Going Crazy in the City: Neighbourhood Context and Mental Health

Abstract

The book chronicles the mental health effects of neighbourhood conditions in Jamaican communities. The work underscores the unquestionable relevance of the socio-ecological perspective and social determinants of health to the public health framework and sustainable development agenda. This book is intended to be provocative, to reach deep into the wellspring of the reader’s thoughts and emotions.

What have we learned?
Set in Jamaica, a Lower Middle Income Country, the work which is based on secondary analysis of the Jamaica Health and Lifestyle Survey II (2007/08) demonstrates that neighbourhood infrastructure (e.g. roads, sidewalks, street lighting, water and the cleanliness of the environment) and the quality of this infrastructure are important variables in the mental health landscape. The burden of depressive symptoms is inversely related to the availability and quality of community infrastructure. Data models show that the urban setting is a trigger for depressive symptoms. Among females, the urban trigger of depressive symptoms is the informal community, while among men it is urban communities with poor infrastructure conditions.

What is distinctive about this work?
The work employs the qualitative art-based research form known as Fiction as Research. This is an art form which allows the writer to “… create a deeper understanding of experiences in a language that is more accessible to people than research published in academic publications. Using fiction creates an opportunity for the writer to simulate the environment, sights, sounds, and smells of reality virtually, which captivates the reader’s imagination...” The writer can therefore ‘create new knowledge for the reader’ or ‘disrupt dominant ideologies orstereotypes’. (Source: Patricia Leavy. Fiction as Research Practice: Short Stories, Novellas, and Novels. Walnut, CA: Left Coast Press Inc., 2013). The author utilizes this technique to script scenes in three urban Jamaican communities - Bottom River, Middle Ground and Hill Drive, as well as a rural community. The findings have been deliberately shared in the language of the people, using the narrative style to enrich the reading experience. The use of illustrations further enhances the interpretation of the issues and facilitates reader engagement.

Why is this work significant?
As an important sustainable development tool/resource to support the attainment of Vision 2030 Jamaica and the Sustainable Development Goals (SDGs), this work is of relevance to key Ministries and agencies which provide health, infrastructural and social development services (e.g. Ministry of Health, Planning Institute of Jamaica, Ministry of Local Government and Community Development, Ministry of Education, Youth & Information, Ministry of Culture, Gender, Entertainment & Sport). The study is also relevant to Jamaica’s International Development Partners which provide funding and technical support for national development priorities. The narrative techniques employed are also aimed at engaging the media in the dissemination of research in the ‘people’s language’ and to support sustainable national development.

Keywords: mental health, neighbourhood conditions, Jamaica, urban, social determinants of health, gender, sustainable development