Research has long suggested that our environment and mental health are intrinsically connected. Studies have shown that everything from noise levels to housing can affect our levels of stress, anxiety and depression, as well as impacting our susceptibility to developing conditions like schizophrenia and psychosis.
Professor James Kirkbride, Professor of Psychiatric and Social Epidemiology at the UCL Division of Psychiatry, explains: “While genetics and individual factors are important, they don’t fully explain the patterns we see in the population. For example, why do rates of psychosis vary so dramatically between urban and rural areas, or among different ethnic groups living in the same city? These disparities suggest that environmental exposures, like social inequality, urban stressors, and community cohesion, play a significant role in influencing mental health outcomes.”
Professor Kirkbride has used epidemiology in his research to explore the spatial distribution of mental health disorders and the environmental factors that may underpin them.
“We’ve used cohort studies, case-control designs, and spatial analyses to examine how factors like urbanicity, deprivation, migration, and ethnic density relate to the incidence of mental health disorders. Collaborations with statisticians, geographers, and anthropologists have been key to developing robust models that account for complex interactions between individual and contextual factors.”
The researchers found that people living in more urban, deprived and socially fragmented areas tend to have a higher risk of developing psychotic disorders. People from ethnic minorities also have up to a five times greater risk of psychotic disorders than the white British population, with first-generation migrants who arrive in the UK in childhood among those at increased risk. While the causes of this variation in risk are likely to be multifactorial, current research suggests that groups who live in environments with fewer economic or social resources may not be able to establish stable and secure conditions that are prerequisites to good health.
“This suggests that social support and community belonging are protective factors. These findings highlight the importance of social cohesion, equity, and inclusive urban planning in promoting mental health,” says Professor Kirkbride.
Like all epidemiological studies, there are some limitations to the research. Causality is hard to establish; even if a link is observed between an environmental factor and a health outcome, proving that one causes the other is complex. Many other variables could be involved.
So what sort of changes are needed to ensure that our mental health is protected at environmental level?
“I’d like to see policies that reduce social inequality, improve housing quality, and foster inclusive, cohesive communities,” says Professor Kirkbride, “Good urban planning could help with this to prioritise safe, inclusive and accessible spaces, that promote positive social connections, and that provide ready access to appropriate mental health services and shared social and economic assets that help communities.
“Investment in early intervention and community-based support can also mitigate the impact of adverse environments. These changes could reduce the incidence of mental health disorders and promote wellbeing across the population.”
In the meantime, there are plenty of ways we can make changes to improve our own environments, which in turn can have an impact on our mental health, particularly by finding ways to strengthen our personal connection within the community in which we live.
Professor Kirkbride says: “While structural change is essential, the evidence suggests that any opportunities individuals can take to build social connections, via activities, networks, clubs, groups etc in their community, could help provide support to mitigate against social adversity and buffet subsequent effects on mental health. Advocating for local improvements—like safer streets or better public spaces—can also make a difference. That said, we must be cautious not to place the burden of change solely on individuals, especially when systemic factors are at play.”