Living in the city doubles mental health problems

The inhabitants of the big cities of Spain “double” mental health problems with respect to those who live in small towns and in the rural world, as reflected in an analysis prepared by NESI Forum based on IX Report on Integration and Social Needs (FOESSA 2025).

The research shows that the problem of mental health, analyzed based on diagnoses made in the past, reaches the 18% in big cities, versus small cities (8%) and the rural environment (9%).

Although Madrid and Barcelona have obtained intermediate results (12%), the negative perception about mental health reaches the 19% in these cities, a proportion that is reduced to 16% in the case of small cities, and 11% in rural areas.

Diagnosed mental health disorders are also higher in large cities, with a 13%compared to the 6% of the rest of the territories.

“That mantra that success is in the city is becoming less and less true,” stated the director of the NESI Forum, Diego Isabel La Monedawho has pointed out greater work stress, worse work-life balance, longer travel times, greater difficulty in accessing decent housing and a weaker social support network as the main factors that aggravate emotional distress.

In fact, the study shows that personal relationships are less frequent in big cities, where a 35% of the population acknowledges maintaining little contact with family members and a 34% with friends, while in small municipalities these percentages drop to 22 and 24%respectively.

This loss of daily ties adds to the difficulty of conciliation, creating a more vulnerable environment from an emotional point of view.

“The pace of life, of stress, of not being able to access decent housing or having to share a flat, not being able to reconcile in the big city, makes people have more problems, more likely to have more mental health problems compared to other territories,” he stated. The Coin.

The growth of cities is linked to stress factors

After this, he expressed that the growth of cities is accompanied by an increase in stress and loneliness factors, and that the lack of time, work pressure or the difficulty of access to decent housing “They are eroding people’s emotional well-being.”

The trends in Madrid and Barcelona they confirm it, and that is that the 28% of its inhabitants declare having little or no neighborhood relations, while in small municipalities this figure is reduced to 9%.

That is why, since Fornesithe “urgency” of implementing an economic and labor decentralization strategy that rebalances the territory and allows people to live where they want, without being “obliged in a big city” because that is where employment is found, has been highlighted.

“It is not just about creating jobs or infrastructure outside large cities, but about allowing people to live with time, social support and quality of life,” he stated. The Coin.

Thus, it has been considered that the territorial balance It is a “fundamental pillar” to structure the territory and eliminate the inequalities and particular problems of each type of population.

Meanwhile, greater economic and labor decentralization will allow those who wish to move from large cities to smaller places that increase the probability of enjoying good social and mental health. “Urban living conditions have become a direct determinant of mental healthand this territorial analysis shows that we must rethink the urban model, decentralize employment and promote more balanced, habitable and humanly connected territories. It is no longer just a question of sustainability, but of collective mental health,” stated La Moneda.

In the study they have distinguished three large groups of territories according to their population, among which are the Crowded Spain (cities with more than 500,000 inhabitants), the Forgotten Spain (medium and small cities of between 10,000 and 500,000 inhabitants) and the Spain Emptied (rural areas, with populations of less than 10,000 inhabitants).

Despite the existing gap in mental health, researchers have not found relevant differences in the perception of physical health, with almost a 80% of the population that declares to enjoy good or very good physical health.