1 00:00:08,210 --> 00:00:13,490 And the last big speak of this group, I come from a slightly different position. 2 00:00:13,490 --> 00:00:22,310 And they come actually as built environment expert concerned about how we design housing, how we design hospitals, areas, 3 00:00:22,310 --> 00:00:33,440 etc. and how that impacts on health generally, but also in specific areas that are suffering from quite a lot of deprivation. 4 00:00:33,440 --> 00:00:40,100 Alan earlier talked about, at least here in Oxford, where I have been working, but also parts of London. 5 00:00:40,100 --> 00:00:46,460 I'm finding some different outcomes in terms of how we, as planners, designers, 6 00:00:46,460 --> 00:00:54,560 architects, etc. can assist other professionals in developing particular strategies. 7 00:00:54,560 --> 00:01:01,970 So which one do I go here? Just yeah. 8 00:01:01,970 --> 00:01:10,790 Yes. Yeah. Yeah. OK. So I would like to focus on my experience of the long longitudinal evaluation 9 00:01:10,790 --> 00:01:15,950 in that part of London area called Islington very close to the city of London, 10 00:01:15,950 --> 00:01:25,760 so very central. And talk about the process of engagement, which was a holistic process, engaging all different professionals, 11 00:01:25,760 --> 00:01:31,970 including primary care providers, also schools and various other institutions, 12 00:01:31,970 --> 00:01:37,940 in order to develop a holistic approach and to see how certain symptoms that 13 00:01:37,940 --> 00:01:44,250 were recorded in terms of mental health and wellbeing could or not be remedied. 14 00:01:44,250 --> 00:01:51,500 So I will talk about this case study and then at the end, provide some information about it. 15 00:01:51,500 --> 00:02:01,070 I mean, some of the research that we have carried out in built in Monmouth area that showed the relationship with mental health and health. 16 00:02:01,070 --> 00:02:11,240 Generally, if we live in really very poor neighbourhoods or very poor housing and it is an architectural determinism, 17 00:02:11,240 --> 00:02:18,800 it is really that quite often there are physical and physiological impacts of living in them, 18 00:02:18,800 --> 00:02:25,130 housing or housing that hasn't got proper ventilation or proper cooling or heating. 19 00:02:25,130 --> 00:02:34,400 So we were trying to establish to what extent this area of London in Islington changed over time. 20 00:02:34,400 --> 00:02:42,590 So my research started in 2012 and has been ongoing until now and will continue for another three years. 21 00:02:42,590 --> 00:02:54,680 And we were trying to establish to what extent large area regeneration of multidisciplinary approach that covered all different experts from housing, 22 00:02:54,680 --> 00:03:08,150 transport, air quality, expert health providers, education, etc. If we work together, what can we find out in terms of the benefits? 23 00:03:08,150 --> 00:03:16,310 So the area is very characteristic of quite a lot of social housing in terms of the deprivation index. 24 00:03:16,310 --> 00:03:26,870 It is poorer than most parts of London, although it has also reach areas and are also very densely populated, 25 00:03:26,870 --> 00:03:31,760 very much rebuilt after the Second World War when it was bombed, 26 00:03:31,760 --> 00:03:37,430 and that quite a lot of modernist architecture that by 24 20, 27 00:03:37,430 --> 00:03:50,150 2004 reached a stage where people couldn't live in many of the houses because they had them suffering of condensation and other deprivation factors. 28 00:03:50,150 --> 00:04:03,020 So the project was launched in 2004, and it was funded by the special fund prepared by the Housing Ministry. 29 00:04:03,020 --> 00:04:04,730 And they said the providers, 30 00:04:04,730 --> 00:04:13,670 which went under the umbrella of New Deal for Communities and the project was a holistic improvement of the area in terms of open spaces, 31 00:04:13,670 --> 00:04:23,570 housing and various other factors, together with the indications that health and particularly mental health will be improved as part of it. 32 00:04:23,570 --> 00:04:27,410 And the key aspect was that residents had to be involved. 33 00:04:27,410 --> 00:04:32,480 So some of the previous talks about voluntary groups and various other projects that the 34 00:04:32,480 --> 00:04:38,270 colleagues talked about was very much also that residents had to be part of the project. 35 00:04:38,270 --> 00:04:43,310 So just to give a sense of size, it has about 10000 people. 36 00:04:43,310 --> 00:04:49,490 I'm talking only about one part of Islington, which is called the South Islington, or AC. 37 00:04:49,490 --> 00:04:55,550 One and 94 percent of residents lived in social housing. 38 00:04:55,550 --> 00:05:03,650 Very little open space, heavily built up and quite a lot of deprivation and signs of very poor health. 39 00:05:03,650 --> 00:05:14,510 So in 2004, 11 percent of people who lived on this date suffered from mental health problems and other symptoms. 40 00:05:14,510 --> 00:05:19,070 And we shall see how over time that has improved. 41 00:05:19,070 --> 00:05:23,420 So this is the quality of the man. 42 00:05:23,420 --> 00:05:33,920 And as it was at the beginning of the project, this area on the top left was very much occupied by homeless people, a lot of drug abuse, 43 00:05:33,920 --> 00:05:44,060 alcohol abuse, etc. But if you look at the quality of the rest of the place, nowhere for children to be seen to be playing lack of greenery. 44 00:05:44,060 --> 00:05:53,150 And that caused quite a lot of environmental problems, and they were also linked to high incidence of crime. 45 00:05:53,150 --> 00:06:01,530 So in terms of recorded mental health issues, high levels of stress, anxiety, panic attacks, depression. 46 00:06:01,530 --> 00:06:14,490 Social isolation, loneliness, insomnia and also children suffered from attention deficit and also quite a lot of the symptoms of mental problems, 47 00:06:14,490 --> 00:06:18,870 other health issues have compounded that and they are linked to obesity, 48 00:06:18,870 --> 00:06:26,010 high levels of hypertension, etc., but also alcohol dependency and other problems. 49 00:06:26,010 --> 00:06:36,870 Now that cause that lot of people were out of work for quite a considerable period of time and that caused even bigger problems in the community. 50 00:06:36,870 --> 00:06:42,600 So what happened with the project was that they had to integrate all different departments, 51 00:06:42,600 --> 00:06:48,890 and it was a segmented into different areas of improvement. 52 00:06:48,890 --> 00:07:00,080 Starting with schools and residents, so particularly children who are suffering from mental health problems were targeted in a positive sense, 53 00:07:00,080 --> 00:07:06,950 the work with the team in order to produce their ideas about how they would feel safe in the environment, 54 00:07:06,950 --> 00:07:12,110 etc. So it was then combined with the residents. 55 00:07:12,110 --> 00:07:20,870 So because a lot of volunteers and also a lot of experts who are joining the team in terms of developing the work, 56 00:07:20,870 --> 00:07:29,510 but what was also critical is that local authority professionals, planners, architects and others. 57 00:07:29,510 --> 00:07:36,170 We are also combining both resources, but also expertise in order to take the area holistically. 58 00:07:36,170 --> 00:07:44,730 So dealing with social services, the built environment, natural environment and other key aspects. 59 00:07:44,730 --> 00:07:50,880 Now, the key aspect was how do you put the project together? It's such a large scale. 60 00:07:50,880 --> 00:07:59,670 So the project was segmented into small area attention and therefore each particular pop and state was 61 00:07:59,670 --> 00:08:07,830 targeted in order to develop community response and also to work with local health providers and others. 62 00:08:07,830 --> 00:08:19,370 And that residents were also trained to do surveys and audits and to provide their own input into the area action plan. 63 00:08:19,370 --> 00:08:27,530 Now, what's particularly interesting about this scheme is that it wasn't just a space for space, a target. 64 00:08:27,530 --> 00:08:36,380 If we look at the overall area, it actually produced the network of connected streets, open spaces, services, 65 00:08:36,380 --> 00:08:43,070 etc. So they too didn't just have one pocket of development and the rest is empty so that you could 66 00:08:43,070 --> 00:08:51,470 walk in five to 10 minutes walking capacity in order to reach the school or to reach the shopping, 67 00:08:51,470 --> 00:08:59,960 etc. So the whole area with the participation of residents was put together into the plan. 68 00:08:59,960 --> 00:09:05,540 So it included 19 streets, eight parks and also seven housing estates. 69 00:09:05,540 --> 00:09:11,150 It was a large project and housing was truly critical in that the the quality of 70 00:09:11,150 --> 00:09:16,880 housing and the internal conditions there as important as external condition. 71 00:09:16,880 --> 00:09:24,290 So it was again combined with various other services. So this is what it looks now. 72 00:09:24,290 --> 00:09:32,210 And so this picture that we saw earlier are now completely different in terms of the outcomes. 73 00:09:32,210 --> 00:09:38,630 So we very cold in the improvement of mental health over the time. 74 00:09:38,630 --> 00:09:47,480 And the current figures show that from 11 percent, the quality of mental health has dropped down to 6.4, 75 00:09:47,480 --> 00:09:52,970 again suffering from mental health, which is still higher than the figures for London. 76 00:09:52,970 --> 00:09:58,920 But it is going in the right direction. And what we find here is the particularly useful. 77 00:09:58,920 --> 00:10:00,710 The work with teenagers, 78 00:10:00,710 --> 00:10:11,690 the children and parents and the whole sector is very much integrated in terms of these multi theme and multidisciplinary working. 79 00:10:11,690 --> 00:10:13,130 And not only that, 80 00:10:13,130 --> 00:10:23,300 the establishing that the whole area improvement is contributing to the retraining of people who suffer from long term mental illness problems. 81 00:10:23,300 --> 00:10:30,110 So they were put back to work through the training. Some became engaged in the local market activities, 82 00:10:30,110 --> 00:10:41,900 and quite a lot of the reports that we are getting is that the economic vitality is also helping in terms of the improvement of mental health. 83 00:10:41,900 --> 00:10:53,210 Now, the St Luke's Community Centre is very critical in this area because they have taken a holistic approach, bringing in health experts, education, 84 00:10:53,210 --> 00:11:00,260 working with food experts, etc. again providing community services with quite a lot of volunteers, 85 00:11:00,260 --> 00:11:04,490 particularly people who were part of the project from day one. 86 00:11:04,490 --> 00:11:11,930 And they are also running summer schools for deprived children who come from very poor families and also are trying to 87 00:11:11,930 --> 00:11:21,140 help with schools in terms of learning how to live more healthily and how to deal with specific problems play areas. 88 00:11:21,140 --> 00:11:26,800 Equally important, we discovered because children are experiencing less stress. 89 00:11:26,800 --> 00:11:36,560 Parents accompanying children and therefore the whole area is creating a much more positive ambience and milea in terms of daily life. 90 00:11:36,560 --> 00:11:42,670 So. A looks and is also running a very interesting scheme for elderly. 91 00:11:42,670 --> 00:11:51,940 So there is a lot of social activation, and again, stress levels have dropped down to much lower levels as children are learning how to cook 92 00:11:51,940 --> 00:11:58,610 and to use different article artefacts and also are learning about different skills. 93 00:11:58,610 --> 00:12:05,290 So gardening has become very much part of the whole social rehabilitation programme. 94 00:12:05,290 --> 00:12:11,140 And various other mental health and wellbeing initiatives are now being put forward, 95 00:12:11,140 --> 00:12:17,260 particularly through looks and looks community centre and looking at the longer term implications in terms of 96 00:12:17,260 --> 00:12:26,350 this holistic approach to healthy living and dealing with the issues in terms of the earlier problems recorded. 97 00:12:26,350 --> 00:12:32,740 But it isn't only about both specifically projects we're doing. 98 00:12:32,740 --> 00:12:40,630 It is also how community as a whole is beginning to take charge and responsibility for some of the initiatives. 99 00:12:40,630 --> 00:12:50,920 So social gatherings are very important to include elderly people who are not going out because they're afraid of crime and other issues. 100 00:12:50,920 --> 00:13:00,190 So the ambience and working with artists has helped very much in terms of this social integration, integration and focus group. 101 00:13:00,190 --> 00:13:07,450 Discussion with participants who suffered at the beginning of the project is that they feel much more engaged. 102 00:13:07,450 --> 00:13:11,890 They are able to control that anxiety. 103 00:13:11,890 --> 00:13:21,470 They are also more proactive in terms of contacting rights, services, etc. So the whole social structure has help in the area. 104 00:13:21,470 --> 00:13:28,400 We also carried out a surveys with different traders and residents, et cetera, 105 00:13:28,400 --> 00:13:34,070 so this was the self-reporting one of the documents they regularly produce. 106 00:13:34,070 --> 00:13:38,540 They are how they feel, how they are improving their health, et cetera, 107 00:13:38,540 --> 00:13:46,310 and how the whole area is changing over time as a result of these multidisciplinary approach. 108 00:13:46,310 --> 00:13:46,940 Equally, 109 00:13:46,940 --> 00:13:57,950 the inter-generational working between elderly residents and younger people again governing has played a critical role and that by the benefits are 110 00:13:57,950 --> 00:14:06,710 that there is a much stronger sense of community that people are now not reluctant to go and seek advice if they need in terms of health improvement. 111 00:14:06,710 --> 00:14:10,070 And also stress levels have decreased. 112 00:14:10,070 --> 00:14:20,210 As I stated earlier, and there is a much more positive aspiration in terms of longer-term activities that can be developed. 113 00:14:20,210 --> 00:14:24,020 I'm not going to talk about each individual aspect in detail. 114 00:14:24,020 --> 00:14:30,830 You can look at it later on, but we have produced an audit in terms of almost like the systems analysis in 115 00:14:30,830 --> 00:14:37,640 terms of how different interventions have helped to improve certain disadvantages. 116 00:14:37,640 --> 00:14:44,390 And therefore it's not only one thing that helped in reducing the stress and mental health problems. 117 00:14:44,390 --> 00:14:49,910 It's multiple initiatives that all contributed together. 118 00:14:49,910 --> 00:15:02,090 So basically, what I can offer to all of us here today is that under the current planning system in the in England, health is an important aspect. 119 00:15:02,090 --> 00:15:06,770 So all built environment professionals need to be knowledgeable about health issues. 120 00:15:06,770 --> 00:15:12,080 How are planning and design can impact and therefore multiple disciplinary teams? 121 00:15:12,080 --> 00:15:18,170 Reducing these healthy plans and audits are very important to produce locally. 122 00:15:18,170 --> 00:15:26,090 So many local neighbourhoods are not producing their own health audits and plans, including Oxford and Oxygen. 123 00:15:26,090 --> 00:15:31,910 And I think through the planning mechanism and connected to health systems and provision, 124 00:15:31,910 --> 00:15:38,630 I think we all can learn a lot from each other and how we can work more holistically in terms of 125 00:15:38,630 --> 00:15:44,780 addressing particular issues that are important in terms of delivering health and wellbeing. 126 00:15:44,780 --> 00:15:51,560 So I think just in concluding remarks that such projects are also helping 127 00:15:51,560 --> 00:15:56,750 generally in terms of getting health and wellbeing on the agenda to be discussed, 128 00:15:56,750 --> 00:16:03,890 not to be hidden, and therefore it is very important in terms of community engagement and other activities. 129 00:16:03,890 --> 00:16:14,698 Thank you.