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IDEA project self-care tool for professionals

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The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes (201

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The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes (201

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Highlights

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Greenspace exposure is associated with wide ranging health benefits across 143 included studies.

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Meta-analysis showed statistically significant reductions in diastolic blood pressure, salivary cortisol and heart rate.

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Meta-analysis found statistically significant decreases in incidence of diabetes, all-cause and cardiovascular mortality.

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A number of meta-analyses were limited by poor study quality and high levels of heterogeneity.

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Greenspace and street greenery may form part of a multi-faceted approach to improve a wide range of health outcomes.

Abstract

Background

The health benefits of greenspaces have demanded the attention of policymakers since the 1800s. Although much evidence suggests greenspace exposure is beneficial for health, there exists no systematic review and meta-analysis to synthesise and quantify the impact of greenspace on a wide range of health outcomes.

Objective

To quantify evidence of the impact of greenspace on a wide range of health outcomes.

Methods

We searched five online databases and reference lists up to January 2017. Studies satisfying a priori eligibility criteria were evaluated independently by two authors.

Results

We included 103 observational and 40 interventional studies investigating ~100 health outcomes. Meta-analysis results showed increased greenspace exposure was associated with decreased salivary cortisol −0.05 (95% CI −0.07, −0.04), heart rate −2.57 (95% CI −4.30, −0.83), diastolic blood pressure −1.97 (95% CI −3.45, −0.19), HDL cholesterol −0.03 (95% CI −0.05, <-0.01), low frequency heart rate variability (HRV) −0.06 (95% CI −0.08, −0.03) and increased high frequency HRV 91.87 (95% CI 50.92, 132.82), as well as decreased risk of preterm birth 0.87 (95% CI 0.80, 0.94), type II diabetes 0.72 (95% CI 0.61, 0.85), all-cause mortality 0.69 (95% CI 0.55, 0.87), small size for gestational age 0.81 (95% CI 0.76, 0.86), cardiovascular mortality 0.84 (95% CI 0.76, 0.93), and an increased incidence of good self-reported health 1.12 (95% CI 1.05, 1.19). Incidence of stroke, hypertension, dyslipidaemia, asthma, and coronary heart disease were reduced. For several non-pooled health outcomes, between 66.7% and 100% of studies showed health-denoting associations with increased greenspace exposure including neurological and cancer-related outcomes, and respiratory mortality.

Conclusions

Greenspace exposure is associated with numerous health benefits in intervention and observational studies. These results are indicative of a beneficial influence of greenspace on a wide range of health outcomes. However several meta-analyses results are limited by poor study quality and high levels of heterogeneity. Green prescriptions involving greenspace use may have substantial benefits. Our findings should encourage practitioners and policymakers to give due regard to how they can create, maintain, and improve existing accessible greenspaces in deprived areas. Furthermore the development of strategies and interventions for the utilisation of such greenspaces by those who stand to benefit the most.

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The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes

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Greenspace exposure is associated with wide ranging health benefits across 143 included studies. * Meta-analysis showed statistically significant reductions in diastolic blood pressure, salivary cortisol and heart rate. * Meta-analysis found statistically significant decreases in incidence of diabetes, all-cause and cardiovascular mortality. * A number of meta-analyses were limited by poor study quality and high levels of heterogeneity.

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What adaptive self-care strategies work for you?

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What adaptive self-care strategies work for you?

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Settings are anonymous: no one will know which comments are yours (unless you are a registered padlet user)!

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What one thing surprised you about your self-care when you completed the SPARK tool?

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What one thing surprised you about your self-care when you completed the SPARK tool?

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Settings are anonymous: no one will know which comments are yours (unless you are a registered padlet user)!

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What happens if your body doesn't get enough sleep?

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What Happens To Your Body And Brain If You Don't Get Sleep | The Human Body

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New research article on social workers' experiences of presenting evidence in Court

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New research article on social workers' experiences of presenting evidence in Court

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The IDEA project is a five country training project for child protection professionals on children’s rights funded by the European Commission Directorate-General for Justice and Consumers. The project has a special focus on professionals in child welfare removals proceedings in courts or court-like bodies.

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Rights, Equality and Citizenship (REC) Programme of the European Union

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About the Child Care Proceedings in the District Court Research Group (UCC)

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About the Child Care Proceedings in the District Court Research Group (UCC)

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The IDEA project is led by this research group. Click on the link to view our publications

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European Colloquium on Socio-Legal Decision Making Models in Child Protection, University of Bergen, Norway, 30-31 January 2014, organised by the Department of Administration and Organization Theory, University of Bergen, Norway, School of Social Sciences and Humanities, University of Tampere, Finland, and the Child Care Proceedings in the District Court Research Group, University College Cork, Ireland.

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Welcome to the UB School of Social Work's Self-Care Starter Kit. The resources on these pages are appropriate for both students in training and for professionals already working in the field. There are additional resources that we trust will be helpful no matter where you are on your self-care journey.

The Self-Care Starter Kit℠ was initially developed for UB School of Social Work students, but it is our hope that these resources will be useful for students and professionals alike. Although the information does not address all that goes into developing the skills of self-care, it does begin the journey.
We recommend you start with Introduction to Self-Care, followed by Developing Your Self-Care Plan.
Using the Materials

You are welcome to use the Self-Care Starter Kit℠ exercises/worksheets without revising them for personal and/or educational (non-commercial) purposes only. We ask that you read over the Creative Commons licensing agreement, let us know that you will be using the materials, include the original citation information that is on them, as well the web address for our site, as an acknowledgement of where it was downloaded from and so people are able to explore our site if they're interested.

Butler, L. D., & McClain-Meeder, K. (2015). Self-Care Starter Kit. Located at http://www.socialwork.buffalo.edu/students/self-care/index.asp

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Acknowledgements

We hope the resources in these pages will be useful as you strive to maintain and enhance your well-being in all the important domains of your life.

We would like to express our heartfelt thanks to all those who have helped us in this effort: the colleagues who generously contributed materials and provided advice on resources, copyright issues, and IT questions; the experts in the field who gave permission to include their materials; the SSW students who provided self-care utilization data and feedback on our materials and original workshop; and our colleagues on the UBSSW Reaccreditation Committee and in the school who provided both informational and tangible support for the development of this program and have incorporated self-care materials and activities in their courses. We are especially grateful to Elaine S. Rinfrette, LCSW-R, PhD for her extensive and essential contributions to every aspect of the development of this program; Shirley Reiser, LCSW and Elaine K. Hammond, LMSW for their far-sighted and widespread efforts to highlight self-care in our school by developing trainings and materials, and through their invaluable contributions to the development of these pages; Dana M. Horne, MEd for designing the self-care (Venn) logo and providing consultation and support; Robert Garlan, PhD for his thoughtful suggestions and text revisions for these webpages; Melissa Dudley, MSW for her excellent research assistance; and David Coppola for his superb work designing and programming the original self-care site webpages.

Lisa D. Butler, PhD
Self-Care Program Team Leader and Associate Professor

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Professional self-care is an essential social work survival skill. Our Self-Care Starter Kit will help students and beginning social work professionals understand the basics of maintaining and enhancing health and well-being.

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HSE website

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YourMentalHealth.ie is a place to learn about mental health and how to support yourself and others. Find resources and support services near you.

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U.S. Dept. of Health and Human Services

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PSYCHED - Mental Health and the Workplace

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PSYCHED - Mental Health and the Workplace

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Promoting Mental Health in the Workplace across Cork City

Download the PSYCHED Flyer

CLOSING DATE FOR APPLICATIONS is Friday March 9th 2018

Click here to apply online
Wednesday February 21st 2018 10am - 1pm Spaces are limited. Book your space here
PSYCHED stands for Positive Support You Can Have Every Day and this Mental Health Promotion Award Scheme is an initiative of Cork Healthy Cities, supported by the Health Service Executive, University College Cork and Cork City Council. The Award Scheme will celebrate efforts made in workplaces across Cork to support the mental well-being of staff, and is aimed at making Cork a Mental Health Promoting City.
PSYCHED aims to:

1. stimulate conversations in the workplace leading to a better understanding of mental health

2. encourage employers to engage with staff to promote and foster mental health in the workplace

3. celebrate commitment, good practice and innovation in mental health promotion in the workplace.

Tina Neylon, Co-ordinator PSYCHED
Tel: 086 603 5552

E-mail: psyched@corkhealthycities.com

What is PSYCHED?

PSYCHED is an initiative of Cork Healthy Cities. This collaboration comprises of the Health Services Executive (Health Promotion and Improvement, Health Action Zone and Mental Health Psychology Service in Cork) Cork City Council, University College Cork and community workplace partners. We want workplaces to get PSYCHED about mental health and wellbeing!

We invite workplaces to get involved by sharing good practice, ideas and workplace initiatives that support the mental wellbeing of their staff.
PSYCHED aims:
1. To stimulate conversations in the workplace leading to a better understanding of mental health

2. To encourage employers to engage with staff to promote and foster mental health in the workplace by setting goals for positive improvement

3. To celebrate commitment, good practice and innovation in mental health promotion in the workplace through participation in the 2018 PSYCHED awards.

To promote better mental health in workplaces across Cork city, an initative which we hope will result in more understanding and reduced stigma towards mental illness in our wider community.
Why get PSYCHED?
Learning about mental health in the workplace helps to develop working environments that are supportive, nurturing and open to growth and change.

Mental health exists on a continuum ranging from poor mental health to positive mental health (see fig.1). Just like our physical health, our mental health can vary from day-to-day. According to Keyes (2002), mental health is comprised of emotional, psychological, and social wellbeing.
How am I doing now? Go to the Top A time for change - why now?
The Department of Health and Children published Healthy Ireland: A Framework for Improved Health and Wellbeing 2013-2025 in 2013 and Connecting for Life: Ireland's National Strategy to Reduce Suicide 2015-2020 in 2015. Both policies aim to improve health and wellbeing outcomes at both a general population level and specific target group levels.

Within the framework of these policies there is considerable scope for a universal intervention programme aimed at promoting mental wellbeing and developing resilience.

Health, both mental and physical, impacts greatly on overall wellbeing, particularly in light of the socioeconomic consequences of poor health. Not only is the individual's immediate support network impacted by poor health, "adverse trends in the health of the community and the population impact on the whole of society." (Department of Health and Children, 2013, p. 6)

According to the World Health Organisation,
"many people have misconceptions about mental health problems." (WHO, 2005, p. 13)
Examples of misconceptions include:

* The belief that mental health problems cannot be treated.
* The belief that personal deficiencies can lead to mental health problems.
* The belief that people diagnosed with mental health disorders are unable to run their own lives or make decisions pertaining to their lives (WHO, 2005).

The improving levels of employment in the country provide considerable scope for the delivery of a universal intervention programme aimed at promoting mental wellbeing via the workplace, particularly considering that "the failure to prevent, recognise and treat mental health problems in the workplace has an impact on employers, employees and their families, and the community generally."

(WHO, 2005, p. 19; tradingeconomics.com, 2015)
Long Term change goals Fig. 2: PSYCHED long term change goals
Figure 2 above, outlines the benefits of the initiative for employers, employees and the community. The aspiration is to create an empathetic workplace culture, open to learning and showing an understanding of mental health - all of which has positive benefits in the wider community.
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What is the relationship between work and mental health?

The WHO states that work "substantially contributes to a person's identity; it provides income for an individual and his or her family, and can make a person feel he or she is playing a useful role in society. It is also an important source of social support."
(WHO, 2005, p. 9)

Furthermore, the workplace itself can have either positive and/or negative effects on an individual's mental wellbeing.

The National Institute for Health and Care Excellence (NICE) recognises that work is "an important determinant of self-esteem and identity [providing] a sense of fulfilment and opportunities for social interaction."
(2009, p. 6)

However, difficult working environments can adversely affect an employee's mental health, particularly when they are exposed to stress. The workplace can be positively or negatively impacted by the wellbeing, mental health and resilience of an employee.
The Workplace Health and Well-Being Strategy: Report of Expert Group (2005) reports that mental health issues, particularly stress, are the second highest cause of work-related health issues within the EU.

Within an Irish context, The main mental health issues that impact on the workplace in terms of absenteeism are anxiety and depression (13%), stress (7%), nervous debility and/or bereavement (4%) and post natal depression (2%). Absence costs small business over €490 million per annum with 4,052,222 days lost in 2014 (SFA, 2016)

Bevan, McGee, and Quadrello (2009) state that up to 20% of all working days lost in Ireland each year are due to stress related illness. Furthermore, the Work Positive Project 2005-2007 cites figures from the Department of Social and Family Affairs indicating that stress was the cause of 1.7% of all occupational injury benefit claims allowed in the Republic of Ireland in 2006.
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Employee and Employer Benefits

Work takes up a third of our day. It has an important role in our lives. The working environment can positively or negatively affect our mental wellbeing and, in the same way, we can positively or negatively affect our workplace.
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What does a PSYCHED workplace look like?

All staff are treated with dignity and respect.

Staff are clear about what they have to do, how they do it and why they are doing it.

Mental well being is actively promoted and is a topic of conversation.

Anyone experiencing a period of low mental health feels supported by colleagues and management

Management and employees know how to ask for and to offer help and are supported by structures and a work culture that facilitates this.

Efforts are made to ensure effective communication between management and staff and among staff members.

Opportunities for new learning and further development are available and encouraged.

Interaction with work colleagues and social connection is part of the working day

Is eligible to be awarded a PSYCHED certification for mental health promotion in the workplace

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How to promote mental health in the workplace
Small changes can make a big difference

Every workplace is different and the common connection between all is people. We all have our good days and not so good days but it is important to achieve a balance between productivity and a positive healthy workplace.

Having a plan and a structure to support mental wellbeing is important to achieve a positive work environment. Small changes can make a big difference . It's not the size of the organisation it is the little things we do that have the biggest impact

There are many ways to promote mental health in your workplace. Below you will find some simple ideas to get you thinking ...

* Identify workplace wellness champions or motivators to encourage and coordinate well being initiatives in the workplace.

* Developing a wellbeing Policy or statement under dignity at work (Having a plan)

* Developing a well being charter on the culture of the organisation that mental health and wellbeing are just as important as physical health.

* Create a staff wellness hub, either a notice board or on your staff website, providing information on minding your mental health e.g. stress management, physical activity, mindfulness and relaxation techniques.

* All work mobile phones having the 24/7 Support lines as a matter of course therefore everybody has access to them.

* Displaying support numbers within your organisation

* Having fun days for people to get to know each other

* Developing a buddy system to support each other

* Having wellness workshops to cover Nutrition, Sleep, Exercise, yoga and other mindfulness

* Get involved in local initiatives (or develop your workplace one) such as fun runs, charity events, choirs; etc. to promote connection and social interaction with others.

* Arrange group walks, fun runs, yoga classes, during or after work to build more opportunities for group physical activity to promote well being.

* Utilise 'walking meetings' or planning sessions, etc to increase opportunities for physical activity within the working day.

* Create a list of workplace and local services and supports which may be useful to staff at different times in their lives, e.g. counselling services, bereavement services, financial guidance. Ensure all staff can access it freely.

* As well as mental wellness, encourage wider health awareness including healthy eating, tobacco use and physical activity, through workplace challenges, canteen calorie posting and group participation in smoking cessation.
* Display 'Little Things' campaign material throughout the workplace to promote awareness of the benefit of even small changes in our day to day lives

Click here for 5 Steps to Workplace Mental Health Promotion
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How Do You Take Part?

Click here to apply online

1. Decide to become PSYCHED about your workplace. Small things make a big difference.

2. Speak to your colleagues and start the conversation about what a PSYCHED, mental health promoting workplace means. For examples: #littlethings and http://corkhealthycities.com/psyched/

3. Send examples of initiatives you are running in your workplace. Not only to be considered for a PSYCHED Award but also to share your good ideas and experience with other businesses. Click here to apply online by March 9th 2018

4. Participating workplaces can display their
great ideas and attend an awards ceremony to be hosted by the Lord Mayor at City Hall, Cork on March 28th 2018.
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Contact Us

E-mail psyched@corkhealthycities.com or

Tel: 021-4921641
We aim to have Cork designated as the first Mental Health Promoting City in Ireland. This can only happen if individuals and companies take up the challenge. The 2017/18 timeline is:

CLOSING DATE FOR APPLICATIONS is Friday March 9th 2018

Click here to apply online

Click here for information leaflet on PSYCHED
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FAST FACTS
What is Mental Health?
* Mental health describes how we think and feel about ourselves and others and how we interpret events in everyday life. It also relates to our ability to cope with change, transition, significant life events and the stress that often comes our way.

* Mental health refers to the emotional resilience to be able to enjoy life and to survive pain, disappointment and sadness, and to the level of belief in your own and others' dignity and worth.

* Most experts consider mental health as a continuum. Thus, the quality of an individual's mental health may have many different possible levels.

* (An understanding of) mental health...includes the awareness that mental health is broader than an absence of mental disorders; that poor mental health affects our ability to cope with and manage our lives, particularly during personal change and through key life events, and decreases our ability to participate fully in life; and that mental health is an essential component of general health, which it underpins (A Vision for Change, 2006). A Note on Key Terms iii

* Mental health and mental well-being are therefore part of everyday life, in that mental well-being is influenced, both positively and negatively, in every area of life; in families, schools, the workplace and in social interactions. (A Vision for Change, 2006).

(Source: Mental Health in Ireland: Awareness and Attitudes (HSE, 2017)
Mental health and the workplace
* The main mental health issues that impact on the workplace in terms of absenteeism are anxiety and depression (13%), stress (7%), nervous debility / bereavement (4%) and post natal depression (2%). Absence costs small business over €490 million per annum with 4,052,222 days lost in 2014 (SFA, 2016)

* The main workplace issues that can create/ lead to poor mental health include: role ambiguity, role conflict, role overload, work-family conflict , performance monitoring, job design, monotony and repetition and job opportunities. (Mellor et al, 2014)

* The most prevalent workplace induced condition affecting mental health is burnout. Burnout is defined as "a stress reaction to prolonged exposure to job stressors." ( Maslach et al, 2000) Burnout symptoms:

 emotional exhaustion,which refers to work-related fatigue;
 depersonalization that results from an indifference to work; and
 diminished feelings of accomplishment, which accounts for a decline in one's competence and productivity."
(Schaufeli, et al, 1996)

* Males and females can exhibit different burnout behaviours with females more inclined to exhibit emotional exhaustion than males and males more likely to exhibit depersonalisation than females. (Purvanova et al, 2010)

* Almost half of Irish workers indicate that their time in work consists mainly of tasks that involve physical activity - moderate physical effort (35%), physically demanding work (13%).

* Roughly a third of Irish workers (34%) spend most of their time sitting. Those aged 35 to 44 are most likely to indicate that the time spent working is mainly spent sitting down (41%) and are least likely to be in jobs that are classified as being physically active (41%). Almost three-quarters (74%) of 35 to 44 year olds indicate that they are currently in work - higher than for any other age group. The extent of long time periods spent sitting in work is a particular challenge for this age group. Addressing this challenge will need to include ways to incorporate physical activity into the working day, including active travel and other workplace-based initiatives.

* A supportive work environment, Employee Assistance Programmes, workplace courses on stress management, resilience training and skills training are all factors that can alleviate and prevent workplace stress. (Mellor, 2014)

Mercer Survey
Methodology: The survey was conducted by Red C among a representative sample of 1,500 employees in the UK and Republic of Ireland between 27th May and the 4th June

Key concerns: Maintaining health - 59%; providing for their family if impacted by illness or death (55%); Paying bills - 54%; Retirement saving - 51%

Impact of key concerns: Reduced concentration - 64%; Reduced job satisfaction - 59%; Lower Productivity - 44%
Improved satisfaction with employer: Help with stress - 61%; Financial and retirement planning advice - 58%; Online training - 58%; Healthy lifestyle support - 48%

Mental Health in Ireland
* In Ireland, one in four people will use a mental health service at some stage of their lives

* 9% of population indicate a probable mental health problem. 11% of people said they had personally experienced a mental health problem.

* 85% of people agree that "anyone can experience a mental health problem".

* 62% would not want others knowing if they themselves had a mental health problem.

* 52% expressed that people with mental health problems should not be allowed to do important jobs such as doctors, nurses, etc.

* Men reported higher positive mental health scores than women (69.8 and 65.9 respectively)

* Similarly, higher positive mental health was reported among younger people than older people
(15-24: 69.1; 75 and older: 61.6)

* Those living in Dublin report lower scores on the Mental Health Index-5 (MHI-5) scale than those living elsewhere (79.8 and 85.2 respectively). This suggests higher levels of psychological distress in Dublin

* Male respondents were more likely to list problems at work and not having a good job as concerns; female respondents, particularly those under 35, were more likely to list the fear of 'not being loved' and interpersonal / working relationship stress as concerns.

* Talking is regarded as the most effective means of looking after your own mental health - to friends, to family members, to people who have had similar experiences and to counsellors or psychotherapists.

* The vast majority of adults would turn to their GP as their first point of professional contact if they thought they had a mental health problem.

* 86% of Irish adults rate their own quality of life as good or very good, but this falls to 64% among those who have personal experience of mental health problems.

* For people who experienced mental health problems, reported quality of life is significantly better if the person has good levels of social contact.

* Approximately half (52%) have had some experience of people with mental health problems
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Promoting Mental Health in the Workplace across Cork City Download the PSYCHED Flyer CLOSING DATE FOR APPLICATIONS is Friday March 9th 2018 Click here to apply online Wednesday February 21st 2018 10am - 1pm Spaces are limited.

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Project TALE - Online trainingImproving legal practice with children and young people

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Project TALE - Online trainingImproving legal practice with children and young people

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This online training tool is designed to support legal practitioners in making the legal process more sensitive to the rights and needs of child clients. Children's special and dependent status creates distinct difficulties for them in pursuing remedies for breaches of their rights.

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Strategic Litigation and Child Participation IDEA Training #1 Resources

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Strategic Litigation and Child Participation IDEA Training #1 Resources

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9th March 2018 Prof Lundy and Prof Skelton

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What activity gives you energy and helps you to recover from this work? 

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What activity gives you energy and helps you to recover from this work? 

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Latest national Health Initiatives

Healthy Ireland is a Government-led initiative which aims to create an Irish society where everyone can enjoy physical and mental health, and where wellbeing is valued and supported at every level of society... continue reading

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The national initiative to improve health and wellbeing

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Healthy Ireland is a Government-led initiative which aims to create an Irish society where everyone can enjoy physical and mental health, and where wellbeing is valued and supported at every level of society... continue reading

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An example of taking complicated legal language and making it child-friendly: https://www.childrenscommissioner.gov.uk/2017/09/29/childrens-commissioner-launches-social-media-giants-terms-and-conditions-jargon-buster-to-give-kids-more-power-in-digital-world/

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ECHR Family Reunification in Care Cases November 13 2017.pdf

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American Counselling Association Factsheet

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When is the last time you did absolutely nothing for 10 whole minutes? Not texting, talking or even thinking? Mindfulness expert Andy Puddicombe describes the transformative power of doing just that: Refreshing your mind for 10 minutes a day, simply by being mindful and experiencing the present moment. (No need for incense or sitting in uncomfortable positions.)

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The friend effect: why the secret of health and happiness is surprisingly simple 

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The friend effect: why the secret of health and happiness is surprisingly simple 

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For some, eating alone can be a joyous thing: forking mouthfuls of pasta straight from the pan, peanut butter licked off a spoon, the unbridled pleasure of walking home from the chippie alone on a cold night. But regularly eating meals in isolation is a different story. This one factor is more strongly associated with unhappiness than any other apart from (unsurprisingly) having a mental illness. This is according to a new study by Oxford Economics that found, in a survey of 8,250 British adults, that people who always eat alone score 7.9 points lower, in terms of happiness, than the national average.

This research is far from the first to suggest a link between eating with others and happiness. Researchers at the University of Oxford last year found that the more that people eat with others, the more likely they are to feel happy and satisfied with their lives. The study also found that people who eat socially are more likely to feel better about themselves and have wider social and emotional support networks.

Robin Dunbar, a professor of psychology, worked on the Oxford University study. He says that "we simply don't know" why people who eat together are happier. But it is clear that this is a regular social ritual, a moment of union and communion in our often chaotic lives. It can be a place of conversation, storytelling and closeness.

"At a psychological level, having friends just makes you happier," says Dunbar. "The kinds of things that you do around the table with other people are very good at triggering the endorphin system, which is part of the brain's pain-management system. Endorphins are opioids, they are chemically related to morphine - they are produced by the brain and give you an opiate high. That's what you get when you do all this social stuff, including patting, cuddling and stroking. It is central to the way primates in general bond in their social groups and relationships."

Our face-to-face relationships are, quite literally, a matter of life or death. "One of the biggest predictors of physical and mental health problems is loneliness," says Dr Nick Lake, joint director for psychology and psychological therapy at Sussex Partnership NHS Foundation Trust. "That makes sense to people when they think of mental health. But the evidence is also clear that if you are someone who is lonely and isolated, your chance of suffering a major long-term condition such as coronary heart disease or cancer is also significantly increased, to the extent that it is almost as big a risk factor as smoking."

One of the most striking pieces of evidence for this, says Dunbar, is a meta-analysis of 148 epidemiological studies that looked for the best predictors that patients would survive for 12 months after a heart attack. "The best two predictors, by a long way, are the number and quality of friends you have and giving up smoking," he says. "You can eat as much as you like, you can slob about, you can drink as much alcohol as you like - the effect is very modest compared with these other two factors."

Human beings are biologically engineered for human interaction - and particularly face-to-face interaction. One study from the University of Michigan found that replacing face-to-face contact with friends and family with messages on social media, emails or text messages could double our risk of depression. The study also found that those who made social contact with family and friends at least three times a week had the lowest level of depressive symptoms.

" We are the most social of all the animals," says Prof Paul Gilbert, a psychologist and the founder of compassion-focused therapy. "Our brains and our bodies are built to be regulated through interactions with others from the day that we are born." This is not the case with many creatures, such as turtles and fish, that procreate in vast numbers. "They don't need looking after," says Gilbert. "Many of them will die before they reach reproductive age. The caring behaviour [associated] with mammals is a major evolutionary adaptation - it changes the brain and the physiology of the body so that a parent is interested in staying close to an infant. One of the most important things is the human capacity for soothing and engaging. So, when a mother smiles at a baby and makes eye contact, that positive emotion in the face and the voice of the mother is stimulating positivity in the child. You can see why it's called mirroring, the baby smiles back.

"The ability to stimulate positive emotions, which is linked to happiness, begins in interactions with others who are having positive emotions about you. So, when we see our friends and they say, 'Good to see you' - it's important."

But there are many factors that might prevent us from seeing friends and family: mental ill health, immobility, a lack of money. Alison Harris is a consultant clinical psychologist and professional lead for psychological services in Salford. "Austerity has a huge influence on the loss of happiness and wellbeing," she says. "Homelessness and unemployment in particular takes us out of contact with others. In addition to the obvious harms of homelessness, it does massively increase social isolation and anxiety. To take that even further, many people are in exile from their communities. In mental health services, we see an enormous amount of grief, depression and anxiety in people who are asylum seekers and refugees and much of that is not just due to trauma or torture or detention or fleeing from their country, but from the severe rupture of being cut off from their families and communities of origin."

When we are around others, it has an effect on our body. Some forms of friendship - going to parties, getting married, having positive interactions with others - stimulate our sympathetic nervous system. Gilbert says that the parasympathetic nervous system (otherwise known as the "rest and digest" system) "is stimulated through the verbal and voice tone of relations with each other. As far as we know, it's not that stimulated through texts. Generally speaking, you're designed to respond to voice tone and expression, and stroking. We are physiologically designed for face-to-face interaction."

Of course, for those struggling with depression, the idea of physical contact can be impossible to fathom. At those moments, the capacity to lift up a mobile phone and type out a text is an enormous mark of progress. It may not be the ideal form of interaction, but it's a vast improvement on staring at a wall.

Dragging ourselves out of low energy states - be that by trying to cultivate compassionate voices internally or having compassionate relationships with others - is key to Gilbert's work. "If you ask someone, 'What is your internal critic most frightened of?' [you will find] it's frightened of rejection, of being seen as no good. Of being unlovable, of not being wanted. All the raging that goes on beneath us, the thing that we fear most is shame - not being good enough or wanted. We are frightened of being revealed to be not so nice."

He says that what has happened in the past decade, with the rise of social media, "is that it has become a very plastic society. We are all living like theatrical actors, presenting ourselves as our best. That can't be real, and so we have many people who feel like failures or useless. They say: 'I'm not as attractive as that, I'm overweight, I'm not kind or compassionate to others.'"

As Gilbert says, the best relationships are the ones where people love us for our perceived dark sides and flaws. "People forget that love is about loving you for the difficult things, not the easy things," he says. It is those who know us intimately who can provide that, and they do it through their physical presence, through touch, and through eating, drinking and sharing with us. Spending time together is social nourishment. So, instead of texting a friend or messaging them on social media, why not knock on their door, look them in the eye and make yourselves both feel better?

This article was amended on 23 May 2018. Dr Alison Harris works for the Greater Manchester Mental Health NHS foundation trust, and not Salford Royal NHS foundation trust, as an earlier version said.
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What do professional golfers, radical queer feminists and Instagram lifestyle influences have in common? They are all devotees of "self-care". While the earlier self-help movement focused on improving yourself, the relatively new self-care movement focuses on preserving yourself. It's lifestyle advice for an age of diminished expectations, where most people have given up on getting to the top and the best they can hope for is to get through the day. Self-care is self-help for a time when about a third of the population will suffer from some kind of anxiety disorder during their lives.

Self-care is a remarkably flexible term. It includes nearly any activity people use to calm, heal and preserve themselves in the face of adversity. Some common forms of self-care include getting enough sleep, eating well, physical exercise, meditating and doing things you like such as watching an 80s teen film. Other suggestions for self-care include tracking your menstrual cycle, having date nights with yourself, doing craft activities such as crochet, learning the art of saying no, and " consciously unfollowing " people on social media.

The central insights may well get lost. This could mean self-care becomes just another brand of self-help

A whole self-care industry has popped up in recent years peddling products such as temporary tattoos featuring slogans like "I am enough". The hashtag #selfcare has been used more than 18 million times on Instagram alone. Type it in and thousands of images of glossy-haired women lounging in health spas will pop up. Although it is still largely targeted at women, self-care has starting to appeal to men too. For instance, the pro-golfer Bryson DeChambeau recently described his self-care ritual during the PGA tour: eating well, listening to his body and playing Fortnite.

Although self-care seems to be everywhere today, it hasn't always been this way. The roots of the current ideas about self-care are to be found in a book by the intellectual historian, Michel Foucault. In the third volume of The History of Sexuality, he examined how ancient Greeks pursued ideas about the " care of the self ". This idea took on a new vitality in A Burst of Light, a book by Audre Lorde. Written after she had been diagnosed with cancer for a second time, Lorde talks about self-care as a radical political act. "Caring for myself is not self-indulgence," she wrote. "It is self-preservation, and that is an act of political warfare." Lorde's ideas about self-care were picked up by many in queer, feminist and activist circles. Caring for yourself became a way of preserving yourself in a world that was hostile to your identity, your community and your way of life.

But the idea of self-care has overflowed the relatively small circles of people who might be familiar with Lorde. The self-care of Instagrammers, professional golfers and overworked executives is probably not intended as "an act of political warfare" as Lorde had hoped. But why, a quarter century after her death, has a radical queer theorist become a go-to lifestyle guru? Maybe others are finally starting to recognise the power of some of Lorde's ideas. Perhaps it is because the widespread existence of anxiety disorders means that many of us share some of Lorde's experience of facing up to fear and trying to survive in a world that seems so hostile. It could be that continued political shocks mean even relatively privileged people have started to feel that the world is against them and the best they can hope for is to endure. It is worth remembering that Google searches for "self-care" peaked between 13 and 19 November 2016, the week after Donald Trump was elected US president.

Self-care might have a wide appeal, but does it work? There are many testimonial accounts of the powerful impact self-care has had on people's lives. For instance, Angie Jaime describes for Vice how communal self-care helped her to deal with a jarring move between cities and the heightened presence of everyday discrimination and racism she faced. These kind of personal stories are backed up by a growing body of scientific evidence suggesting that self-care practices are good for people's physical and mental health. This is particularly true for people with chronic diseases - a group that makes up about 45% of the US population.

But while self-care may work for individuals, it doesn't come without dangers. This once radical idea is being stripped of its politics to make it more palatable to a mass market. As this happens, the central insights associated with self-care may well get lost. This could mean self-care becomes just another brand of self-help. Self-care could also be seen as cheap replacement for social care. Already many governments around the world are starting to focus their resources on promoting self-care in the medical world. This is fine if it is a complement to professional care. But when it becomes a substitute, we probably should be worried. Sometimes we need other people with skills and experience to care for us.
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What was supposed to be an invitation to collective survival becomes yet another form of individualism. This happens when self-care becomes nothing more than another word for "me time". When this occurs, self-care can quite easily transform into self-coddling. Self-care can become an excuse to get out of almost any commitment. This can be a problem not just for the people we let down but also for ourselves. Self-care can become an excuse to avoid pushing ourselves even slightly outside of comfort zones. As a consequence, we miss out on opportunities to learn and to have experiences we can't directly control.

If we spend all our time caring for ourselves, it is likely we will have no time and energy to challenge ourselves. This could easily leave us feeling safe and cared for but also stunted, while doing little to reduce the anxiety about the world around us.

* André Spicer is professor of organisational behaviour at the Cass Business School at City, University of London
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'Self-care': how a radical feminist idea was stripped of politics for the mass market | André Spicer

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What do professional golfers, radical queer feminists and Instagram lifestyle influences have in common? They are all devotees of "self-care". While the earlier self-help movement focused on improving yourself, the relatively new self-care movement focuses on preserving yourself.