It's within this context that the early nineteenth-century doctors and policy-makers began to minimize the use of physical restraints on patients and introduce more humane methods of treatment or relief. Critical to this period was Samuel Tuke who proposed the idea of moral therapy by advocating "madness could be remedied not only by kindness but also by a proper atmosphere and environment". Treatments took place in tranquil and heavily designed gardens, boasting different species of flowers and plants, skylights and sports and recreational facilities. This Edenic setting employed a "therapeutic environment in which sane sensations, ideas and behaviours were reflected within design".
Our collective attitude towards mental health and how we manage and deal with it has evolved dramatically since the days of locking people up in asylums and administering lobotomies. Yet, mental health is still a subject we often struggle with when attempting to talk openly and honestly with one another. Even with social events like Bell Let's Talk or the prevalence of celebrities coming forward with their mental illness, many individuals are still too ashamed to admit they live with a mental illness. As human beings, we pride ourselves on being in control of our affairs and often, by revealing to such, we feel we are depicting a personal weakness or failure. I grew up in Nigeria, and I learned early on that in African society, mental health, depression and the like were subjects that hardly anyone discussed. Adults taught us to either "suck it up" or to "get over it". Even today, mental health stigma and discrimination remain obstacles in this dialogue.
According to theWorld Health Organization, on average, one person dies by suicide every 40 seconds somewhere in the world. Mental illness is responsible for 14 per cent of the entire world’s disease burden and causes more disabilities than any other non-communicable disease. Moreover, this number increases within cities. Environmental scientists have predicted that climate change will increase the number of people living with mental health issues. They stipulate that short-term exposure to extreme weather conditions, multi-year warming and tropical cyclone exposure will worsen mental health for people around the world. Not to mention, the United Nations Governmental Panel on Climate Change—a collection of leading climate scientists—released a report in October warning that if the world’s global temperature exceeds 1.5 degrees Celsius within the next 12 years, the weather will significantly worsen with the risks of drought, floods, extreme heat and poverty for hundreds of millions of people. Therefore, with all these clear warnings, shouldn’t we make mental health a priority for environmental designers and city planners? The question we must ask ourselves is: How should we discuss mental health specifically in design?
A couple of months ago I stumbled across an article on the Architectural Review website, pondering how Can we distinguish the “mad” ambitions for an asylum from the “sane” ones? By Helen Ikla. In the article, she provides a historical review of asylums and how they tested the limits of design. She makes an important observation that I find relatable to our modern day stigma against mental illness, "People who struggle with their mental health want to be in control of their environments, to determine their lives according to their specific requirements, much like everyone else. Thus, instead of speaking of designing for ‘madness’, perhaps it would be more appropriate to simply discuss designing for people."
As environmental designers, we have designed cities and spaces to promote safety, environmental hygiene, sustainability, etc. However, the most critical part of our role as designers is to ensure that people who live in cities or inhabit the spaces we design can feel inspired, productive and deal with the stresses of daily life. How we can achieve this is to make our designs more inclusive and open to both those who live with mental illness as well as for those who do not. City planners, designers and decision-makers all need to have a better understanding of what the underlying factors are within our cities that contribute to the pervasiveness of the mitigating factors that makes it hard for people who live with mental illness to thrive, and propose relevant design solutions to minimize those factors.
For example, one dominant factor that contributes heavily to this issue is the limited access to green spaces in North American cities. A historical review of design and mental health-related issues reveal that there is a strong link between landscape and health and engagement with the natural world and people’s physical and psychological wellbeing. How might our experiences within the landscape act as a type of prevention against mental illness or lessen the effects of mental or physical illness?
The conversation is a lengthy one and directly confronts how we plan modern North American cities, and the role that nature and aesthetics play in the wellbeing of urban dwellers. Likewise, Globe and Mail columnist Andre Picard stipulates what our collective goal for planning cities should be: “If you want healthy communities, you need to create a sense of space, of belonging; you need to build inclusive, diverse spaces, where healthy runners and cyclists, parents pushing strollers, frail seniors with walkers, people using wheelchairs, street people, immigrant shop owners and pin-striped business types all feel at ease moving about and intermingling.”
Ideally, the goal is to create “people-first places” and the hope is that, as designers, we become more aware of our role to combat these issues and create spaces that offer hope and inspiration.
Please stay tuned for my next two articles that explore the correlation between climate change and mental health and how we can begin to design the spaces and places people use to counteract the proliferation of mental illness.