Urban remediation: a new recovery-oriented strategy to manage urban stress after first-episode psychosis
Urban living is a major risk factor for psychosis. Considering worldwide increasing rates of urbanization, new approaches are needed to enhance patients’ wellbeing in cities. Recent data suggest that once psychosis has emerged, patients struggle to adapt to urban milieu and that they lose access to city centers, which contributes to isolation and reduced social contacts. While it is acknowledged that there are promising initiatives to improve mental health in cities, concrete therapeutic strategies to help patients with psychosis to better handle urban stress are lacking. We believe that we should no longer wait to develop and test new therapeutic approaches.
In this review, we first focus on the role of urban planning, policies, and design, and second on possible novel therapeutic strategies at the individual level. We review how patients with psychosis may experience stress in the urban environment. We then review and describe a set of possible strategies, which could be proposed to patients with the first-episode psychosis.
We propose to group these strategies under the umbrella term of ‘urban remediation’ and discuss how this novel approach could help patients to recover from their first psychotic episode.
The concepts developed in this paper are speculative and a lot of work remains to be done before it can be usefully proposed to patients. However, considering the high prevalence of social withdrawal and its detrimental impact on the recovery process, we strongly believe that researchers should invest this new domain to help patients regain access to city centers.
KeywordsUrbanicity City Stress Treatment Cognitive maps
PSB was supported by the Leenaards foundation. This work was also supported by the Swiss National Science Foundation [Grant number CR13I1_153320]. MB is supported by the National Institute for Health Research (NIHR) Applied Research Centre (ARC) West Midlands. The views expressed are those of the author and not necessarily those of the NIHR or the Department of Health and Social Care.
Compliance with ethical standards
Conflict of interest
On behalf of all the authors, the corresponding author states that there is no conflict of interest.
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