Advocacy 

Connecting Civic Life and Mental Health

CfAD’s recently-published Assembly: Civic Design Guidelines reveal evidence-based opportunities for supporting civic life through the design and maintenance of public space. We chatted with Layla McCay, director of the Centre for Urban Design and Mental Health (UD/MH), to discuss how Assembly’s strategies to foster trust can also reinforce positive mental health outcomes.

Layla is a psychiatrist, international public health and health systems specialist, and adjunct professor of international health at Georgetown University. She established UD/MH in 2015 to help increase interest, knowledge sharing, and translational research to improve mental health through smart urban design.

CfAD: As an expert in the field of urban design and mental health, do you see points of intersection between your own research and Assembly’s investigation into civic life outcomes like trust, participation, and stewardship?

Layla: Research identifying links between urban design and mental health demonstrates that belongingness within a neighbourhood helps to support good mental health outcomes. Belongingness helps build social capital and self-esteem, and helps create feelings of understanding and safety in a neighbourhood. These feelings are enhanced by positive, natural social interaction that comes from participating in local activities. Such protective factors for mental health are addressed by Assembly's outcomes of civic trust and appreciation and participation in public life.

Studies show that while public spaces such as parks and plazas can promote good mental health, this depends on their stewardship. A space that is dirty or unkempt and feels uninviting or even threatening will deter use, leaving potential users without the mental health benefits that such spaces are intended to deliver. Meanwhile well-kept spaces attract use. If the local authorities help maintain these spaces, this sends a signal that the neighbourhood population is valued, improving self-esteem, and if the public is involved in their upkeep, that provides further opportunities for public participation, personal pride, and belongingness in a neighbourhood. Such findings from the mental health literature are clearly reinforced by Chapter 2 of the Assembly Guidelines – Prioritize Maintenance.

CfAD: Are there other Assembly strategies or research findings that particularly stand out to you—where place-based initiatives to enhance civic life directly intersect with key opportunities to support mental health?

Layla: Our research at the Centre for Urban Design and Mental Health has found that the urban design areas offering the most opportunity to benefit mental health are: providing access to natural settings, facilitating regular physical activity, fostering pro-social interaction, and enhancing feelings of safety in terms of crime, traffic, and wayfinding. Such concepts strongly intersect with the Assembly Guidelines—notably Chapter 3: Incorporate Nature, Chapter 7: Make Space for Activity, and Chapter 1: Enhance Community Connections.

CfAD: Can you share any examples from your own global work—perhaps a city that’s effectively leveraging public space design to support mental wellbeing, social interaction, and civic trust?

Layla: In Hong Kong, an incredibly dense city, I have observed groups of older people gathering each morning in university plazas to undertake tai chi or chi qigong. I was interested in the shared use of this space—which enabled older people to have daily physical activity and social interaction in safe places with views of nature. The connections created between younger students using the plazas and these older people reinforced a feeling of shared belongingness.

CfAD: Any final thoughts you’d like to share?

Designing cities to actively promote mental health is a relatively new concept—it can feel easier to focus on how places make you feel at the specific moment you are passing through. But research is growing that demonstrates urban design to be a key public health intervention that can help reduce the prevalence and severity of symptoms of many mental disorders, from depression and anxiety, to ADHD and dementia. This approach requires intersectoral working, but it has the potential to reap remarkable benefits across the city. By continuing to advance the research around how urban design impacts holistic health outcomes like mental health and civic life, researchers, design practitioners, and community members can collaboratively work together to foster communities of belonging.

 
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    Evening at West Kowloon Cultural District, Hong Kong. Courtesy of Flickr user johnlsl
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    Older people meet every morning for group exercise at Hong Kong University plaza. Courtesy of Layla McCay
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    Older person reading on a Hong Kong park bench. Courtesy of Mark Hang Fung So via Unsplash