(Volume 4) - Mental Health Disorders - Vula - University of Cape Town

arts programmes. (For further details, see VicHealth, 2004.) The outcomesmeasured in before-and-after study designs indicated significantimprovements in “community pride”; job creation; increased employment; arise in property prices; improved perceptions of housing conditions;reductions in the levels of crime; and improved perceptions aboutgovernment performance (VicHealth, 2004).The other type of intervention that has been mentioned is relocation. In arandomised, controlled study, the Moving to Opportunities (MTO)Programme was implemented in five cities across the United States ofAmerica (Saegert and Evans, 2003). Those in the intervention group wererelocated from poor areas into geographies of greater opportunities, whilecontrols remained in the poor areas (both groups having similar housing inthe different settings). The findings indicated an improved quality of life;greater mental and physical health; less use of harsh parenting techniques;and increased employment in the intervention groups. This finding wasconfirmed by other randomised, controlled trials, where similar interventionsproduced a 50% decrease in the prevalence of mental disorders in lowincomeneighbourhoods (control group) (Truong & Mai, 2006).Data from non-experimental studies have also indicated what other factors atthe neighbourhood level may be important as summarised in Table 9 below.Table 9: Built environment factors found to impacton mental health from observational studiesVariable Effect on mental health Moderatorof effectAccess to publicspaces & layout ofIncreases opportunities for psychologicalrestoration, improves physical activity andPerception ofsafetyneighbourhood social interactions (Saegert and Evans2003; Kaplan 2004; Frumkin 2003)Noise pollution Commonly causes insomnia, impairedconcentration and irritability (Howden-Chapman 2004)‘Walkability’ of aneighbourhoodNatural features,green spacesThe more pedestrian-orientated theneighbourhood, the greater the sense ofcommunity (Lund 2002;Kaplan 2004;Frumkin 2003)Improves sense of community, anxiety,childhood behavioural disorders (Kaplan2004; Howden-Chapman 2004; Frumkin2003)1.3 Cumulative riskThe unequal distribution of economic and social capital results in the mostdisadvantaged members of society being exposed to the greatest number ofhousing and neighbourhood risk factors (Saegert and Evans, 2003). Theaccumulation of multiple stressors over long periods of time results in greaterpsychological and physiological effects (Saegert and Evans, 2003). This35