Urban influences on the development, perpetuation and mitigation of psychosis

Abstract

The urban environment has long been recognised as a risk factor in the development of non-affective psychosis. While epidemiological studies dominate this field, the scoping review detailed in this article aimed to capture service users’ experiences and perspectives of urban environments in relation to their mental health, particularly in the context of recovery. A total of 12 participatory studies were reviewed. Analysis of the findings suggests that childhood urban upbringing may be associated with a dampened emotional reactivity response to stress and that residential instability in childhood may hasten the onset of mental health issues.As symptoms of psychosis emerged, sensory overload and perceived challenges with interpersonal interactions often fuelled service users’ avoidance of urban areas. However, green spaces and community places provided service users with opportunities for relief from symptoms and distress, and community places offered opportunities for connection with others. The authors suggest that practitioners may consider assessing the lived geographies of service users and that mental health service providers may undertake a local geographical survey to identify urban stressors and supportive resources.