Psychological Design

Urban Mental Health


The overall proportion of people living in urban areas has been increasing rapidly, and the speed and extent of urbanization has been astonishing. The concept of cities has given way to urban areas, sprawls, or urban conurbations. The worldwide urbanization has been caused by a number of factors, of which globalization and industrialization are only two of the factors. These have certainly contributed to the speed of urbanization.

Why should living in cities be bad for one’s mental health? It is not an idealized perception that the rural idyll is better.

Epidemiological findings from a number of countries and settings confirm higher rates of psychiatric disorders, including alcohol and substance use in urban areas, although many authors have challenged this view and findings. Often, healthcare facilities are more likely to be situated in urban areas—whether these meet the demand or are due to ease of urban comfort.
Architecture, structures, urban spaces, and processes all play a role in the mental health of individuals. Culture embedded in urban spaces and areas is also important in moulding mental health and help seeking. Youth culture has its own needs and is influenced by urban spaces. Social determinants affect mental health and well-being, and these include urban poverty, lack of green spaces, unemployment, overcrowding, lack of proper public transport, and other factors. Aspiration and discrepancy with achievement can add to poor mental health. Migrants, even when they are from the country, do carry with them stressors related to life events and lost support and values, which can precipitate or contribute to poor mental health.

In this volume we bring together experts in the field of urban studies and mental health. We have been fortunate in our authors, who have delivered their chapters in spite of their busy schedules. We are grateful for their enthusiasm
and their contributions. Our thanks are also due to Pete Stevenson, Senior Commissioning Editor at Oxford University Press, and to his team, especially Lauren Tiley and Rachel Goldsworthy, for their unstinting support.

Dinesh Bhugra
Antonio Ventriglio
João Castaldelli-Maia
Layla McCay


Contributors ix
Abbreviations xiii
Section 1

Urbanization and processes
1 Introduction 3
Dinesh Bhugra, Antonio Ventriglio, João Castaldelli-Maia, and Layla McCay
2 Sociology and the study of cities 16 Anthony M. Orum
3 Urban design and mental health 32 Layla McCay
4 Globalization and urbanization 49 Debby Darmansjah, Gurvinder Kalra, and Dinesh Bhugra
5 Internal migration and internal boundaries 59 Antonio Ventriglio and Dinesh Bhugra
6 Why urban environments matter for refugee mental health 73 Peter Schofield
7 Urbanization and mental health 83 Mauro G. Carta and Dinesh Bhugra
8 Urbanization and marginalization 96 Michael Krausz, Verena Strehlau, Fiona Choi, and Kerry L. Jang
9 Neuroscience of mental illness in the city 108 Jan Golembiewski
10 The psychogenic city 121 Francesca Solmi and James B. Kirkbride
11 Cross-cultural contact: psychosis and the city in modern life 152 Shuo Zhang, Vishal Bhavsar, and Dinesh Bhugra
12 Research challenges 170 Todd Litman

Section 2

Mental ill health in cities
13 Urban design for adolescent mental health 189 Jenny Roe and Alice Roe
14 What has changed in children’s behavioural problems reported in Mexico City over a 13-year period? 204 Jorge Javier Caraveo Anduaga, Nora Angélica Martínez Vélez, and José Erazo Pérez
15 Common mental disorders in cities 226 Santosh K. Chaturvedi and Narayana Manjunatha
16 Suicide in cities 239 Kairi Kõlves, Victoria Ross, and Diego de Leo
17 Sex in the city 249 Dinesh Bhugra and Antonio Ventriglio
18 Gender and sexual minorities 258 Richard Bradlow, Neha Singh, Suraj Beloskar, and Gurvinder Kalra
19 A tale of two cities: urban mental health in Vancouver and New York City 269 Kerry L. Jang, Michael Krausz, Christopher Van Veen,
and Michael Jae Song
20 Urban design for mental health in Tokyo 283 Layla McCay, Emily Suzuki, and Anna Chang
Section 3

Challenges in Urban Settings
21 Urban mental health strategies 303 Todd Litman
22 Re-conceptualizing urban spaces: towards recovery and reintegration of women living with mental disorders 322 Shubhada Maitra
23 Work, worklessness, and mental health 337 Jed Boardman and Tom K. J. Craig
24 Conclusions 354 Dinesh Bhugra, Antonio Ventriglio, João Castaldelli-Maia, and Layla McCay


Suraj Beloskar, Medical Officer, Ganesh Darshan Co-op Society, Mumbai, India
Vishal Bhavsar, Department of Psychosis Studies, Institute of Psychiatry, London, UK
Dinesh Bhugra, Emeritus Professor of Mental Health and Cultural Diversity, Health Service & Population Research Department, Institute of Psychiatry, King’s College London, London, UK
Jed Boardman, Consultant Psychiatrist and Senior Lecturer in Social Psychiatry, Centre for Mental Health, London, South Bank University, London, UK
Richard Bradlow, Hospital Medical Officer, Gippsland Rural Intern Training Program, Latrobe Regional Hospital, Victoria, Australia Jorge Javier Caraveo-Anduaga, Senior Researcher, National Institute of Psychiatry ‘Dr. Ramón de la
Fuente Muñiz’, Mexico City, Mexico Mauro G. Carta, Department of Social Sciences and Public Health,University of Cagliari, Cagliari, Italy
João Castaldelli-Maia, University of São Paulo Medical School, São Paulo, Brazil Anna Chang, Southern California Institute of Architecture, Los Angeles, CA, USA
Santosh K. Chaturvedi, Professor of Psychiatry & Dean Behavioural Sciences, National Institute of Mental Health and Neuro Sciences, Bangalore, India
Fiona Choi, Research Associate, Institute of Mental Health, Department of Psychiatry, The University of British Columbia,
Vancouver, Canada

Tom K.J. Craig, Professor of Social Psychiatry, Institute of Psychiatry, Psychology & Neuroscience King’s College London, London, UK
Debby Darmansjah, Resident Medical Officer, Latrobe Regional Hospital, Traralgon, Victoria, Australia
Diego de Leo, Emeritus Professor of Psychiatry, Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, Australia
Jan Golembiewski, Psychological Design, Sydney, Australia Kerry L. Jang, Professor, University of British Columbia, Vancouver, Canada

Gurvinder Kalra, Psychiatrist, Flynn Adult Inpatient Psychiatric Unit, Latrobe Regional Hospital Mental Health Services, Victoria, Australia

James B. Kirkbride, PsyLife Group, Division of Psychiatry, University College London, London, UK
Kairi Kõlves, Principal Research Fellow and Course Convener at the Australian Institute for Suicide
Research and Prevention, Griffith
University, Brisbane, Australia
Michael Krausz, UBC-Providence
Leadership Chair for Addiction
Research, Department of Psychiatry,
University of British Columbia,
Vancouver, Canada
Todd Litman, Victoria Transport
Policy Institute, Victoria, Canada
Shubhada Maitra, Professor, Centre
for Health and Mental Health,
Project Director, Tarasha and
Muskaan School of Social Work,
Tata Institute of Social Sciences,
Mumbai, India
Narayana Manjunatha, Assistant
Professor of Psychiatry, National
Institute of Mental Health and Neuro
Sciences, Bangalore, India
Layla McCay, Director, Centre for
Urban Design and Mental Health
Anthony M. Orum, Professor
Emeritus, Department of Sociology,
University of Illinois at Chicago,

José Erazo Pérez, Research
Assistant, Autonomous Metropolitan
University, Mexico City, Mexico
Alice Roe, Health Influencing
Officer, Age UK, UK
Jenny Roe, DeShong Professor in
Design and Health and Director,
Center for Design and Health,
School of Architecture, University of
Virginia, Charlottesville, VA, USA
Victoria Ross, Research Fellow,
Australian Institute for Suicide
Research and Prevention, Griffith
University, Mt Gravatt Campus,
Brisbane, Australia
Peter Schofield, MRC Fellow and
Wolfson Lecturer in Population
Health, School of Population Health
Sciences, King’s College London,
London, UK
Neha Singh, Medical Officer,
Kalamboli, Mumbai, India
Francesca Solmi, PsyLife Group,
Division of Psychiatry, University
College London, London, UK
Michael Jae Song, Professor,
Department of Psychiatry, University
of British Columbia, Canada
Verena Strehlau, Scientist at the
Centre of Health Evaluation and
Outcome Sciences (CHEOS),
Vancouver, Canada
Emily Suzuki, Tokyo Medical and
Dental University, Tokyo, Japan

Christopher Van Veen, PhD
Candidate, Simon Fraser University,
Faculty of Health Sciences, British
Columbia, Canada
Nora Angélica Martínez Vélez,
Researcher, National Institute of
Psychiatry ‘Dr. Ramón de la Fuente
Muñiz’, Mexico City, Mexico

Antonio Ventriglio, Psychiatrist,
Department of Mental Health,
and Department of Clinical and
Experimental Medicine, University
of Foggia, Foggia, Italy
Shuo Zhang, Health Service and
Population Research, Institute of
Psychiatry, London, UK

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