Urbanicity and psychosis- are cities bad for mental health? Novel insights from UK data linkage and participant perspectives; mixed methods study

城市化和精神病——城市对心理健康有害吗？

• 批准号: 2604124
• 金额: --
• 依托单位: King's College London
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2021
• 资助国家: 英国
• 起止时间: 2021 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2604124
• 关键词: Urbanicity; psychosis; cities; bad; mental

In the UK, more people who have psychosis live in cities than rural areas, and there is a large body of evidence suggesting that city living may be associated with a higher risk of psychosis. However, the reasons underlying this remain poorly understood. Although it has been suggested that city living may be associated with a heightened risk of social isolation, being 'less connected' to others resident in local communities, and/ or living in more deprived areas which are known to be associated with poor mental health, evidence relating to this remains scarce, particularly from the UK. Public Health England and other local government bodies are increasingly interested in supporting policies targeted at making cities more mental-health friendly, yet data to support such policy remains scarce. In this project we will use electronic health records from one of the largest secondary mental health providers in Europe, covering a catchment of 1.3 million people resident in a well-defined catchment area across the London boroughs of Southwark, Lambeth, Lewisham and Croydon, linked to individual-level information from UK census 2011 (a rich source of information on individual social contexts), to assess the risk of city living being associated with psychosis. The linked dataset comprises around 20,000 people with psychosis each matched to five people without mental health problems, who will act as a 'control' or comparison group. This dataset will enable a quantitative assessment of predictors in the urban built environment (including household poverty, social isolation, family support, ethnicity/ migration status) with the onset of psychosis, in a way that has not been previously possible in the UK. The student undertaking this PhD will also interview up to 20 people with psychosis, to understand their experiences of city living and mental health problems. The information from these interviews will be combined with the quantitative findings from the health records, to further inform insights. The CASE partners for this project, The Centre for Mental Health, is a charity with a major focus on tackling mental health inequalities. Together with the Centre for Mental Health, areas of this project relevant to urban policy will be mapped, taking into account the views of relevant stakeholders (for example public health and charities), which will ensure that findings are translated into actionable policy recommendations.

在英国，居住在城市中的精神病的人数多于农村地区，并且有大量证据表明，城市生活可能与更高的精神病风险有关。但是，此基础的原因仍然很少理解。尽管已经提出，城市生活可能与社会隔离的高风险有关，与居住在当地社区的其他人“较少联系”，并且/或生活在较贫穷的地区，这些地区与不良的心理健康有关，但与此有关的证据仍然很少，尤其是来自英国。英格兰公共卫生和其他地方政府机构越来越有兴趣支持针对城市更加心理健康的政策，但支持这种政策的数据仍然很少。在这个项目中，我们将使用欧洲最大的中学心理健康提供商之一的电子健康记录，涵盖了130万人在伦敦伦敦伦敦自治市镇，兰贝斯，刘易舍姆和克罗伊顿的伦敦区域定义明确的集水区中居住的集水区，与社交中心相关联的人口众所周知，与英国汇总的个人相关联，与个人的信息源相关联，与个人相关联的信息源，与个人相关联。链接的数据集约有20,000人与五个没有心理健康问题的人相匹配，他们将充当“控制”或比较组。该数据集将通过精神病的发作来对城市建筑环境中的预测因素进行定量评估（包括家庭贫困，社会隔离，家庭支持，种族/移民地位），以这种方式以前在英国不可能。攻读该博士学位的学生还将采访多达20人精神病患者，以了解他们对城市生活和心理健康问题的经历。这些访谈中的信息将与健康记录的定量发现相结合，以进一步了解见解。该项目的案件合作伙伴是心理健康中心，是一项慈善机构，重点是应对心理健康不平等。考虑到相关利益相关者的意见（例如，公共卫生和慈善机构），将与心理健康中心一起绘制与城市政策相关的领域，这将确保调查结果转化为可行的政策建议。