Winter, Mental Health and Urban Design: Social connection and Public Spaces

Last week, I had the privilege to do a talk at the Winter Cities Shake-Up. The conference brought together innovative thinkers from all over the world to discuss ways in which we can make the most out of winter. I thoroughly enjoyed the conference and felt that it validated a lot of my feelings around city building in a winter city. One of my favourite moments at the conference was chairing a session in which Gil Penalosa spoke. He’s such an amazing advocate for healthy cities. His 8-80 approach proposes that cities should be designed in a way that is accommodating and liveable for both an 8 year old and 80 year old. If you haven’t seen his work, I’d highly encourage you to visit his website.

My talk focused on winter, mental health and urban design. While I am not an urban planner by training, I believe that occupational therapists are positioned to contribute meaningfully to the conversation on how we build our cities. OTs have a comprehensive  and holistic understanding of health in that we acknowledge the influence the environment can have on well-being. Whereas the traditional medical model sees disability and illness as existing in the person, OTs see illness as a dynamic experience that is influenced by the environments in which we live.

medical-model

The reason I’ve developed such a strong interest in urban design stems from an experience I had working with a client (who I’ll call Philip) who was referred to me because he was experiencing severe depression. Through my conversations with Philip, I learned that he was profoundly lonely. My first thought was to find opportunities for him to connect with others. Using my OT skills I did some community mapping with him. Community mapping involves analyzing and assessing a neighbourhood for the resources and opportunities it has to foster natural connections with others. Philip is on income assistance and the only place he could afford to live was in a group home in the suburbs on the fringe of the city. Through the community mapping process, I soon realized that his neighbourhood had next to no places to meet others. No coffee shops. No libraries. No recreation centres. The only “public space” he had access to was a small park that was a few blocks from his house, which in the winter was barren and uninhabited. Philip was extremely lonely and couldn’t even really do anything about it. He didn’t own a car. He found public transit to be an arduous and lengthy process. He usually got around by walking and his neighbourhood was brutally “unwalkable”.

Through working with Philip, I was witnessing firsthand how urban design was impacting mental health, and since then have had a keen interest in exploring the relationship between design and health outcomes.

My talk at the winter cities was a collection of thoughts around how we can build our cities to support wellness and mental health, particularly in the winters. Winter can be a difficult time for people for a variety of reasons, and it is important to recognize the added challenges it brings (as well as the opportunities it can provide as well).

I thought I’d share some of my thoughts in my next few posts. I’ll be writing about my #lightbrightyeg project in the coming weeks, but in the meantime check out my recent interview on CBC Spark.

Winter and Loneliness

Winter can often keep people indoors and function to further isolate those who already experience significant social exclusion. Social exclusion has been shown to impact both mental and physical health. One study has shown that being excluded activates the same circuits in our brains that physical pain does. Social isolation literally hurts.

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The other fascinating piece around social connection is that it has been shown to release oxytocin which then triggers the release of serotonin. Interestingly, Philip was on an anti-depressant which was designed to increase the amount of serotonin in his brain… It seems that we are trying to medicate loneliness when we should actually be “prescribing” friendships. Humans evolved living in groups and communal settings. In today’s society, we’ve drifted so far away from that model of living.

Serotonin

Public spaces can function as convenors and meeting places. Places where we can connect with each other and get our necessary doses of feel good chemicals, like serotonin. The issue with winter is that it often drives people indoors, away from others. I think that great winter design would make public spaces easier to access in the winter. I live a block away from Cafe Bicyclette, where they have fire pits on their patio. On a wintry day you can sit outside, enjoy a coffee, and meet some neighbours. It’s a fantastic example of a winter city public space.

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If you’ve ever taken a walk on Stephen Ave in Calgary, you’ve probably seen the “trees”. Apparently they were designed to reduce wind gusts, which would reduce windchill and get more people outside connecting with each other. Brilliant.

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My dream is that one day we have outdoor hot tubs for public use in Edmonton’s river valley (if you can help me do this please let me know!!). Research has shown that immersion in warm water releases oxytocin as well. A conversation with someone in a hot tub and you’ve got yourself a good dose of feel good chemicals.

I am hopeful that we are moving in a direction that where we begin to incorporate health into how we design our cities. From my perspective as a health care professional, I see huge potential for urban planning to address some of our most significant health challenges, particularly mental health. I know I’m not alone in thinking this way and would love to hear your thoughts on the topic. Feel free to comment below or tweet me!

Please Talk. We Are Listening

It’s Bell Let’s Talk Day tomorrow. Across the country, people will be tweeting #BellLetsTalk in support of mental health. Each tweet raises 5 cents towards funding for mental health research and program development. To date, they have committed over 66 million dollars.

Beyond fundraising, the initiative has done great work in helping challenge the stigma surrounding mental health. Through encouraging people to talk about their mental illness, they are helping to work towards a society where it’s “normal” to talk about mental health issues.

Most people probably don’t think twice about telling their co-worker they have a headache. You can be sure that most people DO have a difficult time sharing they experience a mental health issue. Understandably, people are scared of sharing their experiences with mental health. Stigma acts as a barrier to what those people need the most – human connection and a support network.

The Bell Let’s Talk initiative comes at a good time. This upcoming weekend, Edmonton will have the opportunity to listen to stories and experiences of LGBTQ youth in relation to the importance of gay/straight alliances. As you’re aware, the issue of GSAs has been in the media lately. This past fall, Laurie Blakeman proposed Bill 202. If Bill 202 was passed, it would require school boards to allow gay-straight alliances if requested by students. Bill 202 was tabled, and Bill 10 was proposed by the PC party. Bill 10 essentially would require a student to engage in “legal recourse” in the event that their school board denied a request for a GSA. This would undeniably tie up youth in a red-tape ridden legal struggle. It also sends a strong message that the youth voice does not matter.

Why are GSAs relevant to the #BellLetsTalk conversation?

Because LGBTQ youth are at a significantly higher risk of experiencing verbal and physical violence at the hands of their own classmates.

Because LGBTQ youth experience higher rates of mental health issues.

Because LGBTQ youth are 3 times more likely attempt suicide.

Because GSAs have been proven to help counteract these sad realities of LGBTQ youth.

GSAs have been shown to help LGBTQ youth feel safer, be less likely to be bullied by fellow students, have more supportive adults in their lives, and indicate that their teachers treat them with more respect. You can read more about their benefits here

GSAs provide a safe environment for all students to talk. To share their experiences. To receive support from one another. To work towards creating a school environment that is conducive to good mental health for everyone.

If you care about the #BellLetsTalk conversation, you care about the #GSAyeg conversation.

Just today, Edmonton City Council voted unanimously to support the efforts of the Edmonton City Youth Council to share their concerns with Bill 10.  We need to stand behind them and demonstrate loud and clear that Edmonton is a compassionate city that supports human rights and values inclusion.

If you can, please try to attend the event this Saturday January 31 at 3 pm at the Winspear Centre. The event is titled “We Are Listening – Sparking Public Conversation on Gay/Straight Alliance”.

You can sign up to attend here.

You can also tune in to the live stream of the event here

If you can’t attend, you can help by sharing the event with your networks. Tweet your messages of support or thoughts about GSAs using the #GSAyeg hashtag.

You can also help by letting me know if you know any youth who would like to share their experiences at the event.

Thanks,

Robin

“I’m no longer accepting things I cannot change. I’m changing things I cannot accept.”

– Angela Davis.

Combating a Toxic Culture in Edmonton: Some Thoughts on Dr. Gabor Mate’s Wisdom

This past Saturday, I had the opportunity to introduce Dr. Gabor Maté. Dr. Maté was in Edmonton to speak as part of the Edmonton Public Library’s Forward Thinking Speaker Series. As I had mentioned in my opening speech, I was a little star struck. In my world, Dr. Maté is a bit of a rockstar and it was a little surreal to be able to meet and introduce his talk.

Dr. Maté’s rockstar appeal is no joke. He speaks on topics of addiction and mental health with a fierce passion and has fans across the world. There was so much demand to see Dr. Maté that EPL had to create a second session. Both of his talks revolved around “growing Edmonton with compassion and social inclusion”. EPL was bang on with bringing him to Edmonton to speak on that topic, as I believe it is currently quite relevant to what our City is working towards. It is no surprise that EPL chose to bring him, seeing as how they are a significant forward -thinking social institution in our city. We are very fortunate to have them.

Dr. Maté is gifted in being able to communicate and articulately explain complex topics of brain development, addiction and social policy in ways that are accessible by all who listen. His approach is informative and inspiring. I left his talks energized and excited about how to apply his wisdom to the city-building currently happening in Edmonton.

I can’t do Dr. Maté’s talk justice, but will try to distill some of the key points I took away.

Dr. Maté began his talk with an astute observation: The fact that we need to discuss social inclusion as a construct is a direct indication that we are lacking something that should come naturally to us as humans. I’ll get into this more later on in the post…

Dr. Maté is currently writing a book on the topic of “toxic culture’. His premise is that our society is one that is currently functioning in a way that is toxic to our well-being and health (both physically and psychologically). Our increasing emphasis on capitalism and individualism is taking us away from our inherent need to be social creatures. The construct of money and the impact it has on the stress we experience has proved to be detrimental to our mental health. He believes that issues of mental health and addictions we currently struggle with can be directly tied to early childhood experiences – trauma during early childhood can significantly impact the way the brain develops. Early childhood trauma can lead to emotional pain, which often can be temporarily soothed by engaging in addictive behaviours. Dr. Maté defined an addiction as a behaviour that provides temporary relief or feelings of wellness which we choose to do despite potential harmful consequences.  Dr. Maté did not make the distinction between illegal and legal substances (i.e alcohol vs heroine) or moral or immoral behaviours (i.e “sex addictions” vs “a shopping addiction).  His intention with this approach was to elucidate that we are all not that different – some of us are just more fortunate than others in our society, which is reflected in how we cope. This approach creates space for compassion. Instead of damning those who engage in “socially unacceptable” behaviours, perhaps we could empathize with them from a place of understanding.

Dr. Maté spoke of the sad history of residential schools in Canada. He discussed intergenerational trauma and how the horrible things that happened in previous generations have trickled down and directly affect today’s generation. Acknowledging the impact of trauma on brain development, mental health and addictions, we can begin to understand the significant impact the residential school fiasco has had on generations of Aboriginal people. The issue is not as black and white as many people believe it to be – systemic oppression at the hands of our own Government has led to the complex issues faced by Aboriginals in our country. This cannot and should not be under-emphasized.

If we know what type of child-rearing environments can lead to poor brain development, what environments are supportive? Dr. Maté stated that the ideal environment was that of the “hunter-gatherer” or “tribal” environments.  These tribal conditions provided numerous attachment figures for the child’s developing brain to grow healthily. Contrast that to today, where more often than not, women are over-burdened and expected to raise children on their own – often times in stressful environments where basic needs aren’t met. How are we to expect future generations to be psychologically healthy given what we know about early brain development? Dr. Maté made the salient point that the way Aboriginals in Canada lived prior to colonization was the ideal child-rearing environment. The Western world has done its best to eradicate that lifestyle. Despite this, we have strong and proud Aboriginals who are doing their best to preserve their culture. I witnessed this earlier this year when I attended the Truth and Reconcilation Comission. Perhaps in our process of reconciliation, We can be open to learning from First Nations as well. Their wisdom will be very important not only in the necessary process of reconciliation, but also in our attempt to reconstruct our society to be one that is inclusive and compassionate.

For some time, I have felt that topics of neuroscience and mental health can be applied to city building and so I was compelled to ask Dr. Maté what he thought about the impact of built space and city planning on issues of mental health and healing. I told him about Edmonton’s current growth and the emphasis being put on city planning. Dr. Maté encouraged the building of more common spaces. Creating schools where children, parents and teachers socialized together outside of school time. In his talk, Dr. Maté lamented at the impact that a Wal-Mart had on a community. The associating parking lot took people off the streets (where they would typically have a chance to connect with others). Local businesses, which can also function as community gathering places, are forced to close down. The interior of a Wal-Mart itself isn’t conducive to connection. It is a chaotic environment where people barely engage with each other, let alone treat each other with respect. Just look to the sad state of the Black Friday riots where people have often been trampled in pursuit of a discounted x-box.

How can we apply Dr. Maté’s wisdom to Edmonton? For starters, I would like to acknowledge some of the things we are doing well:

  • Farmer’s Markets. I’ve had the chance to attend many of our fantastic markets and find that they are an amazing space to interact with other members of our community.
  • Increased support of local businesses. We are slowly moving away from our reliance on box stores or chain restaurants. The success of shops like Earth’s General Store or restaurants like Tres Carnales indicate where we want to spend our money.
  • Not to draw on an old slogan, but we do festivals well in Edmonton. Festivals are yet another chance to connect with fellow citizens.
  • The Mayor’s Task Force on Poverty Elimination. Mayor Iveson has made it his priority to address poverty and homelessness. His inspiring introductory remarks at Saturday night’s talk confirmed that he is passionate about addressing these issues.
  • Thinking behind developments like the Blatchford development. It is apparent in the plans we’ve seen so far, that community spaces, store-front shops and sustainable transportation are all prioritized.

Dr.  Maté’s suggestions revolved around the idea that we need more points of connection with others. Opportunities for human connection not only helps support the healthy development of young brains –  it has been well documented that connecting with others releases feel-good neurochemicals and impacts the reward circuitry in our brain. Interestingly enough, the neurotransmitters that are released naturally through human connection (dopamine & serotonin) are the same ones that are targeted by common anti-depressants and psychiatric medications.

Moving forward, what else can we do? Can we intelligently build public spaces that promote connection with others? Can we address the marginalization of particular groups that effectively bars them from social participation? Can we be more neighbourly? Can we make an effort to connect with people we don’t typically connect with? How can we actively practice the compassion that Dr. Maté so eloquently described as the compassion of transformation?

Dr. Maté contends that in practicing the compassion of transformation, we see people not as their “bad” behaviours, but rather who they are as a possibility of love, wholeness and health. That the true nature of human beings is not to condemn one another or engage in war, but rather that our true nature is one of connection and belonging. In our journey to see others in this light, he encourages us to reflect on our own darkness and see that we may not be so different from one another.

Aware of this information, I would encourage you to think of how we can shape both our social and physical world in a way that is conducive and supportive of human connection. How can we actively combat the toxic culture that Dr. Maté speaks of? If we choose to acknowledge and incorporate his wisdom, I believe we have a fair shot at deeply addressing issues of mental health, addiction and poverty in our wonderful city.

If you are interested in engaging in discussion that addresses how our city can affect our well-being, I’d encourage you to come out to a free screening of the documentary Human Scale. The Human Scale discusses how the built city influences human health and well-being. Following the screening, we will be hosting a panel where we engage in a more depth discussion. Get your free tickets here: www.makesomethingedmonton.ca/HumanScale

If you’re interested in learning more about Dr. Maté, visit his website: www.drgaborMaté.com

You can find his books at the Edmonton Public Library here

Pop-up Bike Lanes, Poverty, and Progress

I was planning on posting to my blog on a monthly basis, but before I knew it the summer flew by. Between attending weddings, prepping for teaching the fall semester at MacEwan, and working on a few Make Something Edmonton projects I’ve been involved with, it’s proven to be a little difficult to sit down and write. However, one project that I was recently involved with has compelled me to take a moment and try to make sense of some of the thoughts that have been buzzing around in my head.

Over the past month, I worked together with a group of dedicated Edmontonians to put on a pop-up bike lane rally that took place on September 20th. Earlier this summer, I saw a call to join a working group that focused on the 102 ave bike lane. The group, headed by the amazing former city councilor and community activist Michael Phair, was concerned that there was a possibility the city would not fund the proposed 102 ave bike lane. And so we brainstormed ideas that could generate public awareness on the issue. On August 13th we decided to look into the possibility of staging a pop up bike lane rally. Barely a month later we were able to bring that idea to fruition. If anyone is looking for a living example of the Make Something Edmonton spirit, you can look to this event.  The support we received from the public was amazing. People offered to help with the event in many capacities – without their help we wouldn’t have been able to pull off the pop up bike lane, which spanned 10 city blocks. My original thought was that we’d set up a bike lane that covered a block, maybe two.  Michael suggested we go big, that we would set up a bike lane on 102 ave that went from 108 st to 118 st. I originally didn’t believe we could make it happen. Most pop up bike lanes that I’ve read about only span a few blocks. But we managed to pull it off. And that’s Edmonton for you – it shows up, helps you carry out your ideas, and exceeds your wildest expectations.

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The intention of the pop up bike lane was to get people together and show the City that we are serious about these bike lanes. To communicate that we want them prioritized in the Capital Budget. We have a small window to act. The Capital Budget will be approved in December 2014 and we need city council to budget for the 102 ave bike lane. It was announced by the City on September 19th that 102 ave was the preferred route – now we just need to pay for it. In the next 5 years, downtown Edmonton will be transformed by new developments of all kinds. The downtown core will attract more people, and bike lanes (in concert with public transit) will need to be part of the strategy in getting those people around our growing city. I know that Edmonton has aspirations in being a “globally competitive city” – I don’t see it being one without viable and smart cycling infrastructure.

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But bike lanes are more than just segregated pieces of concrete or lines painted on a road.

The social, economic and health benefits of bike lanes are numerous. You can read about them here.

One aspect of cycling that I’ve come to appreciate is that it is an accessible and affordable method of transportation for Edmontonians living in poverty. Based on Alberta’s minimum wage of $10.20/hour, annual income would be $21,216 (before taxes). The other day I read an article that stated the average annual cost of owning and operating a compact vehicle is approximately $9500/year . Factor in the average cost of groceries at $5400 a year .  And then there’s rent. Based on these stats from October 2013, the annual cost to rent a two bedroom apartment in Edmonton is $13, 692.  At this point if you do the math, you’ll see that the average person living on minimum wage is barely able to afford their basic needs, let alone own a car. Owning a car could take up to half of their annual income.  And this is assuming they are employed. There are many more people living in much more dire situations. Current stats indicate that 100,810 Edmontonians live in poverty – that’s roughly 12% of our city living in circumstances where it may not be feasible to own and maintain a car.

It is evident that we need more affordable options for transportation. Mayor Don Iveson has done some amazing work working to obtain the funding needed to expand our LRT system. But it doesn’t end there. Public transit is just one facet of active transportation.

We need safe and accessible bike routes throughout our city. Amongst other benefits, establishing bike lanes will demonstrate that we recognize the needs of those who can’t afford cars. For far too long, the system has catered to a certain subset of our population, often those who are the most privileged. We need to shift that type of thinking, and establishing smart and safe bike infrastructure is part of that shift.  Bike lanes are crucial to Edmonton being an inclusive and healthy city.

Last night I had my first meeting with the Community Well Being Working Group, which is working to support the mandate of the Mayor’s Task Force to Eliminate Poverty in Edmonton. I am honored to be involved in helping co-chair that working group, and proud to live in a city where our Mayor has prioritized poverty elimination as one of the foremost areas of action.

When I reflect on how community well being is tied to poverty elimination, I see the establishment of safe cycling infrastructure to be an undeniable part of the solution. I don’t see bike lanes as the sole means of eradicating poverty, but a supportive element that would contribute to that mission. Cycling promotes health, is affordable, and contributes positively to community.

I’ve blathered on a bit, as this topic is one that I am passionate about.

This post was my longwinded way of saying that I encourage urge you to write your city councilors in support of establishing the 102 ave bike lanes in the 2015 Capital Budget .

Thanks for your time,

Robin

What is community?

What is community?

Merriam Webster defines community as

: a group of people who live in the same area (such as a city, town, or neighborhood)

: a group of people who have the same interests, religion, race, etc.

: a group of nations

As you can see, the definition isn’t particularly clear.

I’ve been mulling over this question for some time now. The word “community” is thrown around quite a bit, but I’m not sure we really understand what we mean when we use it.  I’ve often referred to myself as a community builder. I teach in the Faculty of Health and Community Studies. I work on a mental health team in Edmonton called the Community Outreach Assessment and Support Team. Earlier this year I attended the Canadian Association of Occupational Therapists National Conference in Fredericton, where the focus was on “Enabling Healthy Communities”. At the conference we discussed many interesting and innovative community based programs, but I left still puzzled about what community actually was.

I guess my preoccupation with this question began last year, during a conversation I had with a client. The client was experiencing depression and I was called in to help him find some meaningful activities to do in his community.

** (I’ll speak to this more in another post, but occupational therapy is an often misunderstood profession – I see myself as working collaboratively with people to help them explore how doing can provide a sense of purpose and meaning). **

I sat with him and began to talk about all of the things he might be interested in doing. I saw that he was disinterested in the discussion on activities, and so I asked him about his community and what he identified as his community. His reply was that he didn’t have one. I grew to understand that his experience of depression was exacerbated by profound loneliness and social isolation. He saw community as “other people”.

While his response to my question was troubling, it wasn’t surprising. My team supports adults with developmental disabilities – most often the biggest issue that affects their quality of life is chronic loneliness and a lack of connection with others. The reality is that there are many people in Edmonton that don’t see themselves as part of a community – oftentimes due to barriers that are a result of marginalization and oppression.

Following that encounter with my client I was determined to try to do my part in addressing the issue of social isolation and disconnection.  My pursuit in connecting people with communities fueled my desire to understand what community was.

This question was on my mind during the Fall 2013 semester, and so I asked the students of the mental health class I teach at MacEwan University. I received varied responses: a village, “my soccer team”, a city, a culture, “my church”, a support group. My question didn’t provide a definitive answer – and I am happy that it didn’t.

If I asked my father to describe community, he would probably say it was how the people of Saraotalli (his small rural village in Bangladesh) would collectively come together and look out for one another, ranging from sharing farmed produce to taking care of the neighbour’s son. I believe that his upbringing exemplified the common adage “It takes a village to raise a child”.

If you were to ask a sociologist what community was, they would likely tell you that community is a “social construct”. According to Phil Bartle from the Community Empowerment Collective, community is “a set of interactions, human behaviours that have meaning and expectations between its members”.

To further abstract the concept, he states that “a community usually was already existing when all of its current residents were not yet born, and it will likely continue to exist when all of the people in it have left”.

So it seems that community isn’t a physical place as much as it is an idea. But then again, physical spaces have much to do in creating community. Just look at the great community revitalization work being done on 118 ave or the envisioned plan for Blatchford where public spaces will help foster a sense of community.

Maybe we can’t create a universal definition for community. Perhaps it lies in the subjective and personal experience one has with it.

If we can’t define what community is, maybe we can explore the purpose it serves. As my client said, “community is other people”.

Social inclusion is considered a social determinant of health and has been tied to many health outcomes. According to Berkman and Glass (2000) studies have consistently demonstrated people who are socially isolated or disconnected from others have between two and five times the risk of dying from all causes compared to those who maintain strong ties with family, friends & community. (here’s a link to their paper: http://www.ulb.ac.be/esp/psd/foresa/Durkheim.pdf).

Community involvement has direct implications on our health.

As I stated earlier, there are Edmontonians who, for a variety of reasons, don’t feel connected to a community. I believe that we need to remember that as we move forward in participating in our own communities.

When I think of community, I think of human connection, mutual support, and shared vision. Through the sharing of ideas and social capital, members of a community can assist each other in realizing greater goals.

Edmonton has a demonstrated commitment to community. I have heard that we have the most community leagues of any city in the country – which is quite impressive. Often times when you ask people, Why Edmonton? – they respond “because of the community feel”.

So it seems that I haven’t come to a definitive conclusion in my quest to define community, and so I turn to you. I’m curious to hear your perspectives on the following questions:

  • How do you define community?
  • What communities do you belong to?
  • How can you make your community more accessible to others?

Please comment below and share some of your thoughts on the topic. Thanks!

 

(header credit: EEDC https://www.flickr.com/photos/edmontonliveallyear/4148779276)