A systematic review of the evidence on the effect of the built and physical environment on mental health

This paper assesses the strength of the evidence on the impact of the physical environment on mental health and well-being. Using a systematic review methodology, quantitative and qualitative evaluative studies of the effect of the physical environment on child and adult mental health published in English between January 1990 and September 2005 were sought from citation databases. The physical environment was defined in terms of built or natural elements of residential or neighbourhood environments; mental health was defined in terms of psychological symptoms and diagnoses. A total of 99 papers were identified. The strength of the evidence varied and was strongest for the effects of urban birth (on risk of schizophrenia), rural residence (on risk of suicide for males), neighbourhood violence, housing and neighbourhood regeneration, and neighbourhood disorder. The strength of the evidence for an effect of poor housing on mental health was weaker. There was a lack of robust research, and of longitudinal research in many areas, and some aspects of the environment have been very little studied to date. The lack of evidence of environmental effects in some domains does not necessarily mean that there are no effects: rather, that they have not yet been studied or studied meaningfully.