People shape their physical environments - and vice versa. As such, cities provide both resources (e.g., job opportunities, cultural diversity) as well as stressors (e.g., crowding, noise pollution) to their residents and visitors. In this context, numerous studies illustrate a considerable influence of the built environment (townscape, architecture) on health and well-being of interacting people. This impact ranges from physical aspects (e.g., traffic safety, particulate matter) to psychological processes (e.g., stress, loneliness) and behavioral aspects (e.g., physical activity, social behavior). At the same time, phenomena such as homelessness, crime, or mental disorders (e.g., substance addictions, schizophrenia) occur more frequently in cities compared to rural areas, illustrating causal as well as selective processes in the relation of urban environment and mental health. Increasing overall incidences in mental disorders (especially anxiety disorders and depression), the short-term shortage of psychotherapeutic care as well as the long-term economic burden on the health care system ask for a twofold strategy in public health: a) an extension of preventive measures with low threshold, i.e., accessible by large shares of the population, b) an extension of mental health literacy, which will empower the population to be attentive to mental health issues in themselves and others and which in turn can help to reduce stigmatization. While urban green and blue spaces have been researched in terms of restorative environments - allowing to regenerate resources consumed during the day - the built environment is still a resource for this strategy that has received insufficient attention to date. Utilizing the urban built environment not only as restorative but also informative and engaging environments thus affords an opportunity to address and potentially foster mental health and mental health literacy in citizens across socioeconomic backgrounds.
Aspects of mental health, society, space and environment share entangled relations being studied in health geography. Recreational spaces as well as places that are commonly perceived as strenuous, unsafe, or highly stressful are unevenly distributed within urban areas, which is also associated with spatial differences in mental disorders. Spaces in general represent social constructions that reflect power inequalities; they are filled with subjective emotional resonances and sometimes visualize stigmatization of specific groups. As such, the interplay of socio-demographic factors, socio-economic factors and built environment is complex. To capture these entanglements represented in heterogeneous user groups, participatory approaches promise valuable insights. Yet, despite their great potential for fostering mental health in urban space, participatory approaches are still less common in health geography. Therefore, critical voices question whether the limitations of marginalized groups have been sufficiently considered in this field of study so far. Similar challenges arise in urban planning processes: Specific (vulnerable) groups such as children, women, foreign residents, and people with disabilities or elderly people are insufficiently included in planning processes, leading to an underrepresentation of their needs in the resulting environments. To tackle this shortcoming, the approach of co-creation offers a process in which participants jointly develop a solution without being the object of research or interview partners, but creators. Using rather practical or creative (e.g., joint mapping of the built environment, photo-elicitation) than discursive techniques allows contributions from population groups otherwise often excluded from planning processes. Despite certain limitations, participatory approaches promise the possibility to develop appropriate and just solutions in urban mental health.
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