Going Outside: The Real World’s Impact on Youth Mental Health


For children, teens, and young people in towns and cities everywhere, community matters to mental health. Socializing matters. Having activities and safe destinations in the real world—and having the freedom, the agency, to get there—matters enormously, whether the human being in question is enrolled in grade school or navigating their 20s.

Or navigating their 90s. But as Michelle Goldberg articulated in a recent piece for The New York Times, the impact of social media use and screentime on younger generations means that youth are spending less and less time in three dimensions and more and more time in addictive and toxic cyberspace. “If we want to start getting kids offline,” she writes, “we need to give them better places to go instead. . . . We need a lot more places — parks, food courts, movie theaters, even video arcades — where kids can interact in person.”

One reason kids spend so much time inside on their phones is, she points out, widespread parental fear of letting them loose into an unsafe world. Interestingly, a similar call for community engagement and healthy in-person interaction was issued in a recent article in Nature that focused on urban youths specifically, urging cities to do more to support their mental health—such as providing safe spaces for socializing. 

As the article abstract states: “Increasing urbanization over the next three decades will be accompanied by a growing population of children and adolescents living in cities. Shaping the aspects of urban life that influence youth mental health could have an enormous impact on adolescent well-being and adult trajectories.” 

To that end, the authors surveyed “researchers, practitioners, advocates and young people” in compiling “the characteristics of a mental health-friendly city for young people.” Suggested areas of focus and action include “life skills for personal development, valuing and accepting young people’s ideas and choices, providing safe public space for social connection, employment and job security, centring youth input in urban planning and design, and addressing adverse social determinants were priorities by domain.” 

This isn’t something likely to be implemented quickly in cities around the globe. It’s not a short to-do list, with plenty of political, financial, and systemic hurdles to overcome before any significant pieces of it can come to fruition for youth anywhere. There’s vision, and then there’s reality. 

But vision is a starting place. The simple fact that researchers resolved to identify and describe the ideal urban environment for youth—and then pushed for their involvement in planning and policy-making—is a significant step forward in recognizing the complex and powerful forces at play in shaping mental health. Children and young people are molded by environmental factors that either boost or dampen their mental and emotional wellbeing, from the socioeconomic status of their families to the world outside that helps or hurts them on their walk through life. 

The Nature article (based on surveys launched at the start of COVID) isn’t 100% questioning and critical of the current mental healthcare system, as it mentions “normalizing youth seeking mental health care and addressing service gaps” as an area of concern—without stipulating what such services might includes. But even that phrase is wedged into a larger paragraph identifying the biggest issue: “Addressing adverse social determinants of health for young people had the highest overall ranked mean . . . Having access to affordable basic amenities was most frequently ranked first in this domain.” 

And throughout, the authors emphasizes the importance of inclusion, arguing the involvement of “young people marginalized owing to sex, gender, sexual orientation, race, economic status, ethnicity or caste; young people with disabilities; and youth and adults with lived experience of mental health conditions in the design of mental health-friendly cities will help to level power imbalances and increase the likelihood that cities meet their needs.”

Imagine that: asking youth what sort of cities they’d want to live in. It’s a huge question that deserves to be asked—and soon. 

—Amy Biancolli, Family Editor 

[email protected]


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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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