Healing Waters Therapeutic Landscapes in Historic and

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 Healing Waters
Therapeutic Landscapes in Historic and Contemporary Ireland
Ronan Foley
ISBN 978 0 7546 7652 2

Towards Enabling Geographies:

‘Disabled’ Bodies and Minds in Society and Space
Edited by Vera Chouinard, Edward Hall, and Robert Wilton
ISBN 978 0 7546 7561 7

Geographies of Obesity: Environmental Understandings of the Obesity

Epidemic
Edited by Jamie Pearce and Karen Witten
ISBN 978 0 7546 7619 5
Space, Place and Mental Health

SARAH CURTIS
University of Durham, UK
First published 2010 by Ashgate Publishing

Published 2016 by Routledge

2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
711 Third Avenue, New York, NY 10017, USA

Routledge is an imprint of the Taylor & Francis Group, an informa business

Copyright © 2010 Sarah Curtis

Sarah Curtis has asserted her right under the Copyright, Designs and
Patents Act, 1988, to be identified as the author of this work.

All rights reserved. No part of this book may be reprinted or reproduced or

utilised in any form or by any electronic, mechanical, or other means, now
known or hereafter invented, including photocopying and recording, or in
any information storage or retrieval system, without permission in writing
from the publishers.

Notice:
Product or corporate names may be trademarks or registered trademarks,
and are used only for identification and explanation without intent to
infringe.

British Library Cataloguing in Publication Data

Curtis, Sarah, 1954-
Space, place and mental health. -- (Ashgate’s geographies of health series)
1. Mental health--Environmental aspects. 2. Mental illness--
Environmental aspects. 3. Environmental psychology. 4. Mind and body.
5. Medical geography.
I. Title II. Series
616.8'9071-dc22

Library of Congress Cataloging-in-Publication Data

Curtis, Sarah.
 Space, place and mental health / by Sarah Curtis.
p. cm. -- (Ashgate’s geographies of health series)
Includes bibliographical references and index.
ISBN 978-0-7546-7331-6 (hardback)
1. Medical geography. 2. Human geography. 3. Mental health. 4. World
health. I. Title.

RA792.C87 2010
614.4'2--dc22
2010003964

ISBN 978 0 7546 7331 6 (hbk)

ISBN 978 1 3156 1016 0 (ebk)
 Contents

List of Figures
List of Boxes
Foreword
Acknowledgements

1 Mens Sana in Corpore Sano? Introduction to Geographical Perspectives

on Health of the Mind and the Body

2 ‘Virtuous Landscapes’: Therapeutic Material Settings

3 Material Hazards and Risks for Mental Health

4 Resilience, Social Capital and Social Integration

5 Anomie, Status Anxiety and Fear: Socio-spatial Relations and Mental Ill-
health

6 Dreamscapes and Imagined Spaces: The Meaning of Place for Identity,

Spirituality and Mental Health

7 Post-asylum Geographies of Mental Health Care: Spaces for Therapy and

Treatment

8 Place, Space and Population Mental Health

Bibliography
Index
 List of Figures

1.1 Landscapes of health and risk in health geography

1.2 Diagram representing a person’s space/time trajectory through
changing environments relating to human health
1.3 ‘Conventional’ and ‘relational’ understandings of ‘place’
1.4 Linear and non-linear theories of knowledge, after Beck (1999)
1.5 An example of brain scan images of activity in different parts of the
human brain when stimulated by complex problems involving spatial
and interpersonal relationships
1.6 A ‘Social Model of Mental Health’ based on the ‘social model of
health’ proposed by Whitehead and Dalgren (Whitehead, 1995)
1.7 Psychiatric disorders (defined in International Classification of
Diseases Version 10 (ICD10) Chapter V Mental and Behavioural
Disorder)
1.8 Expressions of ‘the nature of happiness’

2.1 An example of a ‘natural’ environment interpreted through the theory

of Biophilia
2.2 ‘Recovery’ of normal blood pressure in relation to ‘exposure’ to film
of natural and unnatural settings
2.3 Community survey in Adelaide: odds ratio of having better mental
health: people living in areas with medium or higher levels of
‘perceived greenness’ compared with those in areas where greenness
levels were perceived to be low
2.4 View of Denali National Park
2.5 Shinrin-yoku and psychological stress levels
2.6 Varying appeal of different visions of trees: different environments
including trees
2.7 Scenes of Bath Spa (SW England)
2.8 Selected examples of research in environmental psychology on the
attractive elements of waterscapes
2.9 Some aspects of water that people seem to find attractive
2.10 Representation of the Feng-Shui model
2.11 The Feng-Shui Compass
2.12 The Royal Crescent at Bath Spa, England
2.13 Scene from the Antigone, Montpellier, France: an example of a
therapeutic landscape in an urban setting
3.1 Miyake Island disaster (a volcanic event): Relationship between loss
and relocation and psychological symptoms of PTSD
3.2 Severity of psychological impacts of different types of disaster
3.3 The association between flood exposure and depressive symptoms,
Kentucky, USA
3.4 Structural equation model showing relationships example of SEM
results between aspects of exposure to the Indian Ocean tsunami and
psychological health
3.5 A socio-ecological model of the key relationships influencing the
associations between flood events and mental health
3.6 Conceptual framework of factors influencing the psychosocial impacts
of environmental contaminants
3.7 The New Morbidity model of risk for mental retardation proximal
variables

4.1 Neighbourhood environments and rules of access

4.2 Berkman et al.’s model of the links between social integration and
health
4.3a Diagram from multiple correspondence analysis of survey respondents
in relation to economic and social capital dimensions
4.3b Diagram from multiple correspondence analysis of health determinants
distinguishing economic and social capital dimensions
4.4 Social networks in the Framingham survey sample and the relationship
with individuals’ happiness
4.5 Variation in risk of common mental disorders in relation to individual’s
household deprivation and the level of friendship ties typical of their
 residential area
4.6 Mental health related to ‘ethnic density’ for East Asian school children
in East London

5.1 Variation in social environment and material living conditions in

relation to population mental health
5.2 Graph showing the effect of Bayesian smoothing on age standardised
suicide ratios
5.3 Young people in England: trend in per cent ‘distressed’ by social
conditions in place of residence
5.4 Relationships between externalising psychological problems in early
adulthood, neighbourhood deprivation earlier in life and parental
education
5.5 Results of structural equation modelling to explore the links between
area deprivation, social cohesion and mother’s and child’s
psychological health
5.6 Residential locations of a group of people with schizophrenia in
Nottingham – residential locations at different time points

6.1 Tokyo by Stephen Wiltshire

6.2 Delphi in Greece
6.3 The Solidarity Memorial in Gdansk, Poland
6.4 A church building in Katowice, Poland
6.5 Durham Cathedral, Durham, England
6.6 Sculpture in Durham city representing St Cuthbert’s coffin being
brought to Dunelm, the site of Durham Cathedral
6.7 Standing stones at Avebury in the south of England
6.8 Uluru, Northern Territory, Australia
6.9 Traditional gardens in Kyoto, Japan
6.10 Grafitti of an unthreatening kind

7.1 Jeremy Bentham (1791), Panopticon: or, the inspection-house

7.2 Interior of a newly built psychiatric inpatient unit
7.3 NHS staff viewing a full scale ‘mock up’ model of an individual
patient’s room designed for a new secure psychiatric facility being
built in England
7.4 A representation of the typical daily action space of a participant in a
study by Townley et al. (2009) of social integration of people with
serious mental illness living independently in the community in South
Carolina, USA
7.5 New York City in 2000. Zip code areas grouped in quintiles by income
and Standardised Admission Ratios for psychiatric hospital admissions

8.1 Example of an approach to assessment of mental wellbeing used by

Scottish Government
8.2 Information from the WHO (2005) Mental Health Atlas showing
differences in provision of mental health care among countries
grouped by national income
8.3 Different types of national health service systems and their use for
local area estimates of need to use services
8.4 Comparison of two ways to estimate ‘needs’ for psychiatric services in
the population of local areas
8.5 Conceptual Framework linking Green Infrastructure, Ecosystem and
Human Health
 List of Boxes

1.1 Suggestions for further reading about health geography

1.2 Suggestions for complementary reading on the development of
geographies of mental health
1.3 Measuring ill health in populations: plain language definitions of some
key terms
1.4 Measuring symptoms of depression in population surveys
1.5 Illustrative items from the WHOQOL questionnaire

3.1 Examples of questionnaire instruments which are widely used to assess

the prevalence of PTSD in populations surveys
3.2 Qualitative studies of experience of flooding in England

4.1 An example of an ethnographic approach to the study of social

environment and social cohesion using interviews and participant
observation
4.2 Using photovoice to study social capital

5.1 Durkheim’s theory of anomie

5.2 Designing ‘ecological’ research on mental health and socio-economic
conditions
5.3 Using Bayesian smoothing methods to adjust indicators of rates of
psychiatric disorders in small geographical areas
5.4 Ecological associations between suicide, material deprivation and social
fragmentation in Britain

7.1 Perceptions of therapeutic landscapes in a psychiatric hospital: A post-

occupation evaluation of views about the associations between design
and wellbeing in a newly built psychiatric inpatient unit in London, UK
7.2 The action spaces of people with mental illness in South Carolina: A
study by Townley et al. (2009)

8.1 The WHO (2005) Mental Health Declaration for Europe

8.2 Different approaches to estimating population needs for mental health
services at the small area scale
 Foreword

This book aims to provide an overview of research on mental health from a

geographical perspective and to show how and why space and place are
important for mental health of individuals and populations. One objective is
to move forward the research agenda in this field by considering in
combination fields of research which are often treated rather separately. The
book aims to interest an interdisciplinary audience of researchers concerned
with mental health of individuals and population. The book is also intended
to offer an introduction for higher level undergraduate and postgraduate
students who may be undertaking courses in health geography, public
health, sociology or anthropology of health and illness. For this reason I
have attempted to provide some explanation of basic concepts throughout
the discussion, and some specific illustrations of research ideas and
methods have been presented in ‘boxes’ which are intended to provide
suitable cases for discussion in class. A summary of some possible learning
objectives is offered at the end of each chapter (though these are illustrative
rather than exhaustive) and some suggestions for introductory reading are
also listed.
 Acknowledgements

I would like to thank those who have helped in the production of this book
and in the research on which this book is based. Special thanks go to staff at
Ashgate and to Kimberley Armstrong and Jenny Laws at Durham for all
their editorial assistance. Also I want particularly to thank my husband
Brian Blundell for his unfailing support and good humour, without which
this would not have got done.