Whitley Rob, Prince Martin
New Hampshire-Dartmouth Psychiatric Research Center, 2 Whipple Place, Suite 202, Lebanon, NH 03766, USA.
Health Promot Int. 2006 Mar;21(1):19-26. doi: 10.1093/heapro/dai024. Epub 2005 Oct 6.
Researchers and policy-makers are increasingly recognizing that urban socio-environmental conditions can affect the development and course of numerous health problems. The aim of this paper is to investigate the impact an urban regeneration programme can have on everyday functioning, coping and recovery for people with a mental illness. We were also interested in discerning which component parts of the regeneration are the most important in positively affecting people with mental illness. These questions were explored through an in-depth qualitative case study of the Gospel Oak neighbourhood in London, which recently underwent an intensive urban regeneration programme. Interviews and focus groups were conducted with residents living with a mental illness (n = 16). Relevant participant observation was also conducted. Participants reported that interventions that improved community safety were by far the most important in affecting everyday coping and functioning. Interventions that improved the quantity and quality of shared community facilities had a positive, but milder effect on mental health. Component parts that appeared to have little effect included environmental landscaping and greater community involvement in decision-making processes. Most participants reported that their mental illness was a consequence of severe insults over the life-span, for example childhood neglect or family breakdown. Thus, the regeneration was seen as something that could assist coping, but not something that could significantly contribute to complete recovery. Our results thus suggest that urban regeneration can have a mild impact on people with mental illness, but this appears to be outweighed by life-span experience of severe individual-level risk factors. That said, some of our findings converge with other studies indicating that community safety and community facilities can play a role in positively affecting mental health. Further ethnographic and epidemiological research is necessary to explore these two factors.
研究人员和政策制定者越来越认识到，城市社会环境状况会影响众多健康问题的发展和进程。本文旨在调查城市更新项目对患有精神疾病的人的日常功能、应对能力和康复的影响。我们还想了解更新项目的哪些组成部分对患有精神疾病的人产生积极影响最为重要。通过对伦敦福音橡树社区进行深入的定性案例研究来探讨这些问题，该社区最近经历了一项密集的城市更新项目。对16名患有精神疾病的居民进行了访谈和焦点小组讨论。还进行了相关的参与观察。参与者报告称，改善社区安全的干预措施在影响日常应对和功能方面是最重要的。改善共享社区设施的数量和质量的干预措施对心理健康有积极但较温和的影响。似乎没有什么效果的组成部分包括环境美化和社区更多地参与决策过程。大多数参与者报告称，他们的精神疾病是一生遭受严重创伤的结果，例如童年被忽视或家庭破裂。因此，更新被视为有助于应对的事情，但不是能显著促进完全康复的事情。我们的研究结果表明，城市更新对患有精神疾病的人可能有轻微影响，但这似乎被严重的个人层面风险因素的终生经历所抵消。话虽如此，我们的一些研究结果与其他研究一致，表明社区安全和社区设施可以在积极影响心理健康方面发挥作用。需要进一步开展人种志和流行病学研究来探讨这两个因素。
