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Potential solutions include health worker education coupled with incentives to embed policy into practice, better communication about approaches beyond the punitive, legislation that allows both disclosure to patients and quality improvement protection for institutions, apology protection for providers, comprehensive disclosure programs that include patient compensation, delinking of patient compensation from regulatory scrutiny of disclosing physicians, legal and contractual requirements for disclosure, and better measurement of its occurrence and quality. A longer-term solution involves educating the public and health care workers about patient safety.

Overcrowding, noise and air pollution, long commutes and lack of daylight can take a huge toll on the mental well-being of city-dwellers. With mental healthcare services under increasing pressure, could a better approach to urban design and planning provide a solution? The restrictions faced by city residents around the world during the COVID-19 pandemic has brought home just how much urban design can affect our mental health – and created an imperative to seize this opportunity. Restorative Cities explores a new way of designing cities, one which places mental health and wellness at the forefront. Establishing a blueprint for urban design for mental health, it examines a range of strategies – from sensory architecture to place-making for creativity and community – and brings a genuinely evidence-based approach that will appeal to designers and planners, health practitioners and researchers alike - and provide compelling insights for anyone who cares about how our surroundings affect us. Written by a psychiatrist and public health specialist, and an environmental psychologist with extensive experience of architectural practice, this much-needed work will prompt debate and inspire built environment students and professionals to think more about the positive potential of their designs for mental well-being.

BackgroundThis study was conducted in rapidly urbanizing Ulaanbaatar, Mongolia, to examine patterns of perceived neighborhood quality by residents and the associations between these patterns and self-reported general and mental health in middle-aged women.MethodsA questionnaire survey was administered to 960 women aged 40–60 years. Demographic and socio-economic characteristics, subjects’ perception of their neighborhood environment, general health status, and mental health as measured using a 12-item General Health Questionnaire (GHQ12) were reported.ResultsA total of 830 women completed the questionnaire. Subjects reporting their general health as very good or good accounted for 80.3% and those with a GHQ12 ≥16, which reflects psychological distress or severe distress, accounted for 16.1%. A principal component analysis of the perceptions of neighborhood environment by the residents identified six qualities: physical environment, designed environment, neighborhood community, public safety, natural environment, and citizen services. The perception of better-quality citizen services in the neighborhood was associated with better self-reported general health (odds ratio [OR] = 1.330, 95% confidence interval [CI] 1.093–1.618), and the perception of better-quality public safety was associated with less psychological distress (OR = 0.718, 95% CI 0.589–0.876); these associations were independent of education, income, occupation, type of residential area, and number of years living in the current khoroo.ConclusionsThe perception of the quality of a neighborhood environment can affect the self-reported general and mental health of residents, even after accounting for the type of residential area and individual socio-economic status. Developing high-quality neighborhoods is an essential component of good planning to promote population health in urban environments.