As cities around the world continue to attract young people for jobs, education and social opportunities, a new study has identified characteristics that could support the mental health of young city dwellers. The findings, based on survey responses from a global panel of adolescents and young adults, provide a set of priorities that urban planners can adopt to build urban environments that are safe, just and inclusive.
To determine the characteristics of the city that could strengthen the mental health of young people, the researchers conducted an initial survey among a group of more than 400 people, including young people and a multidisciplinary group of researchers, practitioners and advocates. Through two follow-up surveys, participants prioritized six features that would support the mental health of young urban residents: opportunities to build life skills; an age-friendly environment that embraces the feelings and values of young people; free and safe public spaces where young people can connect; employment and job security; interventions targeting the social determinants of health; and urban design with input and priorities of young people.
The paper was published online on February 21 at Nature.
The study’s lead author is Pamela Collins, MD, MPH, chair of the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health. The study was conducted while Collins was a professor at the University of Washington. The article was written by an international, interdisciplinary team, including RISE Cities, a global non-profit organization working to transform mental health policy and practice in cities, particularly for young people.
Cities have long attracted young people. A UNICEF study predicts that cities will be home to 70 percent of the world’s children by 2050. Although urban environments influence a wide range of health outcomes, both positive and negative, their impact is uneven. Mental disorders are the leading causes of disability among 10- to 24-year-olds worldwide. Exposure to urban inequality, violence, lack of green space and fear of displacement disproportionately affects marginalized groups, increasing the risk of poor mental health among urban youth.
“We’re currently living with the largest population of adolescents in the history of the world, so this is an incredibly important group of people for global attention,” says Collins. “An investment in young people is an investment in their current well-being and future potential, and it is an investment in the next generation – the children they will bear.”
Data collection for the study began in April 2020 at the start of the COVID-19 pandemic. To capture its possible impacts, the researchers added an open-ended survey question asking panelists how the pandemic has affected their perceptions of urban youth mental health. The panelists reported that the pandemic is either shedding new light on the inequality and uneven distribution of resources facing marginalized communities in urban areas, or confirming their preconceptions about how social vulnerability worsens health outcomes.
For their study, the researchers recruited a group of more than 400 individuals from 53 countries, including 327 young people aged 14 to 25, from a variety of fields including education, advocacy, adolescent health, mental health and substance use, urban planning and development, data and technology, housing and criminal justice. The researchers conducted three back-to-back panelist surveys beginning in April 2020 that asked participants to identify elements of urban life that would support young people’s mental health.
The first 37 characteristics were then grouped into six domains: intrapersonal, interpersonal, community, organizational, policy, and environment. Within these areas, panelists ranked features based on immediate impact on youth mental health, ability to help youth thrive, and ease or feasibility of implementation.
Taken together, the characteristics identified in the study provide a comprehensive set of priorities that policymakers and urban planners can use as a guide to improving the mental health of young urban residents. Among them: Youth-focused mental health and educational services could support young people’s emotional development and self-efficacy. Investing in spaces that facilitate social connections can help alleviate young people’s experiences of isolation and support their need for healthy, trusting relationships. Creating employment opportunities and job security can reverse the economic losses that young people and their families suffered during the pandemic and help cities retain residents after the exodus from urban centers of the COVID era.
The findings show that creating a mental health-friendly city for young people requires investment in multiple interrelated sectors such as transport, housing, employment, health and urban planning, with a central focus on social and economic equity. They also require policy approaches to urban planning that commit to systemic and sustainable collaboration without increasing existing privilege through initiatives such as gentrification and green space development at the expense of marginalized communities in need of affordable housing.
The authors say this framework emphasizes that cities’ responses must involve young people in planning and designing interventions that directly affect their mental health and well-being.
Making cities conducive to adolescent and young adult mental health is co-authored by an international, interdisciplinary team of 31 researchers led by the University of Washington’s Global Mental Health Consortium, Urban@UW, the University of Melbourne and citiesRISE. Author funding is listed in the Acknowledgments section of the document.
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