RUHSAL HASTALIKLARIN KENT YAŞAMIYLA ENTEGRASYONU: TEMATİK BİR LİTERATÜR ANALİZİ (2003-2024)

Öz

Bu çalışma ruhsal hastalıkların kentsel yaşam entegrasyonu ile ilgili bilimsel bilgi birikimini betimlemek ve ana temaları ortaya çıkarmak amacıyla ele alınmıştır. Nitel araştırma yöntemlerinden doküman analizi tekniğine başvurulmuştur. Konuyla ilgili 2003-2024 yıllarını kapsayacak şekilde ulusal ve uluslararası veri tabanları taranmıştır. Veri kaynakları olarak PubMed, Web of Science, Scopus ve TR Dizin akademik veri tabanlarından anahtar kelimeler ile yapılan taramalarda alınma kriterlerine uyan 40 çalışmaya rastlanmıştır. Elde edilen bulgular, betimleyici yaklaşımla değerlendirilmiştir. 2003-2024 yılları arasındaki tematik incelemede, en çok yayının 2017-2021 yılları arasında olduğu görülmektedir. Yapılan tematik analizde belirlenen dört temanın dağılımları şöyle bulunmuştur: “Kentsel çevre ve psikolojik stres” (n=18); “Sosyal eşitsizlik ve damgalama” (n=13), “Yeşil alanlar ve ruh sağlığı” (n=6) ile “Sosyal izolasyon ve yalnızlık” (n=3) temalarının izlediği saptanmıştır. Ülke dağılımına bakıldığında, Amerika Birleşik Devletleri (n=17) ilgili temalarda en fazla yayına sahip ülke olarak öne çıkmaktadır. Ruhsal hastalıklar ve kentsel yaşamın entegrasyonu, ruh sağlığı sorunları ile kentsel ortamlarda yaşama deneyimleri arasındaki karmaşık ilişkiyi ifade eder. Hızlı değişim, sosyal karmaşıklık, yüksek nüfus yoğunluğu ve çevresel stres faktörleri ile karakterize edilen kentsel yaşam, ruh sağlığı koşullarının başlangıcını, alevlenmesini veya yönetimini ya da akıl hastalığı da bireylerin kentsel alanlarda gezinme, etkileşim kurma ve deneyimleme biçimlerini etkileyebilir. Kentsel yaşam ve ruhsal sağlık arasındaki karmaşık ilişkiyi anlamak, daha sağlıklı kentsel alanlar yaratmak ve kent sakinleri için ruh sağlığı sonuçlarını iyileştirmek için çok önemlidir.

Anahtar Kelimeler

• Kentsel Yaşam
• Psikiyatri Hemşireliği
• Ruh Sağlığı
• Tematik Analiz
• Toplum Ruh Sağlığı.

INTEGRATION OF MENTAL ILLNESSES WITH URBAN LIFE: A THEMATIC LITERATURE ANALYSIS (2003-2024)

Öz

This study aims to describe the body of scientific knowledge on the integration of mental health into urban living and to identify its main themes. The document analysis technique-one of the qualitative research methods-was employed. National and international academic databases covering the years 2003-2024 were systematically reviewed. Data sources included PubMed, Web of Science, Scopus, and TR Dizin, and 40 studies meeting the inclusion criteria were identified through keyword searches. The results were analyzed using a descriptive approach. The thematic analysis of studies published between 2003 and 2024 revealed that the highest concentration of publications occurred between 2017 and 2021. The descriptive analysis identified four primary themes with the following distributions: “Urban environment and psychological stress” (n=18), “Social inequality and stigma” (n=13), “Green spaces and mental health” (n=6), and “Social isolation and loneliness” (n=3). Regarding country distribution, the United States (n=17) emerged as the leading contributor to the relevant themes. The integration of mental health and urban living reflects the complex relationship between mental health problems and the experience of living in urban settings. Characterized by rapid change, social complexity, high population density, and environmental stressors, urban life can influence the onset, exacerbation, or management of mental health conditions, while mental illness can also shape how individuals navigate, interact with, and experience urban spaces. Understanding the complex relationship between urban life and mental health is essential for creating healthier urban environments and improving mental health outcomes for city residents.

Anahtar Kelimeler

• Community mental health
• Mental health
• Psychiatric nursing
• Thematic analysis
• Urban life.

Kaynakça

1. Adli, M., Berger, M., Brakemeier, E. L., Engel, L., Fingerhut, J., Hehl, R., ... & Stollmann, J. (2016). Neurourbanistische ein methodischer Schulterschluss zwischen Stadtplanung und Neurowissenschaften. Die Psychiatrie, 13(2), 70-78. doi.org/10.1055/s-0038-1670122
2. Baba, C., Kearns, A., McIntosh, E., Tannahill, C., & Lewsey, J. (2017). Is empowerment a route to improving mental health and wellbeing in an urban regeneration (UR) context? Urban Studies, 54(7), 1619-1637. doi.org/10.1177/0042098016632435
3. Baranyi, G., Cherrie, M., Curtis, S. E., Dibben, C., & Pearce, J. (2020). Changing levels of local crime and mental health: A natural experiment using self-reported and service use data in Scotland. Journal of Epidemiology and Community Health, 74(10), 806-814. http://dx.doi.org/10.1136/jech-2020-213837.
4. Barton, H., & Grant, M. (2006). A health map for the local human habitat. The journal of the Royal Society for the Promotion of Health, 126(6), 252-3.
5. Bonnell, L. N., Clifton, J., Rose, G. L., Waddell, E. N., & Littenberg, B. (2022). Urban-rural differences in mental and physical health among primary care patients with multiple chronic conditions: A secondary analysis from a randomized clinical trial. International Journal of Environmental Research and Public Health, 19(23), 15580. doi.org/10.3390/ijerph192315580
6. Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., & Greenberg, N. (2020). The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. The Lancet, 395(10227), 912-920. doi.org/10.1016/S0140-6736(20)30460-8
7. Cacioppo, J. T., & Patrick, W. (2008). Loneliness: Human nature and the need for social connection. New York, NY: W. W. Norton & Company.
8. Callaghan, A., McCombe, G., Harrold, A., McMeel, C., Mills, G., Moore-Cherry, N., & Cullen, W. (2021). The impact of green spaces on mental health in urban settings: A scoping review. Journal of Mental Health, 30(2), 179-193. doi.org/10.1080/09638237.2020.1755027

9. Chen, K., Zhang, T., Liu, F., Zhang, Y., & Song, Y. (2021). How does urban green space impact residents’ mental health: A literature review of mediators. International Journal of Environmental Research and Public Health, 18(22), 11746. doi.org/10.3390/ijerph182211746
10. Cho, Y., Ryu, S.-H., Lee, B. R., Kim, K. H., Lee, E., & Choi, J. (2015). Effects of artificial light at night on human health: A literature review of observational and experimental studies applied to exposure assessment. Chronobiology International, 32(9), 1294-1310. doi.org/10.3109/07420528.2015.1073158
11. Dığrak, E., Koçoglu, D., & Akın, B. (2014). Kırsal bir bölgedeki yetişkinlerde ruhsal sorunların belirlenmesi. Psikiyatri Hemşireleri Dergisi, 5(3), 122-128. doi.org/10.5505/phd.2014.35220
12. Doran, C. M., & Hargreaves, D. (2021). The social determinants of mental health in urban environments: A critical review. Journal of Urban Health, 98(2), 207-219.
13. Evans, G. W. (2003). The built environment and mental health. Journal of Urban Health, 80(4), 536-555. doi.org/10.1093/jurban/jtg063 Forrest, L. N., Waschbusch, D. A., Pearl, A. M., Bixler, E. O., Sinoway, L. I., Kraschnewski, J. L., ... & Fowler, P. J., Tompsett, C. J., Braciszewski, J. M., Jacques-Tiura, A. J., & Baltes, B. B. (2009). Community violence: A meta-analysis on the effect of exposure and mental health outcomes of children and adolescents. Development and Psychopathology, 21(1), 227-259. doi.org/10.1017/S0954579409000145
14. Gong, Y., Palmer, S., Gallacher, J., Marsden, T., & Fone, D. (2016). A systematic review of the relationship between objective measurements of the urban environment and psychological distress. Environment International, 96, 48-57. doi.org/10.1016/j.envint.2016.08.019
15. Gruebner, O., Rapp, M. A., Adli, M., Kluge, U., Galea, S., & Heinz, A. (2017). Cities and mental health. Deutsches Ärzteblatt International, 114(8), 121-127. doi.org/10.3238/arztebl.2017.0121
16. Hartig, T., & Kahn, P. H. (2016). Living in cities, naturally. Science, 352(6288), 938-940. doi.org/10.1126/science.aaf3759
17. Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science, 10(2), 227-237. doi.org/10.1177/1745691614568352
18. Jetten, J., Schmitt, M. T., Branscombe, N. R., Garza, A. A., & Mewse, A. J. (2011). Group commitment in the face of discrimination: The role of legitimacy appraisals. European Journal of Social Psychology, 41(1), 116-126. doi.org/10.1002/ejsp.743
19. Johnstone, M., Jetten, J., Dingle, G. A., Parsell, C., & Walter, Z. C. (2015). Discrimination and well-being amongst the homeless: The role of multiple group membership. Frontiers in Psychology, 6, 739. doi.org/10.3389/fpsyg.2015.00739
20. Kepley, H. O., & Streeter, R. A. (2018). Closing behavioral health workforce gaps: A HRSA program expanding direct mental health service access in underserved areas. American Journal of Preventive Medicine, 54(6), 190-191.
21. Kirkbride, J. B., Hameed, Y., Ankireddypalli, G., Ioannidis, K., Crane, C. M., Nasir, M., ... & Jones, P. B. (2015). The epidemiology of first-episode psychosis in early intervention in psychosis services: Findings from the Social Epidemiology of Psychoses in East Anglia [SEPEA] study. American Journal of Psychiatry, 172(6), 512-522. https://doi.org/10.1176/appi.ajp.2014.14010111
22. Krefis, A. C., Augustin, M., Schlünzen, K. H., Oßenbrügge, J., & Augustin, J. (2018). How does the urban environment affect health and well-being? A systematic review. Urban Science, 2(1), 21. doi.org/10.3390/urbansci2010021
23. Liang, L., Gobeawan, L., Lau, S. K., Lin, E. S., & Ang, K. K. (2024). Urban green spaces and mental well-being: A systematic review of studies comparing virtual reality versus real nature. Future Internet, 16(6), 182. doi.org/10.3390/fi16060182
24. Lund, C., Breen, A., Flisher, A. J., Kakuma, R., Corrigall, J., Joska, J. A., & Patel, V. (2010). Poverty and common mental disorders in low and middle income countries: A systematic review. Social Science & Medicine, 71(3), 517-528. https://doi.org/10.1016/j.socscimed.2010.04.027
25. Maas, J., van Dillen, S. M. E., Verheij, R. A., & Groenewegen, P. P. (2009). Social contacts as a possible mechanism behind the relation between green space and health. Health & Place, 15(2), 586-595. https://doi.org/10.1016/j.healthplace.2008.09.006
26. Marmot, M. (2018). The health gap: The challenge of an unequal world. London: Bloomsbury Publishing.
27. Marzukhi, M. A., Ghazali, N. M., Leh, O. L. H., Kamaruddin, S. M., Ahmad, P., Misni, A., & Ghani, M. Z. A. (2019). The influence of urban physical environment on mental health: A theoretical framework. (Proceedings of the Korean Institute of Ecological Architecture and Environment Conference), 19(2), 88-94.
28. Morales, D. A., Barksdale, C. L., & Beckel-Mitchener, A. C. (2020). A call to action to address rural mental health disparities. Journal of Clinical and Translational Science, 4(5), 463-467.
29. Pietrabissa, G., & Simpson, S. G. (2020). Psychological consequences of social isolation during COVID-19 outbreak. Frontiers in Psychology, 11, 2201. doi.org/10.3389/fpsyg.2020.02201
30. Poreddi, V., Konduru, R., & Badamath, S. (2013). Ruhsal hastalığı olan kişiler arasında insan hakları ihlalleri; kırsal ve kentsel bölgelerin kıyaslanması. Turkish Journal of Psychiatry, 24(3), 163-181.
31. Prizeman, K., McCabe, C., & Weinstein, N. (2024). Stigma and its impact on disclosure and mental health secrecy in young people with clinical depression symptoms: A qualitative analysis. PLOS ONE, 19(1), e0296221. doi.org/10.1371/journal.pone.0296221
32. Sampson, R. J. (2012). Great American city: Chicago and the enduring neighborhood effect. Chicago, IL: University of Chicago Press. Saunders, E. F. (2023). Urban vs. rural differences in psychiatric diagnoses, symptom severity, and functioning in a psychiatric sample. PLOS ONE, 18(10), e0286366. doi.org/10.1371/journal.pone.0286366
33. Solmi, F., & Dykxhoorn, J. (2017). Urban-rural differences in major mental health conditions. New York, NY: Springer.
34. Thornicroft, G., Mehta, N., Clement, S., Evans-Lacko, S., Doherty, M., Rose, D., ... & Henderson, C. (2017). Evidence for effective interventions to reduce mental-health-related stigma and discrimination. The Lancet, 387(10023), 1123-1132. doi.org/10.1016/S0140-6736(15)00298-6
35. Weaver, A., Joseph, A. H., Robert, J. T., Niki, N. M., & Jamie, M. A. (2015). Urban vs rural residence and the prevalence of depression and mood disorder among African American women and non-Hispanic white women. JAMA Psychiatry, 72(6), 576-583. doi:10.1001/jamapsychiatry.2015.10
36. Wei, Y. D., Wang, Y., Curtis, D. S., Shin, S., & Wen, M. (2024). Built environment, natural environment, and mental health. Geohealth, 8(6), e2024GH001047. https://doi.org/10.1029/2024GH001047
37. Weisburd, D., Cave, B., Nelson, M., White, C., Haviland, A., Ready, J., ... & Sikkema, K. (2018). Mean streets and mental health: Depression and post‐traumatic stress disorder at crime hot spots. American Journal of Community Psychology, 61(3-4), 285-295. doi.org/10.1002/ajcp.12232
38. Weissman, J., Russell, D., Jay, M., Beasley, J. M., Malaspina, D., & Pegus, C. (2017). Disparities in health care utilization and functional limitations among adults with serious psychological distress, 2006-2014. Psychiatric Services, 68(7), 653-659. doi.org/10.1176/appi.ps.201600260
39. World Health Organization. (2014). Social determinants of mental health. (Alıntı 2025, 15 Haziran) Kaynak: https://www.who.int/publications/i/item/9789241506809. 18.06.2025
40. Wilkinson, R., & Pickett, K. (2018). The spirit level: Why equality is better for everyone. London: Penguin Books.
41. Zijlema, W. L., Triguero-Mas, M., Smith, G., Cirach, M., Martinez, D., Dadvand, P., ... & Nieuwenhuijsen, M. J. (2017). The relationship between natural outdoor environments and cognitive functioning and its mediators. Environmental Research, 155, 268-275. https://doi.org/10.1016/j.envres.2017.02.017