THEORY AND METHODS

Thinking inside the bubble: evidence for a new contextual unit in urban mental health

Rob Whitley¹, Martin Prince², Margaret Cargo³

¹ Division of Social and Trans-cultural Psychiatry, Department of Psychiatry, McGill University, Montreal, Canada
² Section of Epidemiology, Institute of Psychiatry, King’s College London, UK
³ Psychosocial Research Division, Douglas Hospital Research Centre-McGill University, Montreal, Canada

Correspondence to:
Correspondence to:
Dr R Whitley
Division of Social and Trans-cultural Psychiatry, Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, Quebec, Canada H3A 1A1; robert.whitley{at}mail.mcgill.ca

Objective: Previous quantitative research has suggested that there is a link between housing, the urban environment, and mental health. However, methodological and design issues make it difficult to disentangle the relative influence of dwelling specific and wider urban environmental influences on individual mental health. The aim of this study was to explore the link between the dwelling, the immediate urban environment, and mental health to generate a new conceptual framework by which understanding of dwelling and urban environmental influences on mental health can be advanced.

Design and participants: Qualitative interviews and focus groups were conducted with 32 inner city residents. Participants, stratified by sex and mental health status, were randomly recruited from a wider quantitative survey. An almost equal number of men and women as well as people with or without mental health problems participated, allowing for comparison of experience. Data were analysed inductively to generate an appropriate theoretical framework regarding dwelling and urban environmental influences on mental health.

Setting: An inner city neighbourhood of about 6200 people in north west London. Most of that population live in public housing.

Main results: The principal study finding is that between the dwelling unit and the neighbourhood unit, evidence was found for another meaningful contextual unit of analysis, the "residential bubble" through which effects on mental health can be mediated. The residential bubble describes a limited area of three dimensional space that surrounds a dwelling, encompassing immediate neighbours (above, below, and adjacent) and shared public space bordering the dwelling. Positive events and processes within the bubble had a beneficial influence on mental health whereas negative ones tended to have a damaging influence. These seemed to disproportionately have an impact on people with pre-existing mental health problems.

Conclusion: The concept of the "residential bubble" may be a meaningful new contextual unit of analysis in urban mental health. This may have important implications with regards to interventions and measurement development.

Keywords: housing; mental health; qualitative

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Elephants in the living room and "ISMS" of all kinds–whimsical and reflective contributions from the board

Carlos Alvarez-Dardet, John R Ashton
J Epidemiol Community Health 2005 59: 813. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Whitley, R., Harris, M., Drake, R. E. (2008). Safety and Security in Small-Scale Recovery Housing for People With Severe Mental Illness: An Inner-City Case Study. Psychiatr. Serv. 59: 165-169 [Abstract] [Full Text]  
• Lawlor, D. A., Ronalds, G., Macintyre, S., Clark, H., Leon, D. A. (2006). Family Socioeconomic Position at Birth and Future Cardiovascular Disease Risk: Findings From the Aberdeen Children of the 1950s Cohort Study. AJPH 96: 1271-1277 [Abstract] [Full Text]  
• Whitley, R., Prince, M. (2006). Can urban regeneration programmes assist coping and recovery for people with mental illness? Suggestions from a qualitative case study. HEALTH PROMOT INT 21: 19-26 [Abstract] [Full Text]