Abstract
Good mental health is related to mental and psychological well-being, and there is growing interest in the potential role of the built environment on mental health, yet the evidence base underpinning the direct or indirect effects of the built environment is not fully clear. The aim of this overview is to assess the effect of the built environment on mental health-related outcomes. Methods. This study provides an overview of published systematic reviews (SRs) that assess the effect of the built environment on mental health. We reported the overview according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases searched until November 2019 included the Cochrane Database of Systematic Reviews, EMBASE, MEDLINE (OVID 1946 to present), LILACS, and PsycINFO. Two authors independently selected reviews, extracted data, and assessed the methodological quality of included reviews using the Assessing Methodological Quality of Systematic Reviews-2 (AMSTAR-2). Results. In total, 357 records were identified from a structured search of five databases combined with the references of the included studies, and eleven SRs were included in the narrative synthesis. Outcomes included mental health and well-being, depression and stress, and psychological distress. According to AMSTAR-2 scores, the quality assessment of the included SRs was categorized as “high” in two SRs and as “critically low” in nine SRs. According to the conclusions of the SRs reported by the authors, only one SR reported a “beneficial” effect on mental health and well-being outcomes. Conclusion. There was insufficient evidence to make firm conclusions on the effects of built environment interventions on mental health outcomes (well-being, depression and stress, and psychological distress). The evidence collected reported high heterogeneity (outcomes and measures) and a moderate- to low-quality assessment among the included SRs.
Highlights
Mental health is the well-being of the individual and the sum of his/her abilities to contribute to the community and adequately handle the daily stages of stress [1]
Mental disorders impose an enormous global disease burden, affecting every community and age group across all income countries [3], and it accounts for an estimated 32.4% of years lived with disability (YLDs) and 13.0% of disability-adjusted life years (DALYs) [4]
Research on the association between built environment and health has increased in recent years; Smith et al reported that improving neighborhood walkability and quality of green areas and providing adequate active transport infrastructure are likely to generate positive impacts on activity in children and adults [10]; on the other hand, Nowak et al reported that a poor-quality built environment is related to negative birth outcomes [11]
Summary
Mental health is the well-being of the individual and the sum of his/her abilities to contribute to the community and adequately handle the daily stages of stress [1]. E built environment is a broad term that encompasses the man-made physical elements of the environment such as homes, buildings, streets, open spaces, and infrastructure, which could have an impact on the physical and mental levels of the person and the health of a community [9]. Studies about the relationship between built environments and mental health have reported that a state of wellbeing, response to stressors, the ability to work productively, and to make contributions to the community all can be affected by factors such as the quality of public utilities, walking distance to public spaces, access to transport, and level of infrastructure [8, 12,13,14,15,16,17]. Generaal et al reported through analysis across eight Dutch cohort studies that urbanization is associated with depression, indicating that a wide range of environmental aspects may relate to poor mental health [18]
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