According to the United Nations, in 30 years, two-thirds of us will live in cities. 

And one of the things we need to think about as we expand our urban footprint is mental health.

Research suggests people living in cities may have a harder time with mental health.

“City life damages mental health in ways we’re just starting to understand,” says Kate Baggaley on Popular Science.

According to Junus van der Wal, lead author of a paper published in The Lancet Psychiatry journal 

“Life in the city is attractive in many ways, but it also has various unintended disadvantages”. “Understanding the complex relationships between urban factors and mental health is vital for treating common mental disorders.”

This is particularly a cause for concern in India, where we have some of the world’s most populated and polluted cities.

Here, we look at 7 ways to make Indian cities better for mental health.

#1 – Safety

Mental health in a city begins with its citizens feeling safe.

In a deep dive into principles for designing safer cities EMBARQ Network looks at what city planners can do.

“Avoid urban sprawl,” they say, recommending compact connected blocks with easy access to facilities. The article suggests zones for pedestrians and cyclists and slowing down traffic.

Source: The City Fix

Chandigarh comes to mind as a relatively safe design, with “sectors” that house facilities like shopping areas, schools, and hospitals in each sector with easy access to transportation outside.

But safety is a lot more than sidewalks, bicycle zones, and even hospitals.

For women especially who cite. In an article on why women don’t seem to walk as much as men, The Guardian cites personal safety as a major reason women use vehicles more often than men do. 

Kalpana Viswanath is a co-founder of the safe-cities organization Safetipin, a company that makes apps to analyze the safety levels of cities.

She highlights the importance of key actions, like

• Developing visible, well-lit areas
• Simple things like avoiding high walls
• Having plenty of street lights and cameras in place.

#2 – Greenery

The National Center for Biotechnology Information (NCBI) emphasizes the importance of green space for mental health by incorporating green spaces into the design of buildings and facilities. They conclude that

“Green spaces provide vital health services as well as environmental services; they are equigenic, reducing socioeconomic health inequalities, facilitating activity and promoting better mental health and well-being.” 

This is backed up by the National Academy of Sciences, USA, which says “Residential green space in childhood is associated with lower risk of psychiatric disorders from adolescence into adulthood.”

How can we incorporate more green spaces?

• Cities and properties can incorporate walkable green spaces, trees, avenues, and parks into the layout design
• City planners can draft policy, baking needs for greenery into regulatory requirements for commercial properties and public spaces.

#3 – Air quality

Air pollution is linked to the increased severity of mental illness. Research published in the British Journal of Psychiatry reported that exposure to higher levels of air pollution could lead to an increased risk of serious mental health issues.

Nine of the world’s 10 most polluted cities are in India, with the fewest air quality monitors in place, according to this case study. “India faces extreme air pollution and related disease burden,” it concludes. 

The paper notes that “monitor density in India is low relative to comparator countries,” and suggests satellite-derived estimates, speciation, and spatial monitoring.

What cities can do to improve air quality

• Regulate and enforce chimney filters
• Improve public transit services
• Improve walking and bicycling facilities
• Plant roadside trees
• Locate factories spaced apart and outside city limits
• Enforce policies against the use of plastic bags

#4 – Noise

Noise is another big city concern. More people living in smaller spaces means not only increased traffic and commercial sounds but an elevated ambient noise level.

We may filter and ignore conversations, traffic sounds, and machines on a crowded street, but we still hear them, and the buzz has an impact.

Noise, as we know, also severely impacts sleep and stress levels. Mental Health Today cites poor sleep, stress, anxiety, impaired focus, a sense of hopelessness, depression, and exhaustion among effects of noise pollution.

Cities can employ several strategies to control noise pollution like

• Replacing gasoline-powered vehicles with electric vehicles
• Building bicycle lanes and sidewalks that reduce overall vehicle usage.
• Lawmakers can outline policy and enforcement over decibel levels in gatherings and public announcements.
• City planners and approval authorities can incentivize factories and industries outside the cities rather than inside.

#5 – Activity

The link between activity and mental health is well established.

“A review of the evidence for the benefits of physical activity for people with certain mental health conditions – depression, schizophrenia and dementia – indicated improved mood, slowed cognitive decline, delayed disease onset, increased muscle strength, better physical fitness, control of existing non-communicable diseases (NCDs) and a decreased likelihood of developing other NCDs such as diabetes and obesity” says the WHO.

While rural and suburban lifestyles come with a greater necessity for walking, cities too can do a lot to promote regular exercise and activity.

Cities can incorporate activity into city and facility design directly and indirectly by

• Installing walkways and staircases in addition to elevators and escalators in public places
• Installing overhead and underground walkways at street crossings
• Improving public transport, encouraging city dwellers to walk to connecting points
• Installing fitness equipment and aerobic spaces in public parks
• Allocating space for running routes, football pitches, cricket grounds, and other sports in public areas wherever possible
• Offering on-demand rentable bicycles for citizens and visitors

#6 – Sanitation

When we think of sanitation, we associate it with obvious physical angles to health.

But inadequate sanitation facilities pose a threat to mental health as well, especially in cities with large slum populations.

The Journal of Water and Health notes that “…there are psychosocial outcomes associated with the lack of access to safe water and adequate sanitation for both individuals and households in deprived settings.”

When it comes to sanitation, Indian cities can do a lot. We can

• Ensure clean and consistent water supply
• Build and maintain toilet facilities for slum-dwellers and the homeless
• Provide toilet facilities in public places
• Install underground drainage systems with water treatment and recycling plants

#7 – Inequality

Perceived inequality leads to higher levels of anxiety and depression.

“Income inequality has been linked to physical morbidity, mortality, and such psychosocial outcomes as violence…. Within countries, markers of socioeconomic disadvantage (low education, unemployment, and deprivation) and low levels of social capital have been associated with mental illness,” says the NCBI.

Cities can do their bit to tackle growing income disparity and inequality. For example:

• Provide spaces for unregulated workers like food and fruit hawkers to sell wares on streets
• Provide financial subsidies and allocate housing boards for the less privileged
• Improve public school facilities to be on par with private schools
• Provide access to quality subsidized healthcare in areas where people of low income are concentrated

Conclusion

Whether we like it or not, we are all gunning for city life more than ever.

That means we will build new urban areas. Neighborhoods that were villages 20 years ago are now semi-urban. This growth hasn’t stopped despite economic ups and downs, owing to our exploding population levels and infrastructure needs.

With work from home being normalized and existing metros bursting at their seams, we can expect the urban sprawl to spill into corners of the country that offer basics like water and livable weather.

This lays the responsibility on all of us to do our bit and hold our city planners accountable for building more inclusive, green, sustainable, and healthful cities that bode well for our collective mental health.