including group homes. Graduates from group home settings tend to  remain in reasonable proximity during their transition times.   Thus a confounded relationship between location and mental illness would be expected.  

Depressive symptomatology may be exacerbated by physical surroundings, however it is apparently not documented whether such surroundings contribute to the development of clinical depression which affects up to 8% of the population. .  

Nor have physical factors in the environment been manipulated to determine the ability to intervene on any of the mental illnesses.  Given the plethora of seniors housing communities that have developed, it would seem that some cohort analysis of the geriatric psychiatric impacts of different seniors housing options would be one of the easiest studies to undertake, if you are aware of such a study, please let DrpHealth know  (drphealth@gmail.com)

A literature search on the topic of mental health and the built environment will not result in anything more than a similar superficial scan of the potential impacts.   It seems to be an area where real investment is justified given the over 20% of Canadians that will experience a significant mental illness. 

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