Meet Jane. They live in a one-bedroom apartment close to the main road in a metropolitan city. The traffic noise disrupts their sleep, and the poor air quality impacts her physical health. To make matters worse, a low income at their job increases stress and causes insomnia. The worsened mental health and lack of sleep also interfere with work productivity, triggering a cycle of burnout and exhaustion. Jane cuts off from their peers and friends, feeling cornered from the stressors of work-life and health.

Jane is among the millions of people facing the impact of a busy city on mental health. Two trends underlie this experience: one, there is growing urbanization unraveling globally; and two, people living in cities are more likely to face depression, anxiety, and addiction. “A great deal of knowledge has been accumulated about the extent to which these disadvantages in and of themselves are associated with mental disorders,” Junus van der Wal, a researcher at Amsterdam UMC, said. “But in order to really understand what living in a busy city does to your mental health, it is necessary to study all such factors together.”

Junus, along with a group of researchers, simultaneously identified factors that influence the urban environment and people’s mental well-being. The most significant victory of any city is how safe it can make the person feel, which makes building mental health into urban infrastructure a critical design consideration. Published in Lancet Psychiatry last week, researchers put forth a framework on how sustainable cities can build good mental health practices in their framework.

The researchers found the shared links to both included ambient, physical, and social urban environment that “impacted someone’s mental health condition. Even the U.K.’s Design Council put forth a framework called ‘Mind the GAPS”: green place (parks and vertical gardens), active place (wide pavements or areas to exercise), pro-social place (recreational hubs), and safe place (design of roads). “Part of achieving thriving, resilient, sustainable cities is ensuring that citizens can realize their potential, cope with the normal stresses of life,” they noted in a blog.

A raft of studies has linked urban green space (such as vegetated land or parks) with lower stress and improved cognitive functioning. Even in the current analysis, someone like Jane may benefit from a park created between the main road building. Something like that would improve emotional health and work to purify the polluted air and nullify the impact on physical and mental health. One theory to explain the positive effects is Edward Wilson’s Biophilia Theory that argues humans have a biological need to contact other species. Another theory notes it is the aesthetics of a natural setting that distances people from the routine of their daily lives that have an uplifting impact.

The researchers also found merit in weaving in spaces to exercise to boost a city’s approach to urban mental health. Active transport options, such as convenient pedestrian and bike paths, help reduce “stressful, sedentary commutes, with the added benefit of freeing up leisure time and sleep time to promote good mental health further,” experts noted.

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The researchers also found a “feedback loop” prevalent in the urban mental health dynamic. “If many people in the area have mental health problems, for example, this can hurt the social cohesion of the neighborhood, which in turn can harm the residents,” Claudi Bockting, co-director of UMH and professor of Clinical Psychology within Psychiatry, said.

Mental health for urban dwellers is also linked to feeling safe. Getting lost, robbed, or harassed are dangers people identify with a city, so interventions like good street lighting and distinct landmarks can increase the perception of safety and reduce stress.

Then an intervention like a park could “reduce stress and traffic congestion, possibly increase social cohesion in the neighborhood and help to counteract air pollution.” Many aspects linked towards building a sustainable city — such as eco-friendly transport, social inclusion, and urban gardening — work in tandem to uplift mental health.

In 2009, German researchers linked air quality in a neighborhood with people’s level of happiness. They looked at if fitting low-carbon equipment at power plants that reduce emissions would improve people’s emotional well-being. They found the change translated into a significant improvement in people’s self-reported level of happiness. “Some possible reasons for the direct link include aesthetics such as haze, smell and even taste, as well as anxiety about personal health or the health of others,” Peter Howley, a professor at the University of Leeds, wrote in The Conversation.

The new framework can help see how the factors interact and affect individuals and “also to come up with targeted interventions and treatments to improve the mental health of urban dwellers.”

People are the heart of any city. Designing roads, houses, and any urban infrastructure must thus integrate mental well-being practices. I’m reminded of what Andrea Mechelli, a professor of mental health, said: “Cities offer a swath of obstacles and opportunities, freedom and captivity, which can challenge as well as nurture us, often at the same time.”