Mental Health and the Urban Environment

Does the typical American urban environment contribute to symptoms of depression, anxiety, and other mental health issues? This question, about the intersection of the built environment and mental health, has been floating around in my head for a while, and it felt like the right time to explore it. What better moment than Mental Health Awareness Month to dig into how our cities affect how we feel?

I hope this post starts to tie together some of the ideas I’ve touched on in earlier entries and adds more weight to the broader conversation I want to help shape. Too often in the AEC industry, we overlook the emotional and psychological impact of our work- how a space can influence not just the masses who pass through it, but a single individual, in a single moment.

Let me be clear: this isn’t about discrediting the valuable work already being done. There are countless practitioners, researchers, and advocates dedicated to evaluating and improving the ways built environments affect human well-being. On the physical health front, their impact is undeniable- challenging harmful practices, influencing legislation, and reshaping building codes.

When it comes to mental health, however, we're only just beginning to scratch the surface. I believe scale, tangibility, and awareness are three critical components missing from the larger puzzle.

Let’s talk scale. From an urban planning lens, where do we even begin? The average person may not realize just how deeply city design shapes their everyday life- through access to parks, transit, housing, and even light and sound exposure. And with so many stakeholders involved- governments, developers, community members- urban design becomes a slow-moving machine, often hindered by bureaucracy, inertia, and legacy systems.

Tangibility is also a challenge. The complexities of urban systems make it hard for people to see cause and effect. Yet we know from research that long-term residents in gentrifying neighborhoods are more likely to experience serious psychological distress. The stress of displacement, rising rents, and eroding community networks has been tied to elevated rates of anxiety and depression, especially among low-income and elderly populations. And this isn’t just anecdotal; studies have shown that people displaced due to gentrification have double the hospitalization rates for mental illness compared to those who stay in place.

Cities like New York, due to their size, density, and visibility, have become essential testing grounds for innovation in urban design. From housing reform to pedestrian-friendly streets and community engagement, these experiments show what’s possible. But many smaller or mid-sized cities haven’t seen the same traction, and often remain governed by outdated planning mindsets: more highways, less mass transit, segregated affordable housing.

Why does that thinking persist? Because status quo is comfortable. Systems that ignore mental health impacts aren’t necessarily malicious, they’re just relics of a time when “grin and bear it” was the standard. It’s taken decades for society to acknowledge that mental health deserves as much attention as physical health, and we’re still not fully there.

So, where do we go from here? I won’t pretend to have all the answers. But I believe that continued advocacy, expanded public education, and ongoing research are how we shift the narrative. As outdated attitudes fade, and as mental well-being gains long-overdue recognition, I’m hopeful we’ll see a deeper, more sustained integration of mental health considerations into how we design, plan, and build.

And for those of us in design, planning, or policy: the more we keep mental health top of mind, the better our cities, and the lives lived within them, will be.