There is a clear link between the nature and quality of the built environment and the mental health of those engaging with it. As part of the Greater Greener Essex project, much work is being undertaken to understand and take advantage of the positive impact green space can have on the mental health of residents.

Living in an urban environment can lead to numerous mental health benefits – for example, increased opportunities for taking part in economic, cultural and educational pursuits that keep the mind active. There are also, however, aspects of urban living that are considered to have the potential to have a negative impact on mental health. The Centre of Urban Design and Mental Health (UD/MH) categorises these potential impacts into two groups – those which relate to increased stimuli and those which act to strip away factors or activities with positive mental health associations.

Factors which create a mental imbalance as a consequence of increased stimuli include a general feeling of density and lack of open space, overcrowding, noise, smell, constantly changing visual stimuli, a sense of disarray and pollution. In response, the individual seeks out quiet, private spaces they can control; over time, this can evolve into a more permanent social isolation, which may then manifest in feelings of depression and anxiety.

The urban environment may also act to remove factors that maintain mental health and wellbeing: a commonly recognised issue is the reduction in opportunity to access open green space that comes with a more urbanised living environment. Commuting may also have a negative impact, both in terms of mental stress and commuting’s impact on free time to devote to leisure and exercise (both of which are associated with mental health benefits). Factors such as pedestrian footfall, light and noise are more likely to lead to sleep deprivation in urban environments than in their rural equivalents. In addition – and it is accepted that this is a generalisation – urban environments may be less likely to give rise to strong social networks of friends and family than smaller, more rural communities, in part due to their more dispersed nature.

Ease of orientation and familiarity help to make environments more accessible to people with dementia, which makes it important that developments and their constituent areas are visually distinct. A variety of landmarks and architectural features in diverse styles and materials can help to achieve this, while practical features such as trees and street furniture can be used to the same effect. Indeed, using benches and public toilets in this manner has the dual benefit of also providing benefits to the wider population.

Another positive measure in this respect is a reduction in unnecessary clutter and potentially disorienting visual and auditory stimuli, which can be screened through planting. The Royal Town Planning Institute (RTPI) has suggested that planners consult people with dementia, asking them to explain how they make decisions about where to go and gaining insight into how clearly they understand their environment.

Therapeutic and mental health benefits that have been attributed to interactions with green spaces and natural environments include reduced anxiety, increased self-esteem and psychological wellbeing, improved mood, improved academic performance and improved cognitive functions. Research by the UNESCO UK Man and Biosphere (MAB) Urban Forum has shown that colourful and interesting urban green spaces help to build a sense of civic pride.

Nature-based therapy has also been suggested as a treatment to relieve mental and physical illness and improve recovery time from stressful situations or medical procedures. One study showed that views of trees reduced the amount of moderate-to-strong analgesics needed by patients post-surgery, as well as reducing the number of days they spent in hospital compared to those whose view consisted of a brick wall. (Green Space and Health Postnote 538, Houses of Parliament – Parliamentary Office of Science & Technology, 2016).

The Chartered Association of Built Engineers (CABE) report ‘Community Green’ (2010) drew on clinical evidence to suggest that exposure to an outdoor green environment can considerably reduce stress. Simply being able to view nature can produce significant recovery or restoration from stress within 3-5 minutes.

Through the Green Care project, Essex County Council is actively working to develop strategies aimed at making more effective use of green spaces, so as better to support the broad needs (including mental health needs) of Essex residents. This project is being taken forward under the Greater Greener Essex principles, which seek to establish multifunctional priorities for green spaces across the county. Using green assets such as country parks to support the health and wellbeing of residents is a new concept for the council, but it is recognised that the opportunities to improve health and wellbeing could be significant. The Green Care project launched in Spring 2017 and involves reviewing evidence, mapping current assets, scoping and establishing pilot schemes and establishing both a vision and intended outcomes.