NSW Mental Health Commissioner Catherine Lourey sat down with the Cities Leadership Institute to talk about the urban environment and mental health, the ‘Living Well’ strategic plan and the role of local government in supporting community health and wellbeing.
CLI: How would you describe the relationship between the built-environment and mental health?
Catherine Lourey: Good mental health is essential - not just for our personal wellbeing, but also to sustain resilient, healthy city populations. Urban areas provide great opportunities but also sometimes overwhelming stimuli, like crowding, traffic and noise. This can result in increased stress, leading people to retreat to their private spaces and reject the social connections that promote good mental health.
City dwellers often have less access to the things that improve our wellbeing - nature, exercise and, strangely, a sense of community. Compared to people who live in rural or regional areas they have an almost 40% increased risk of depression, over 20 % more of anxiety, and double the risk of developing schizophrenia. But it doesn’t have to be this way. There is clear evidence that urban design can help promote good mental health, help prevent mental illness and help support people with mental health problems.
CLI: What initiatives has the NSW Mental Health Commission put forward to address this?
Catherine Lourey: The field of urban design for the promotion of mental health is expanding rapidly. Currently the NSW Government, including planners at all levels of government, is working to incorporate health, including mental health, into urban design. The Mental Health Commission is working with various agencies to ensure policies and designs have a favourable impact on wellbeing.
Mental health is not the sole responsibility of one agency. It is our responsibility as individuals, and the responsibility of all agencies under the NSW Government. The community and urban planners can play a vital role in our future wellbeing. The NSW Wellbeing Collaborative, established by the Commission in 2015, works across Government and community organisations to support wellbeing initiatives, to share knowledge about wellbeing and promote innovative and successful wellbeing activities. It aims to embed consideration of mental health and wellbeing across the design of programs and policies, and in workplaces and the community more generally.
On another front, in Sydney last year the Greater Sydney Commission hosted an International Initiative for Mental Health Leadership (IIMHL) event on ‘Urban Planning Supporting Health and Wellbeing’. Leaders, including the Mental Health Commission, exchanged knowledge on how people's health and wellbeing can be improved by quality urban planning. The event included a site visit to Wollondilly Shire Council to engage with their social planning strategy. Last year the Mental Health Commission also met with the Greater Sydney Commission to introduce the work of the NSW Wellbeing Collaborative. We are continuing to work with them to look at wellbeing and liveability measures in Sydney. Later in 2018 another IIMHL event will focus on ‘Building bridges beyond borders: Cities and urban regions as platforms for mental health.’
CLI: In a recent interview, you said ‘People live and recover in the community, and that is where our investment should be’. Can you tell us more about community based support programs?
Catherine Lourey: The NSW Mental Health Commission's vision is for people who experience mental illness to live satisfying, contributing lives in their community. For this to occur a network of services must be in place that is holistic and comprehensive, encompassing both clinical services and the social supports that people need to stay well in the community. This includes housing, employment, education and social participation.
CLI: What does your strategic plan ‘Living Well’ aim to do?
Catherine Lourey: Living Well is an effective community system that wraps services and support around people living with severe mental illness. The strategic plan articulates a whole-of-government, whole-of-life, whole-of-community vision for mental health and well-being in NSW. It’s about strengthening community-based responses to mental health needs, and shifting the mental health system away from acute crisis care towards prevention and earlier intervention. It highlights the importance of integrated care and a whole-of-government perspective on mental health and well-being.
CLI: So how do we create more inclusive cities,
that have a positive impact on the community and also improve mental health?
Catherine Lourey: Simple things like improved street lighting and housing layout can increase a sense of safety. Creating green spaces and better connections between people can also help to improve mental health. Plenty of open, green spaces encourage outdoor social activity, as well as a sense of community.
CLI: How do you see this relating to local governments? What can they do to ensure they are planning for a positive and inclusive community?
Catherine Lourey: There is a real opportunity for urban planners to have a great impact on mental health and well-being. The world in general, including Australia, is becoming increasingly urbanised. Cities can be enormously supportive of mental health and well-being, such as providing cultural opportunities and employment. We also need to give at least equal consideration to the 'soft' infrastructure of human relationships and social support systems as we do to the 'hard' infrastructure of roads, pipes and power lines.
CLI: Finally, what are urban design elements that can improve mental health?
Catherine Lourey: Internationally, the Centre for Urban Design and Mental Health in Georgetown suggests four broad approaches to supporting mental health through urban design and planning; Green space, active space, social space and safe space.
Green spaces must be built into our everyday life. This means green space that you can see and experience around your home, see from your work place or eat your lunch in.
Active spaces are essential for encouraging walkable, easy activity and are a great opportunity for physical and mental health.
Social spaces promote natural interactions, even simple measures like chessboards, benches and gym equipment in parks can help us to be more social.
We must design our built environment around safe spaces in order to reduce the propensity for crime, traffic and even useability for people with cognitive disabilities. Other factors to consider are housing design and homelessness. Housing design, neighbourhood design and the availability of affordable housing have immense impacts on our mental wellbeing.