A Whole New

A University of Virginia professor has imagined an entirely new way to design urban areas for optimal mental health, at a time when people around the world have had to live largely in isolation in the past year and a half because of the coronavirus pandemic.

The approach is cataloged in a new book, “Restorative Cities: Urban Design for Mental Health and Wellbeing,” co-written by Jenny Roe, director of the School of Architecture’s Center for Design and Health.

“There is the Center for Active Design in New York, which promotes and sets out attributes of a city that helps physical health and walkability,” said Roe, the Mary Irene Deshong Professor of Design and Health in UVA’s Department of Urban and Environmental Planning. “But we’ve paid very little attention to urban design for mental health.

“We’ve all had to live and work at home in our local neighborhoods,” she said. “We’ve come to rely on those local neighborhoods for all sorts of social contacts and essential services, such as groceries at the local store. And I sense there’s a feeling for change in our local environments. And this demand for change has also come at a point in time when mental health is no longer a taboo subject.”

Interestingly, Roe and her co-author, Layla McCay, director of the Centre for Urban Design and Mental Health in London and a psychiatrist and public health specialist, began working on the new approach long before the coronavirus changed the world. They started writing the book in 2018 and delivered the manuscript to the publisher, Bloomsbury, in the spring of 2020, in an incredibly prescient move. She and McCay then tailored the book to take into account the coronavirus pandemic.

Roe’s passion for this work is rooted in the contrast of her childhood experiences of walking in the beautiful Yorkshire dales and Scottish Highlands and then moving, as a young professional, to a so-called “sink estate” community in London, places that are characterized by having high levels of social and economic deprivation.

“I was working as a landscape architect in the 1980s in very deprived communities in London, trying to improve the quality of outdoor space, and had this hunch that the quality of these spaces could really impact health and well-being and help with the mental health stressors of living in those deprived neighborhoods,” she said. “We lived right by a busy flyover with streams of traffic, and the air pollution was thick.

“That is what propelled me into a career in landscape architecture, and then environmental psychology,” she continued, “in order to evidence the value of access to high-quality outdoor spaces, including public parks, for the people who live in those types of housing estates.”

Her new book is based on 50 years of research in restorative environments, which is an approach to architecture and urban design that benefits mental health. It is laid out in seven chapters on such concepts as “The Green City,” “The Blue City” and “The Sensory City.” And the approaches are tailored to enhance existing urban areas as well as designing new spaces.

Let’s take the chapters one by one.

Roe says not only can urban vegetation clean the air and filter noise, but it can also reduce depression and stress and even improve our sleep.

“With green space, we’re not saying you have to have a host of large urban parks. You can have a series of smaller, pocket parks that are connected by tree-lined avenues, tree-lined streets or a canal way or green trails. But the connecting pieces are critical for access and walkability.

“I think there’s a problem in Charlottesville at the [moment],” she said. “We’ve got some really lovely green trails, but they’re not [all] connected to parks and they’re not connected together. If you’re looking to walk four or five miles or cycle four or five miles in the city safely, it’s quite difficult to do right now.”

Water has a calming effect that Roe and her co-author say is essential in redesigning urban spaces. That means increasing access to “blue space” in the heart of the city. “Water is probably one of the most restorative attributes of an environment,” Roe said. “It’s a dynamic attribute that moves with light and wind; we can touch it, and it fosters curiosity and wonder in all of us. It’s highly conducive to supporting mental well-being. But we need to provide safe access and equitable access.”

The right kind of sound in a city is also key to good mental health, Roe said. Creating a sonic refuge – a bird sanctuary for example, or a place of quiet – or a kinetic sculpture that dynamically interacts with the wind can promote restorative health.

“So as well as reducing unpleasant noise,” Roe said, “we can also introduce what I call ‘positive soundscapes.’ Acoustics in the city are most often thought of in negative terms, but we need to understand the benefits of positive soundscape to the people living amongst them.”

Roe said this concept is designing for “conviviality” which is the antidote to loneliness and isolation, and even boredom. “We call it ‘the neighborly city’ in the book. How we build strong social networks, the way we design our streets and our residential blocks and how well they’re connected to each other is super important for people’s social relationships. And in turn, if you have strong social relationships, you’re much less likely to develop mental health problems,” she said.

The active city incorporates more daily activity into people’s lives by consciously bringing in more opportunities for walking or biking, activities that support mental health as well as physical health.

“Active living integrates physical activity into everyday life and enables mobility and walkability and other modes of independent transit, like skateboarding or traveling by scooter, for all ages,” Roe said. “There are a lot of mental health benefits associated with walking and being safe, including improved brain health and memory functioning – particularly important for older people and in child development.”

Roe says the benefits of play for child well-being are well-known. “But in the book, we’re arguing for an all-age play approach. We don’t stop being creative and being curious when we hit our teens. We have a need for curiosity and wonder in our environment across the lifespan.”

When people think of play, they often think of fixed playgrounds for children, or perhaps skate parks. “These are really important facilities,” Roe said. “But we argue in the book for are other playable concepts in the city. They’re not necessarily designed for play, but they allow playful activities to take place”

Take parkour, for example, in which people use the attributes of the built environment to jump, skip or step from one structure to another as a kind of obstacle course.

“Another example is interactive exhibits – the Cloud Gate in Chicago, for example, a mirrored gigantic bean where you see yourself in reflection in the context of the city, more playfully,” Roe said. “I think the ideas on play are some of the most innovative in the book because we’re making a case for urban design using non-conventional play contexts.”

“When we say inclusive, we mean designing for all ages, genders, all races and ethnicities or sexual orientations, all socio-economic strata, and for the whole range of physical, sensory and cognitive needs. … many of whom are forgotten in urban design,” Roe said.

She points to novel urban development in Barcelona, where there are so-called “Super Blocks,” which, among other things, have co-created the urban environment with residents of all ages and socioeconomic strata, and include mixed-use, mixed-age living, with vehicle-free zones to encourage walking, play facilities and picnic tables for outdoor eating and social interaction.

Roe and McCay say that at a time when the coronavirus pandemic has placed increased pressure on mental health care services, this new approach to urban design is essential.

“It’s become easier to talk about mental health during COVID-19. This presents a real opportunity,” Roe said. “And that’s what the book is trying to leverage: the public health opportunity to enhance our environment that we live in, work in and move through on a daily basis, for mental health and social well-being.”

Roe said the book demonstrates how to put mental health “right at the heart of urban design.”

“It’s really clear to us, the authors, that we’ve really got an opportunity to use the built environment for mental health that we haven’t seized,” she said. “And at the minute, particularly with COVID-19, whilst we’re past the worse, we don’t know what’s ahead of us. [The pandemic] released this tsunami of mental health problems. We’re still processing the impact of this COVID era in which we’ve all suffered from uncertainty, anxiety, loss, whilst also still living with it.

"When you combine mental health stressors with increasingly dire issues related to climate change and social justice issues like hunger, food insecurity and health care, Roe said the world has a “golden opportunity right now to seize the day, because I think people are looking for more from their local neighborhood.”