When we think about mental health, we often think very narrowly. We think of happiness and self-esteem. We might think of the illnesses which rob us of those things—like addiction and schizophrenia and bipolar disorder. We surely think of love, family, and home. Main Street would seem to be the last thing we need to worry about—we need a clinic, a pharmacy, some pamphlets on self- help. What else is there?

George Engel, a psychiatrist who helped internists and surgeons understand their patients’ needs, developed a concept that expanded their focus beyond the biology inside the human body to include the sociology of illness—the influence of other actors on the unfolding drama of individual illness. His model can help us think about the importance of Main Streets for mental health.

Engel helped us see that it is the world surrounding the person that ultimately makes our health and our sanity. What I have learned is that the world pivots around Main Street. There, we enact our sociability and make our society. Main Street uses statues, decorations, and bricks to remind us of our beauty, courage, and stability. Main Streets connect one neighborhood to the larger units of society, to the city, the state, and the nation; they deliver our culture. We go to Main Street to get the newspaper, and we find out what’s going on in the world.

To study Main Streets, I’ve gone around the country and the world. In Brattleboro, Vermont, for the annual Strolling of the Heifers, I sat on the Main Street curb and felt that we were all connected. In Niagara Falls, I joined hundreds of citizens as we sauntered down Main Street in a Walk to the Falls. In Saint Louis, I walked the cheerful Cherokee Street and learned how activists had installed a basketball court to give teens a place of their own. In Johannesburg, I found a Main Street bakery that served poached eggs on rye toast. At fairs and festivals, I have found treats and jewelry on pop-up Main Streets. In all these settings there was a feeling of effervescence that I struggled to capture in words. At a family gathering, watching two-year-old Mei-Ling find her way through a forest of adoring adults, I was struck by how much the way people coo over a child is like going to market: the market is meant to embrace us individually and collectively, to coo over us, to welcome us, to offer us something special, if only the chance to be together.

Main Streets work because they assemble commercial and civic institutions with public space to make a box. Its sides are formed by the line of buildings on either side, the sidewalks and street create the bottom, and the sky the top. In Maplewood, New Jersey, on a Main Street close to my home, I watched a Town Centre being built. It is a cookie-cutter luxury apartment complex, that replaced the old post office building and will limit the view of the sky, the sky being crucial to the joy of the space, like a present we’ve just opened.

From visits to Main Streets in more than 135 cities, I’ve come to take the box—and its comfortable feeling—for granted. What still perplexes me is the flurry of information from signs of all kinds. One day, on Main Street in Orange, New Jersey, I noticed a character in a mural on the wall of the old YWCA. I called her Jane, because she reminded me of the Dick and Jane readers from grammar school. I was stunned by her gaze, which I found sinister, juxtaposed with a massive squirrel eating a tomato. Across the way from Evil Jane is a Revolutionary War statue, the Dispatch Rider, as he is known. He towers over the city, projecting purpose and seriousness like a Disney prince. I was reminded of a book by Malvina Hoffman, which my mother gave me when I was a teenager interested in sculpture. Hoffman was famous for her work for the Races of Man exhibit—sculptures intended to show the progression of the races, from savage to barbaric to civilized. Not surprisingly, it was the Europeans who were civilized and therefore at the top of the heap. The Dispatch Rider is the Nordic type in Hoffman’s scheme.

In thinking about Evil Jane and the Dispatch Rider, I am reminded of what the author of an 1858 guidebook to the statues in the Cathedral at Chartres wrote: “It is good for the reader to remember that all the iconography of churches of the Middle Ages was a book of doctrine and morals... Oh are they wrong, those writers who only saw whims of the imagination installed with neither taste nor logic.”

The cornerstone of sanity is solidarity. And the cornerstone of solidarity is understanding that we are all in this together. In Cleveland, in the aftermath of deindustrialization, some of the neighborhoods have fallen. The bustle of shopping on the city’s flourishing Main Streets is in contrast to long empty stretches—devoid of housing and businesses—in between them. In those stretches are semi-abandoned Main Streets that a tourist wouldn’t find because they have fallen off the map. Hopscotching from one cheery place to another creates a peculiar reality of the city, a map that is fractured, wherein Main Streets are seemingly independent of one another. The fracture is the deeper reality of the city, the true state of our national consciousness. Lacking the integrity of our whole environment, we are neither whole nor sane.

In Sinclair Lewis’s 1920 novel Main Street, Carol Milford marries into the establishment of a prairie village. Carol’s efforts to bring some beauty into life there are countered each time by the ethos of Main Street: don’t patronize people who don’t patronize you; don’t put on airs; don’t reach for the sublime; don’t think we will spend our money on the public good. Lewis paid attention to the detail of Carol’s defeat against the constant assertion by the establishment of its infallibility—“the humdrum inevitable tragedy of struggle against inertia.” At the end of the novel, what catches her eye is her baby daughter—she will see change.

Sinclair Lewis tells us that Carol, without understanding or accepting it, was a revolutionist, a radical, and therefore possessed of “constructive ideas” which only the destroyer can have, since the reformer believes that all the essential constructing has already been done.

In 1957, when I was a child in Orange, New Jersey, my mother, Maggie, born the same time as Carol’s daughter, went to the Board of Education and asked for a map of school districts, which showed that they had been illegally gerrymandered. My father, Ernie, had been involved in politics since his youth in Jersey City. He ran the Fair Practices program of the United Electrical, Radio and Machine Works of America, and this took him all around the country in the struggle against discrimination. The concrete knowledge of the political process—how to build an organization, how to map out a long-range plan, how to write a leaflet, how to knock on doors—all of this he had learned in the union and he used it. This fight against school segregation was the first time that the African American community in Orange entered the political fray. Hopeless endeavors and expected defeats led to new eras.

It is we—Carol Milford’s sons and daughters and grandchildren and great- grandchildren—who make Main Street with our constructive ideas. And when we make Main Streets that work, we create a source of strength and support, a place of communication and joy, of solace and surprise. Each individual Main Street is a piece of the net, each tacking down a bit of America.