The concept of urban resilience and its relation to resilience in mental health: Prospects for research in schizophrenia

Abstract

The relationship between schizophrenia and the city is well known and widely documented in the literature, albeit with many questions still unanswered. While it is clear that there is a higher incidence of schizophrenia in cities, there is little known on causality - or its direction - in that relationship. Also, despite the fact that several clinical and epidemiological parameters play a role in the relationship between schizophrenia and the city, this relationship has not been investigated or interpreted holistically. In particular, biological, psychological and social parameters have been extensively explored, usually in isolation, but not as a part of the wider urban environment. A concept that could potentially offer such integration between the urban environment and the biopsycho- social approach may be the concept of psychological resilience. Psychological resilience is a central notion of Preventive Psychiatry, both in theory and in practice. It refers to a person's ability to cope with adversity and to recover. It describes, in holistic terms, the psychological potential that each person has, taking together all positive psychological factors but also their functioning and reactions in their own environment. It is intriguing that the same concept, (even by the same name - urban resilience), exists in relation to urban planning and architecture, referring to a city's ability to help its inhabitants and systems to withstand and recover from adversity. As with people, the factors that make a city resilient are many and complex. Surprisingly, however, the factors that define psychological and urban resilience are conceptually related, as ultimately both serve the person/citizen. Thus, the factors that make up urban resilience may be complementary to the factors that make up mental resilience and vice versa. Consequently, not only is the conceptual affinity of urban resilience and psychological resilience logical, but also the individual factors that define the two are also related. It would be interesting to study these factors and to examine the role of resilience (or lack thereof) in the occurrence of mental illness - in particular schizophrenia - in cities. In this paper we present the concepts of psychological and urban resilience, we identify the factors that characterize urban resilience, and define its practical relationship with psychological resilience in the case of schizophrenia. Finally, we explore the potential and prospects of this novel multidisciplinary approach for tackling schizophrenia, for use in public health, and for further research.