Abstract
An astonishing change has come over the world in the past three-quarters of a century. For the first time since the Neolithic era, the majority of human beings are not involved in agriculture, and the majority of us now live in towns. Concomitant with this has been a growing awareness of the influence of the environment on health, although ‘Matters related to space and place still tend to be marginal to the core focus and interests of mental health professionals’ (Lord, 2020). Even when consideration is given to the environment it nearly always relates to contact with the natural world (Guha, 2019). However, as Baker and Steemers point out in Healthy Homes, we in the west and, indeed, in much of the world, spend some 90% of our time inside buildings – up to 70% of it in our homes.
The majority of physical disorders presented in modern western societies are lifestyle-related: diabetes, some cancers, coronary disorders, and so on. This is the case for the whole population, and even more so for people with mental illness. Many mental disorders in themselves induce lethargy, many pharmacological treatments have a negative effect on cardiometabolic functioning, people with mental disorders tend to be poorer than average and therefore live in more restricted surroundings, many feel socially excluded and therefore unwilling to go out (Filia et al., 2019), and some are restrained in hospitals or, especially, care homes. People with severe mental illness die 15–20 years earlier than their peers, chiefly from preventable and manageable physical health conditions (Stubbs & Rosenbaum, 2018). Consideration therefore needs to be given to the built environment within which most of us spend most of our time.
Professional specialisation means that exercise experts learn very little about mental disorder, mental health practitioners learn very little about building design and are only beginning to appreciate the benefits of physical activity (Cherubal et al., 2019), and until I came across the books under review, I was under the impression that architects learned and cared very little about what their customers actually did – an architect designing say, a library, seemed entirely concerned with the ‘wow’ factor – a mayor or governor should be able to come in, be impressed enough to say ‘wow’ and then go out again, rather than try to sit and read in it. Alternatively, they seemed to me to churn out dreary glass and concrete blocks, without any concern for the health and wellbeing of the occupants. Consulting architects seemed to me to be about as bad at consulting their clients as hospital consultants.
The books under review indicate that I was not altogether correct: there are architects, planners and designers who do have our health in mind. Ben Channon is the ‘Mental Wellbeing Ambassador’ at Assael Architecture. Happy by Design is a bright cheerful little paperback, briefly outlining the ways in which architects can make us happier by giving us access to light, by considering our comfort, by giving us some control over our environment, by improving contact with nature, by allowing both for privacy and for social interaction, and by encouraging beneficial activities. The only criticism I would make is the assumption throughout that we are dealing with new buildings: mention is made of designing buildings in such a way that they can be re-appropriated for alternative future use, but I would have welcomed a chapter on ways of adapting and extending existing buildings to improve our happiness. Clearly in such a small volume, it is impossible to go into detail, but this book can be recommended as a handy checklist that all developers should be made to look through before starting any project.
Healthy Homes, by a couple of Cambridge academic architects, covers much the same ground, but in greater detail. If Happy by Design is a checklist, then this is more of a practical working text for architects and designers, discussing both physical and psychological wellbeing in terms of factors such as wind directions, light, heating, access to nature, and noise. Again, it can be criticised for focussing too much on new builds where the architect has a free hand on layout, though there are sections on altering existing buildings [I was particularly struck with the ‘Victorian Terrace House’ because it looks like the one I live in.] There could, perhaps, have been more discussion of the compromises which have to be made when designing and constructing homes, but, on the whole this book could be recommended to any trainee architect with a social conscience.
Happy by Design and Healthy Homes are handy basic texts for designing a building. Healthy Place Making is, in contrast, a text aimed at people designing whole urban areas. The author is an architect who has worked on housing projects in the United Kingdom and community plans in Europe and beyond, as well as projects such as the London Wetlands Centre. Basing himself on the assumption that ‘prevention is better than cure’ London outlines the main health problems affecting modern urban communities, summarises their causes – sedentary lifestyles, poor diet/food poverty, poor air quality, noise pollution, loneliness, isolation, lack of social interaction, fear of crime, and, interaction of vehicles with cyclists and pedestrians. He then works his way through methods by which planners can counter these. Copious examples of successful planning are scattered through the book. Some of these, I must admit, look like typical developers’ publicity shots – photographs of clean white people strolling through litter-free plazas in blazing sunshine, but at least they are encouraging. They cheered me up so much, I had to go out and walk among the nearby horrors being inflicted on Greenwich Peninsula and central Lewisham to remind myself that, although depression and anxiety disorders can strike anywhere, people are more likely to become depressed and anxious in depressing surroundings, plenty of which are currently under construction. An optimistic book that can be recommended to planners everywhere.
There is, inevitably, a considerable overlap of content between all these books. Happy by Design and Healthy Homes focus more on individual buildings, and Healthy Placemaking is concerned more with district planning. Wellbeing in Interiors, as its name suggests, is more concerned with the insides of buildings. This is the topic of most relevance to readers of this journal. Few of us will ever get the chance to commission entire buildings, and anyway designing hospitals is a specialised branch of architecture (Singha, 2020). Most of us, however, do have some say in the interiors of the places in which we live and work. Making places comfortable for service users is extremely important. Peter and Helen Tyrer (2019) have, indeed, based an entire therapy: ‘Nidotherapy’ [from the Latin ‘Nido’ – a nest] on the assumption that making service users’ surroundings match with their idea of comfort is of vital importance. This does mean not giving architects and designers too much of a free hand. Matscheck et al. (2020) noted that ‘the importance of small things’ in the comfort of service users means that ‘a facilitating factor may be the absence of too detailed plans’. Architects need to learn to ‘ leave trust to users and professionals’. At the same time, we need to rely on the expertise of people like Elina Grigoriou and her contributors in such matters as heating, lighting, security, access, material safety, and so on. It is a case of finding a balance between the expertise of the designer and allowing us, and especially, allowing service users to feel that they have some control over their environment.
Most of us will spend most of our time inside buildings, service users to an even greater extent than the rest of us. The more that our environments harmonise with our needs, and the more control we have over them, the better for our mental health. It is therefore good to know that there are some architects with social consciences around, like the authors under review.
