Emerging research from the fields of both psychology and cognitive neuroscience tells us that being social is fundamental to being human. And yet, despite the intentions of urban designers and planners in constructing a built environment that meets our needs, we can no longer deny that our involvement in creating an urban landscape is often driven more by the forces of laissez-faire capitalism and less by the empirical evidence of urbanism that fosters good mental health and well-being.
At the face of what I dub ‘urbanisms of mass destruction’, this auto-critical stance is no longer a luxury for designers but rather is an existential wake-up call to the complex realities that shape the built environment. Only through a sincere admission of our failure to understand those nuances and apply them in our design can there be a reckoning that may lead to a different future. This editorial is less about urban design’s role in ameliorating specific mental health issues but is more about the meta-narrative of how American urbanism and the state of the mental health in the United States of America are woven together.
To examine how these strands entwine, let us consider two trends. The state of mental health in the United States is dismal to say the least. First, there has been an increase in the rate of antidepressant use in this country among teens and adults (people ages 12 and older) of almost 400% between 1988–1994 and 2005–2008. Secondly, over a 12-month period, 25 percent of adults in the U.S. will experience some sort of mental disorder, making the U.S. the country with the highest prevalence of reported mental health problems. Over one’s entire lifetime, the average American has a 47.4 percent chance of having any kind of mental health disorder.
One could argue that the built environment and the structure of the cities themselves are merely co-relational with the state of mental health in the United States. I contend that this logic is akin to the tobacco industry denying their role in the increasing prevalence of lung cancer. Just as the philosopher Descartes used his mind-body dualism theory to argue that the mind and body are distinct entities, designers seem to hold a social-spatial dualism theory for the built environment. And so we, as urban designers, play the ‘innocent card’, ascribing the increasing prevalence of mental disorders to the larger socio-cultural complexities of living in a post-industrial, highly capitalistic society.
But research is starting to change that dualistic and reductionist perception. Certainly many different factors contribute to the development of mental disorders, but amongst those, a corollary can be extended to the built environment. I propose that we are complicit in creating a built environment that contributes to mentally unhealthy standards of the built environment.
Frank Lloyd Wright, the famous American architect, famously made the proposal for Broadacre City in 1934, advocating for an acre of land for all Americans where they could live and grow their own food. This idea of the self-sufficient individual entity (the single family home) had rational logic. But behind this apparent pursuit of the American dream, individuals were walled off from others by white picket fences, forgetting that humans have evolved to be social creatures. And yet, Lloyd Wright’s idea flourished. In the book Bowling Alone, Robert Putnam discusses the consequences: we have become increasingly disconnected from one another, and our social structures—be they PTA, church, or political parties—are disintegrating. In their place, a dystopian existence of isolation has emerged, a Lonelitopia, where collections of loners reside in generic places of ‘nowhere’, lacking the coherent group, strong social bonds, social customs, cultures and connections that foster a sense of mental health, well-being and happiness.
Iatrogenesis is a medical term for the process by which the healer inadvertently harms the patient. Applied in the scenario of the built environment, I argue that architects, planners and urban designers are causing iatrogenic harm to urban populations by failing to consider the determinants of good mental health in their design. Certain spatial morphologies of the cities can, for example, affect feelings of security, and reinforce or prohibit certain social interactions and connectivity that play an important role in the determinants of mental health. Instead, espousing the character of the zeitgeist, our designs have become reductionist and rational, treated as an engineering solution to address immediate needs, rather than considering the complex pathological social condition of the urbanism of the American dream that they would eventually create.
The issue of the mental health has deep connotations for a society. Given the exigencies of the 21st century, from frequent extreme weather events due to climate change to the financial system, urbanisms will have to face stresses, disruptions and disasters. The foundational element of people’s resiliency in such events is their social capital. In the current state, I opine that the loss of such social capital has put the United States in a deep social dilemma.
Numerous studies now show that a fundamental component of being happy is social connections. Our brains are wired to be social and deprivation of such a need undermines our mental health. As designers, playing the ‘innocence card’ will do us no service if we are to recalibrate our profession and discipline taking into consideration the growing empirical evidence that people’s mental health is very much affected by the spatial and social construct of their built environment. We may include the bar and the coffee shop to create life in a place, but unless we address the fundamental unit of our habitation and how they are assembled in the urban landscape, these coffee shops may provide a picturesque quality to our projects but will not be enough to contribute to better mental health. As urban designers, it is our disciplinary obligation to delve deeper into the design consequences of advances in social psychology and cognitive understanding of human beings, through practice and scholarship. The urban designer must embrace the need to restructure the built environment to foster social connectivity, spontaneity and a richness that fosters empathic co-existence.
EDITORIAL published in the Journal of Urban Design and Mental Health