An epidemiological study of 94 counties in the US showed that people living in cities had a 17% greater chance of developing either mild psychological distress or serious psychological distress compared with people living in more rural places (Dhingra et al., 2009).
Another study has shown that the urban environment is a potential risk factor for psychotic people to increase anxiety and paranoia symptoms (Ellett, Freeman & Garety, 2008). Yet another review indicates that urban birth and residence appears to be risk factors for developing severe mental illness (Torrey et al., 1997).
It also seems like those who live in lower social classes in larger cities are at a higher risk of developing mental disorders because lower social class does not seem to be linked to mental disorders in rural environments.
Moreover, it seems that biological factors should be taken into consideration because the exposure to lead and other heavy metals, air-polluting gases, toxic waste sites and industrial effluents also seem to predispose to higher rates of severe mental illness (Torrey et al., 1997).
Rural and urban environments and lifestyles can be sources of both stress and resilience. For example, urbanization can be a source of cultural growth, development, and tolerance for diversity. A tolerance for diversity decreases the stigmas associated with mental illness, which in turn may benefit the ones who suffer from it (Marsella, 1998).