How does the built environment impact on mental health? 

With an estimated £1.4bn spent every year by the NHS as a result of sub-standard housing, an All-Party-Parliamentary-Group that brought together an expert panel of policy makers and built environment professionals last week sought to find out.

Chaired by Ealing Central and Acton MP Rupa Huq, the session found that, essentially, the poor quality of UK housing meant that people’s wellbeing and health is suffering, in contrast to advances being made in the offices and retail sectors. But attention to green spaces, adequate light levels and encouraging healthy lifestyles are all ways that design can fight back.

‘The post-Grenfell bill for remedial works is likely to be £10bn - so there isn’t much spare cash for housing’, said Karen Buck, MP for Westminster North. Although, over the course of many decades there has been reasonably steady progress, the shocking situation, Buck went on, is that here are still around 1 million properties in the UK housing 2.5 million people that are ‘unfit for human habitation’ under the 2004 housing act and pose an actual potential risk to health and even to life".

The bulk (75%) is in the private rented sector, with a major problem stored up as people age into that sector. Buck read excerpts from her housing casework – including emails from concerned residents about damp, mould and cold, even flooding and mice infestations affecting children’s respiratory systems – which ‘shocked her into distress’. Westminster, said Buck, had historically been at the forefront of housing problems, with slum landlords and associated with very poor-quality housing. And today, the people living in these properties tend to be disproportionately, disadvantaged people – the disabled, those with mental health issues, and BAME communities as well as a high proportion of students. 

A number of changes including restrictions on housing benefit have increasingly concentrated those people with least housing choice in the worst condition of properties, said Buck. Permitted development rights schemes are to the fore here as a key problem, with conditions falling short of decent quality housing. Furthermore, environmental health officers are, Buck said, one of the ‘emergency services’, but only enforce in around 1% of all those homes that are unfit. ‘So it will take 100 years to get through all those properties’. Funds are an issue, but interest in this is patchy: Newham has carried out 50% of enforcement actions. Tenants feel disempowered in terms of an ability to act against their landlords so tenants rights need strengthening, Buck added, especially since large parts of the country are legal aid ‘deserts’ – even if London is better served in this respect. 

Sophia Cox, sustainability advisor at the UK Green Building Council (UKGBC), said that it was impossible to talk of mental health separately to physical health and community wellbeing:‘As a sector we are good at looking at health and wellbeing in office and retail space, where it leads to better productivity from your staff, and that if it’s a really nice retail space we know we will get higher footfall’, Cox said. ‘We are less good where it's at its most important – and that’s in people's homes’. 

Key issues for Cox include energy efficiency of homes, especially since 11% of UK households are in fuel poverty, and the cold often forces families to live in one room, thus making learning spaces for children difficult. Green spaces offer positive contributions to London with schemes like Wild West End offering benefits to people’s wellbeing, recovery rates for hospital patients are higher for those near green spaces and there are commercial benefits in house prices on those with views of green spaces, Cox went on. But male construction site workers are three times as likely to commit suicide as the average male. ‘We need to make these jobs better for people.’ Noise, too, has detrimental impacts on health, while climatic issues are making more homes at risk of flooding, leading to further high levels of anxiety.

Ben Channon, head of wellbeing at Assael Architecture and author of Happy by Designsaid one in four people will suffer from a diagnosable mental health problem each year, and one in five say their housing affects their mental health in a negative way. But we are all affected by the built environment, for good or bad. ‘I believe we can design built environments which help us to thrive and which can help us to live better lives’, said Channon. We spend 90% of our time inside buildings, most of us live in urban areas, and studies have shown in office workers that those with less natural light nearby get less sleep, a crucial component of good mental health. Messy spaces create increased levels of cortisol too, while adding greenery to the office can lift mood. ‘We are a part of nature, and I think we forget that quite a lot’. 

Designing for better health can include getting buildings comfortable in terms of acoustics, daylight, ventilation, and in engaging our physical senses, said Channon. But unlike with carbon, for example, there is a gap in the profession over demonstrating how properties cater for health and wellbeing. ‘We need to try and engage people’s senses more in the buildings we are designing’, said Channon. Similarly, we need to design buildings to encourage them to be more active and feel ‘at home’, leading to higher levels of happiness. ‘We’re designing places for people to live, and if we do that, fundamentally we’re going to create great architecture that’s going to benefit people’s mental health’.