Urban Mental Health: Perspectives of Local Stakeholders on Factors That Shape Mental Health of City Residents.

Mental health issues are more prevalent in urban areas, which is increasingly concerning as urbanization accelerates worldwide. Therefore, understanding the various aspects of urban life that influence mental health is crucial. We explored the perspectives on urban mental health of local professionals who are working within the field of mental health and policy in urban settings. Since this group of stakeholders has the professional capacity to shape the way mental health is addressed at the local level, it is particularly important to understand how they conceptualize urban mental health and what factors they see as key contributors to mental health among urban residents. We conducted 51 semistructured interviews with stakeholders in five European cities-Brasov, Ljubljana, Oxford, Riga, and Rotterdam. Local researchers analyzed the interview transcripts using the reflexive thematic analysis approach and then synthesized the themes across cities to identify key factors influencing urban mental health according to the local stakeholders. Our analysis generated eight themes illustrating how stakeholders conceptualized urban mental health. Participants described mental health arising from the dynamic interplay of individual vulnerabilities and personal responsibility, social relationships, disadvantage and exclusion, access to mental health services, opportunities afforded by the cities, environmental exposures, and wider societal crises. Participants emphasized the growing importance of mental health in Europe, noting increased awareness of and reduced stigma related to mental health problems. The evolving perception of mental health, combined with the complexities of urban life and societal changes, highlights the need for innovative and holistic strategies in urban public mental health.