A System of Systems of Mental Health in Cities, Digging Deep into the Origins of Complexity
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ORIGINAL ARTICLE
A System of Systems of Mental Health in Cities, Digging Deep into the Origins of Complexity Elhabib Moustaid1 · Maksims Kornevs1 · Fredrik Lindencrona2 · Sebastiaan Meijer1
© The Author(s) 2020
Abstract Mental health in urban environments is often treated from a healthcare provision perspective. Research in recent decades showed that mental illness in cities is a result of dysfunctional coordination between different city systems and structures. Given the nature of the city as a system of systems, this work builds through a participatory method, a general system dynamic model of factors that affect mental health in urban and regional environments. Through this method, we investigated the challenges of the application of such methodology to identify essential factors, feedback loops, and dependencies between systems to move forward in planning for mental health in cities. The outcome is a general model that showed the importance of factors that vary from individuals, families to communities and feedback loops that span multiple systems such as the city physical infrastructures, social environments, schools, labor market, and healthcare provision. Keywords Mental health · System dynamics modeling · Participatory methods · Urban health
Introduction Complexity science and systems thinking have gained more relevance in recent decades in many domains of application, including health care policy and urban planning. Complexity science has provided new ways of looking at cities providing tools to tackle wicked problems without neglecting their often pluralistic, interdisciplinary, multi-faceted nature (Batty 2013; Portugali 2012). Models and simulations provide a toolbox of investigation of the complexity (Batty and Torrens 2005). The late decades saw an increase in the use of models and simulations due to increasing modeling abilities and higher computational powers attributed to technological * Elhabib Moustaid [email protected] Maksims Kornevs [email protected] Fredrik Lindencrona [email protected] Sebastiaan Meijer [email protected] 1
Royal Institute of Technology KTH, Hälsovägen 11, 141 52 Huddinge, Sweden
Sveriges Kommuner Och Landsting, Hornsgatan 20, 118 20 Stockholm, Sweden
2
advances. These advances made modeling and simulation available outside the realm of scientific use, resulting in an expansion of the application of those methodologies to realworld, day-to-day problems. In healthcare notably, there is an embrace of systems thinking and modeling in different levels of applications; either on a macroscopic level of dealing with epidemics of disease or at a microscopic level of deciding the best treatments for patients (Bures et al. 2014). Carey et al. (2015) summarize particularly decades of application of systems and modeling approaches to public health policy. Their summary of 135 articles showed four main domains of application of system thinking in public health. First, studies that showed the potential of using such methodologies to investigate healthcare. Second, instances
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