"Remember the West End!"  It's a rally cry that people of a certain age in Boston will remember.  In 1958, the Boston Redevelopment Authority began work demolishing 48 acres of Boston's West End, displacing thousands of people from lower-working class families in the process.  Although there were many different rationales for such urban renewal projects, countless examples of which can be found in North America, Europe, and elsewhere, health was certainly foremost among them.  Overcrowding spread disease; so did poor sanitation.  Many of the rickety buildings built on the cheap during the nineteenth century to house millions of immigrants from Europe were also susceptible to other health hazards, especially fires. More subtle, however, were the risks to mental health that mid-twentieth-century urban planners and psychiatrists perceived in the slums of American cities.

Many theorists had decried the damaging impact cities posed to mental health.  Dirty, overcrowded, noisy, polluted, hectic, and impersonal, cities were thought by some to represent all the ills of modern society.  The late-nineteenth century disorder neurasthenia, for example, was thought to be particularly rife in American cities; one of the most popular cures for it was to spend time out in the countryside.  Many asylums were also situated in rural areas in accordance with the thought that bucolic surroundings could encourage recovery.  

Following the Second World War, crowded urban neighborhoods came under renewed criticism for the mental health problems they were thought to cause.  People living in cramped conditions were thought to be prone to breakdown, depression, and even violence.  Such suspicions were borne out in the famous rat experiments of John B. Calhoun (1917-1995) at the National Institute of Mental Health (NIMH), the original "rats of NIMH."  Moreover, the thin walls of urban tenements meant that one (or one's children) heard whatever was going on next door, be it a fight, a blaring television set, or whatever else.  The privacy required for healthy mental development was thought to be lacking.  

All of this combined to condemn many neighborhoods to the scrapheap, including Boston's West End.  But was the West End so pathological for mental health?  As plans were underway for the redevelopment of the West End, sociologist Herbert Gans began studying the predominantly Italian (but also Polish, Irish, and Jewish) neighborhood and found that its structure was actually more conducive to healthy development than most planners thought.  In the book that would encapsulate his views, The Urban Villagers, Gans contested that the West End was actually a slum, and questioned the benefits of redevelopment.  Although the neighborhood was crowded and some of the buildings were dilapidated, the social space of the West End was actually very healthy and vibrant.  Many agreed with Gans and "Remember the West End" became a clarion call for those who feared for the destruction of neighborhoods like it.  

Despite the convictions of Gans and others that the redevelopment plans were flawed, they went ahead, as they did across North America. Suburbs replaced central neighborhoods and many downtown cores rotted as a result.  Today, environmental arguments have been behind attempts to revitalize and repopulate city centers in North America and Europe.  But what of the repercussions for mental health?  While the answer to this question is complex and will vary depending on where you choose to examine, it does appear clear that one thing that was lost with the destruction of communities such as the West End was a sense of community that is often necessary for good mental health.  Of course, communities are not always healthy or positive; they can be closed and xenophobic and secretive, as other aspects of Boston's history would attest.  But, generally speaking, strong communities are good for mental health: they provide a sense of security and safety, especially during times of crisis. They serves as an extended family for people, especially those who cannot rely on their own, and provide a grounding for people that lends a certain stability.  

Unfortunately for the urban planners of the post-war period, however, communities evolve organically; they cannot be made, even out of shiny, new buildings.  They are much easier to destroy than to create. For a more detailed account of the story of the West End and urban mental health, see semanticscholar.

Wikimedia Commons Boston's West End
Source: Wikimedia Commons Boston's West End

References

Ramsden, E. & Smith, M. (2017). Remembering the west end: social science, mental health and the American urban environment, 1939-1968. Urban History 

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