This paper was launched at the Legatum Institute on Thursday, 9 June 2016. Watch here.


There is a housing crisis in the UK. As psychiatrists, we work with some of the most disadvantaged and vulnerable individuals in society, and the association between the lack of a stable home and mental health is clear. We wanted to ask how where we live, our built environment, and where we recover from illness impacts our health.

We know that being fit and healthy is not purely about the absence of disease, and good mental health is not simply referring to the absence of a formal diagnosis of mental illness. It is a state of wellbeing in which the individual realises his or her own abilities, can cope with the normal stresses of daily life, can work productively and fruitfully and is able to make a contribution to his or her community”.1 The home is not only about shelter, it is also symbolic. It is the space where we can be ourselves, form intimate relations, feel safe and keep precious things, all contributors to wellbeing.

Genetics and a person’s upbringing have significant effects on mental health, but social environments also play a large role. Environments affect family stress, social support and home stability—factors that in turn influence childhood development and, therefore the future life of that individual.

Good, affordable, spacious housing for individuals and their families is an important determinant of physical and mental health, employment, academic achievement and wellbeing.2 In the current UK crisis, not only is there a lack of affordable, adequate-quality housing, indications suggest that demand will continue to increase as the proportion of single-occupancy housing increases.

In the UK, the rate at which houses are being built does not reflect demand.3 The average household size in England is steadily decreasing from 2.33 to 2.16 due, in part, to a rise in single-occupancy households (54%); there is a substantial increase in people over the age of 65 who are living alone. DCLG data predict a 27% rise in numbers of households in England over the next 30 years, with over 5.8 million additional households. The British land market is highly volatile and very highly priced. Supply is tight as a result of planning constraints.

The National Planning Policy Framework (NPPF) was introduced in March 2012 with the abolition of the Regional Development Agencies. The idea was for planning to be devolved to local areas, but concerns have already arisen. Local councils are beholden to their residents, who are often reluctant to see new housing in their area, reducing availability for sites and therefore housing. Acquiring sites is a competitive process and the party with the highest bid will secure the deal. This incentivises developers to increase density and reduce the amounts spent on design and build quality. In effect, with current building rules and market forces, developers are being encouraged to build small units. As a result, UK homes appear to be shrinking—they are the smallest in Western Europe for both public and private housing. In Ireland, new homes are 15% bigger, in the Netherlands 53% bigger, and in Denmark, the average newly-built home in 2005 was 80% bigger than in the UK.4 In England, the newer the home, the smaller it is likely to be. This increases the risk of overcrowding in high-density areas with little to persuade developers to design spaces which are desirable and liveable.

But why does where we live have such a strong impact on our wellbeing? In 1943, Maslow published the hierarchy of needs—a theory in psychology describing the pattern that human motivations usually move through.5 Primary are the needs for food and shelter. However housing can also feed into all of the higher levels— providing safety, a sense of belonging, as well as a base from which to progress and generate self-esteem and self-actualisation. Housing is one of the cornerstones from which a human being may develop and flourish.

About the Architecture of Prosperity Series

The Architecture of Prosperity, which forms part of the Legatum Institute's 'The Culture of Prosperity' programme, evaluates the impact of the built environment on human wellbeing and the capacity for creativity. The series of lectures, seminars and conferences address the central question of why some forms of architecture promote prosperity while others are linked to vicious effects.