Cities Play Pivotal Role In Shaping Adolescent Mental Health
In a rapidly urbanizing world, the challenges and opportunities for adolescent mental health and well-being are increasingly intertwined with city life. The Lancet's article, authored by a team of experts, highlights the significant impact of urbanization on the mental health of young people.
The well-being of adolescents, aged between 10 and 19, plays a crucial role in shaping their future life prospects. The World Health Organization (WHO) estimates that adolescence accounts for a substantial 35% of the global disease burden. A key aspect of this concern is the promotion of good mental health, as mental health problems now make up over a third of the total burden of disease in adolescents.
A striking statistic is that out of the 1.2 billion adolescents worldwide, nine out of 10 reside in low-income and middle-income countries (LMICs). These regions grapple with pervasive social and environmental challenges such as poverty, armed conflicts, violence, and environmental stressors. These factors contribute to significant mental health difficulties in adolescents. Additionally, LMICs face numerous obstacles related to the supply and demand of mental health care. It is anticipated that by 2030, more than half of urban populations will be under the age of 18, with LMICs accounting for a substantial portion of this growth.
The state of the world's cities, where the majority of these young individuals reside, exerts a lasting influence on their health and life prospects. Investing in adolescent health and wellbeing offers a triple dividend of benefits, impacting the present, future adult life, and the next generation. Strategies focusing on skill development, problem-solving, and interpersonal skills, along with supportive home, school, and living environments, are pivotal for fostering long-term positive well-being.
However, being an adolescent in a rapidly urbanizing world comes with its set of challenges. Urban living, in comparison to rural areas, is linked to a higher risk of mental health issues, including depression, anxiety, and some psychotic disorders. Additionally, urban environments carry an increased risk of concentrated poverty, low social capital, social segregation, and various other social and environmental adversities. These early mental health challenges can have enduring effects on social disability and other adverse economic outcomes in adulthood.
Nonetheless, urbanization, characterized by population growth, spatial expansion, and the concentration of people in cities, also opens doors to economic opportunities, interpersonal connections, placemaking, and personal identity development. These factors are associated with improved health and well-being. Yet, they coexist with challenges such as marginalization, exclusion, sedentary lifestyles, and safety and security concerns.
Urbanization has the potential to exacerbate existing inequalities, especially in marginalized communities. It can perpetuate disparities in access to quality education, healthcare, housing, and social services, and limit opportunities for young people living in economically disadvantaged cities. Urban spaces can also pose challenges for physical activity due to limited access to safe public spaces and recreational facilities, along with concerns about safety associated with urban crime and violence.
Cities illustrate how various factors, including environmental, social, and individual elements, can shape mental well-being. Therefore, the need for action to improve mental health extends beyond narrowly defined mental health promotion.
Over the next 30 years, the majority of urban growth is expected to occur in Africa and Asia, where the highest concentration of adolescents resides, often in medium-sized cities with insufficient infrastructure. These intermediary cities are understudied compared to large urban centres, and a lack of data makes coherent urban development challenging. The absence of a uniform definition of "youth" further contributes to inconsistent policies, data collection challenges, difficulties in delivering tailored interventions, and uneven resource allocation.
Despite these challenges, cities provide an opportunity to address inequalities by developing and deploying mental health interventions at multiple levels within the urban ecosystem. Policy flexibility and local networks play a crucial role in driving change, and cities can serve as leaders in policy changes at regional and national levels. Stakeholders from the government, the third sector, and industry groups are more likely to engage in cross-boundary collaborations that challenge the status quo. Furthermore, cities are well-suited for digital interventions to enhance access to mental health resources, thanks to extensive internet connectivity and smartphone usage.
To support the mental health and well-being of young people in cities, it's essential to move away from isolated approaches and implement multilevel interventions that align individual skills, social networks, and environmental domains toward inner development. This approach has the potential to transform urban environments into mental health-promoting contexts for all adolescents.
The challenge ahead involves harnessing these multiple systems to promote better mental health and create conditions for communities to work towards mental well-being. This approach calls for a reevaluation of existing social and economic systems while supporting youth-led initiatives and intergenerational leadership. Policy experts and young people emphasize the importance of investing in multilevel intervention science, growing the next generation of youth leaders in mental health, developing unconventional cross-sector relationships, and identifying community spaces, including green areas, to promote mental health.
Investing in research and implementing interventions for young people's well-being in cities is essential to understand and create environments where adolescents can thrive. The future of today's young generation will have a profound impact on addressing persistent global challenges, ranging from poverty reduction to improved educational and economic outcomes, as well as the promotion of sustainable and gender-equitable societies. It's a collective responsibility to ensure that urbanization fosters the mental health and well-being of the next generation.
Source: Article - 'Why cities matter for adolescent mental health and wellbeing' by Elliot Hannon, Sweetbert M Anselimus, Nicole Bardikoff, Barbara Bulc, Stefan Germann, Pattie P Gonsalves, G J Melendez-Torres, Laura Ospina-Pinillos, Moitreyee Sinha, and Maureen Wanjiru published on The Lancet.
