Fear of crime, mobility and mental health in inner-city London, UK

Abstract

This paper examines the relationship between fear of crime and mental health, and assesses the role interventions may have in helping overcome any negative impact arising from this fear. The data were gathered over a 2-year period in the Gospel Oak neighbourhood of North London using in-depth interviews, focus groups and participant observation. The data are analysed primarily by comparing the impact of fear of crime across sub-groups notably divided by gender, age and mental health status. It was found that fear of crime had a disproportionately negative impact on certain sub-groups, most notably low-income mothers, and to a lesser extent the mentally ill. They experienced what we term “time–space inequalities” as a consequence of fear of crime and other related factors. These inequalities describe variation in the ability to access and utilise different times and spaces within both the immediate and the wider environment. These have negative behavioural and affective consequences that appear to impact on overall mental health. They restrict spatial and temporal movement deterring protective social activity, health-promoting community involvement and use of services. Affective consequences include negative mood and low self-esteem. These inequalities were experienced less in other groups such as mentally healthy men or middle-income women. They appeared to be diminished by interventions that encourage spatial and temporal movement. These include comprehensive local transport, government-issued free travel passes for vulnerable populations and neighbourhood community safety measures such as the installation of CCTV. We suggest that experience of time–space inequalities may be damaging to mental health and that interventions which lessen them may help prevent, ameliorate or shorten episodes of mental illness.

Introduction

Policy interest in how factors particular to urban environments can affect health has recently been revived by governmental and non-governmental organisations alike. The World Health Organisation (1994) has instigated an intervention known as “Healthy Cities” for urban areas where a series of health-promoting initiatives are taken to improve health. In the UK the British Government has introduced a similar intervention known as “Health Action Zones” (Department of Health, 1998). Ongoing government rhetoric acknowledges the role social and environmental conditions can play in the aetiology of health outcomes, British Prime Minister Blair recently remarked:

Depression is a particular concern, which costs lives and affects quality of life. We can achieve goals…but only if we tackle the underlying social, economic and environmental conditions as well as specific causes (Dawson & Tylee, 2001).

Though the policy climate may have recently shifted, there has been a long historical tradition in public health research of investigating the role factors specific to urban environments can play in determining health outcomes (Ashton & Seymour, 1998). This tradition may be more prominent in research on physical health, though there is a smaller amount of historical evidence suggesting a relationship with mental health. For example Faris and Dunham (1939) demonstrated an association between urbanicity and schizophrenia in Chicago in an early seminal study. They found a “doughnut effect”, with greater prevalence of schizophrenia downtown than in the outer suburbs. More recent studies have shown that people with schizophrenia still tend to live in socially deprived areas (e.g., Logdberg, Nilsson, Levander, & Levander, 2004). One ever-present issue in these type of studies regards direction of causality; i.e., does living in a deprived area cause mental health problems or does the experience of mental health problems cause suffering individuals to drift to deprived areas? It has been argued that socio-environmental factors prevalent in urban areas, such as fear of crime, directly worsen residents’ mental health (e.g., Freeman, 1984). However, little empirical attention has recently been paid to the relationship between fear of crime and mental health outcomes. One of the few notable exceptions is a British neighbourhood longitudinal case study that found a drop in fear of crime correlated with a drop in rates of anxiety and depression (Halpern, 1995). This drop was ascribed to a comprehensive urban regeneration programme that put an emphasis on community safety. Halpern likened the collective effect of fear of crime that was observed at the beginning of his study to individual phobic/anxiety neuroses in that it immobilises behaviour and stunts affect leading to social withdrawal. In a similar longitudinal study, Dalgard and Tambs (1997) found that improvement in social and physical characteristics of different Oslo neighbourhoods correlated with collective improvement in mental health. More recently Chandola (2001) found that fear of crime in the UK was associated with self-rated health (a variable presumably combining elements of physical and mental health) even after adjustment for notable individual and household-level risk factors.

In light of the paucity of studies, the present paper attempts to explore the relationship between fear of crime and mental health. As this is an under-researched area, we decided to adopt an open-ended qualitative approach by an ethnographic exploration of fear of crime in the neighbourhood of Gospel Oak, London, UK. This allowed us to make an in-depth examination of our field of interest, giving us the opportunity to construct a theory that may be tested by others. Relevant issues raised in both the social psychiatry and criminology literature drove our design and methodology. Despite many points of commonality, these two literatures stand largely unconnected. Thus the present paper not only draws its theoretical basis from these two sources, but also attempts to add to them, aiming to bridge the two in a manner accessible and relevant to both criminology and social psychiatry.

As mentioned, the small amount of social psychiatry literature exploring crime as a risk factor suggests that fear of crime can negatively influence mental health, and that increases in community safety may have a positive influence on mental health. However mechanisms of effect remain unestablished, and it is unknown whether specific sub-groups’ mental health suffers disproportionately. Thus a key aim of the present paper is to explore these two issues. Related to this, we also examine which, if any, interventions, appeared to promote mental health by reducing fear of crime.

With regard to the vast criminology literature, most survey evidence suggests that certain sub-groups in the city, most notably women and older people, experience more fear of crime in the public sphere than others (Lindstrom, Merlo, & Ostergren, 2003; Maxfield, 1987; Yodanis, 2004). However qualitative evidence has suggested that fear of crime in older people (Pain (1995), Pain (1997a)) and women (Gilchrist, Bannister, Ditton, & Farrall, 1998; Stanko & Hobdell, 1993) may have been significantly over-estimated or mis-conceptualised. In a review of the literature, Pain (2001) notes that relations between fear of crime and the social identities of age and gender are exceedingly complex and that there are no easy answers to many questions current in this area of criminology. In light of this uncertainty in the criminology literature, as well as the gap in the literature of social psychiatry, a key aim of the present study is to qualitatively compare the impact of fear of crime among men and women, as well as younger and older adults. This is in line with recent research in public health suggesting that women and older people may be particularly at risk of negative factors associated with neighbourhood context (Ellaway & Macintyre, 2001; Macintyre, Ellaway, & Cummins, 2002).

As a qualitative study, the present paper does not attempt to establish comparable rates of fear of crime in sub-groups. Furthermore, it does not attempt to explain fear of crime. This study is primarily anchored in social psychiatry. Therefore its most significant aim and novel contribution is its assessment of the impact of fear of crime on mental health, per se and by sub-group. We were primarily interested in participants’ cognitive, behavioural and affective response to fear of crime, assessing how this can relate to mental health. In order to explore this point further, we also compare the experience and impact of fear of crime for people with or without mental health problems. It has been remarked that the mentally ill are a social group that have been excluded from fear of crime research, even though they may theoretically be at increased risk (Pain, 2000). Examination of their narratives addresses a further gap in the literature. In addition we aimed to explore in detail how mental health status interacts with age and gender. We were interested in assessing whether certain groups suffered double (or triple) jeopardy as a consequence of their mental health status, age and gender.