“Top-down approaches, such as financial government support to access mental health professionals, help but can only take you so far,” says Stefania Pascut, the Healthy Cities representative in the Italian city of Udine. “An effective public mental health intervention must include community-led approaches that involve all parts of society, strive to unlock the potential of underutilized community spaces, and maximize the power of digital tools.”
Promoting digital spaces to increase health literacy
WHO/Europe research indicates that children, young adults and older people are struggling to grapple with the immediate impact of the pandemic – the lives lost globally and the health and socioeconomic consequences – as well as the long-term effects of the pandemic and public health measures to protect the population.
The Healthy City of Udine has invested significant resources in addressing the mental health needs of its population, including by applying a community-based approach centred around promoting a healthy lifestyle. This has included making the most of digital spaces as the only meeting platform during lockdown.
“Older people, of which our city’s population represent over 26%, suffered from increased loneliness and social isolation,” adds Stefania. “They also required support in ensuring they could independently access health-related resources. The City therefore organized health literacy courses, which taught older people how to use multimedia platforms and technological tools to autonomously find information, such as infection-prevention measures and COVID-19-related public health requirements.”
People-centred urban places
“Socially, physically and culturally enabling environments that are actively inclusive have a great impact on mental health,” Stefania explains. “When talking about and applying the principles of person-centred place-making, we refer to humane urban spaces built for and by everyone.”
“It’s not enough, for example, to have green parks available in urban spaces – these parks also need to be accessible and offer opportunities for older people to enjoy them,” continues Stefania. “In Udine, we have been offering public-run initiatives, such as open-air painting lessons in parks and urban gardening activities.”
“This community-based approach is particularly important in creating age-friendly, person-centred environments where people can meet intergenerationally, engage with others and promote physical exercise.”
Designing and making the best use of urban places that improve health and well-being is one of the elements outlined in the Copenhagen Consensus of Mayors, which guides the Healthy Cities Network and lays out a transformative approach for safe, inclusive, sustainable and resilient societies.
Using play as an innovative place-making paradigm
The playful paradigm is a tool to develop equitable and democratic societies, where games are employed to raise awareness about healthy lifestyles, promote inclusivity, involve older people in the community, and help develop improved communication between parents and children. In Udine, various groups of older people meet in libraries on a weekly basis to play together, and there is also a ‘game library’ where everyone can play for free.
“I often have had difficulties interacting with others, especially during my time in elementary school,” said one of the young students who benefited from an activity organized by the City. “I now learned how there are different ways to listen, that my opinion matters, and to be more in tune with my own feelings as well.”
“Not only children, but people of all ages benefit from play – it facilitates emotional capacity and resilience and helps establish relations by making it easier to overcome physical and cognitive deficiencies as well as age, linguistic and cultural barriers. Creating these enabling environments for mental health and well-being also allows for unexpressed needs to be met before symptoms become evident. This life-course approach, which addresses mental health issues, is a journey towards better health for all.”
Sharing experiences, inspiring other Healthy Cities
Stefania shared Udine’s work during a recent webinar on mental health held by the Healthy Cities Network. The Network brings its members together monthly for thematic webinars that present WHO recommendations on health topics, while encouraging cities to share best practices and interventions and discuss possible solutions for challenges other cities may be facing.
The Healthy Cities Network promotes the priorities set out in the European Programme of Work, including the need to focus on long-neglected issues such as mental health, take advantage of the possibilities unlocked by digital health, and strengthen healthier behaviours by empowering people to take charge of their own health.