How city living affects mental health-a qualitative exploration of urban stressors among adults in a megacity in India

Abstract

Background

India’s rapid urbanization presents both opportunities and challenges, offering better healthcare and infrastructure while also impacting physical and mental health. The reasons behind the higher prevalence of mental health issues in urban areas remain underexplored, particularly in the Indian context. This study seeks to fill that gap by examining urban stressors in an Indian megacity, aiming to inform urban planning and enhance mental well-being.

Method

The study involved 24 in-depth interviews with non-slum residents aged 30–60 years. Data was collected based on predefined themes, categorized into physical and social urban environments, and further analyzed into subthemes.

Results

Five key urban factors were consistently reported as negatively affecting mental health: housing issues, traffic and transportation challenges, neighborhood characteristics, cost of living, and employment-related stress. Additionally, factors such as water quality and availability, air and noise pollution, solid waste management, safety concerns, social cohesion, and the accessibility and affordability of recreational facilities contributed to varying levels of distress among different participant groups.

Conclusion

This study underscores the complex interaction between physical and social environmental factors in influencing mental health of residents of the city. The findings underscore the importance of adopting a multisectoral and inclusive approach to urban planning that places mental well-being at its core. Integrating mental health into city development guided by frameworks such as HiAP approach (Health in All Policies), the WHO Healthy Cities initiative, GAPS (Green, Active, Prosocial, and Safe places), among others can support the creation of inclusive and sustainable urban spaces in alignment with Sustainable Development Goal 11 (SDG 11). However, this study has certain limitations, primarily the lack of generalizability due to its qualitative design conducted in a single Indian megacity, as well as the absence of assessment of mental health outcomes using standardized mental health assessment tools.