Completed research projects
Read about our completed projects.
Calculating the suicide rate for the New Zealand construction industry (2020-2021)
Dr Gabrielle Jenkin, June Atkinson
This research funded by BRANZ and supported by MATES New Zealand aimed to refine the the definition of the construction industry, clarify its prevalence of suicide and calculate industry suicide rates.
Targeted suicide prevention report (PDF)
Executive summary report (PDF)
Boys don't cry': Understanding masculinity and mental health-related stigma among men (2018–2021)
Dr Sarah McKenzie
The stigma of mental illness has been described as having worse consequences than the conditions themselves. Stigma is known to have negative impacts on men's mental health help-seeking and the use of services amid impeding disclosures and diminishing social connection and amplifying economic hardship. Although men often face barriers to discussing their struggles with, and help-seeking for mental illness challenges, research focused on men's lived experiences of mental illness stigma is, at best, emergent. This study based on interviews with men in New Zealand aimed to examine men's lived experiences of stigma in relation to mental distress. This research was funded by a University of Otago Health Sciences Career Development Postdoctoral Fellowship.
Acute Mental Health Facility Design: the New Zealand experience (2017–2021)
Dr Gabrielle Jenkin, Dr Susanna Every-Palmer, Dr Debbie Peterson, Chris Watson, Dr Evangelia Chrysikou, Jacqueline McIntosh
The acute mental health ward is the modern equivalent of the old mental asylum but little is known about factors informing its design and use or the underpinning philosophy of care upon which these facilities are based and if they could benefit from improvements.
This multidisciplinary study drew on perspectives from social science, psychiatry, nursing and architecture to understand the architectural design, therapeutic philosophy and social regime of the modern acute mental health unit in New Zealand.
It examined as case studies, four acute adult psychiatric wards in New Zealand. Using multiple existing sources of data, including architects plans, briefs and grey literature and collecting new data via in-depth interviews and small focus groups with mental health consumers resident in the wards, staff and other ward users and stakeholders, the findings from this research will inform a much needed evidence base for optimal acute psychiatric facility design in NZ. This research is funded by a Marsden Fast Start.
See: Jenkin, G L S, McIntosh, J, and Every-Palmer, S (2021), Fit for what purpose? Exploring bicultural frameworks for the architectural design of acute mental health facilities. International Journal of Environmental Research & Public Health, 18(5), 2343. doi: 10.3390/ijerph18052343
Gender mender, bender or defender: Understanding decision making in Aotearoa/New Zealand for people born with a variation in sex characteristics (2020)
Dr Denise Steers
People born with a variation in sex characteristics (VSC) face the challenge of having atypically sexed bodies. This PhD project recruited 10 young adults with a VSC (14 to 24 years); 18 parents of children with a VSC; and 22 health professionals working in the VSC field. Interviews were semi-structured, digitally recorded and transcribed. Using thematic analysis, we identified key themes regarding participants' experiences of health care decision-making. This study has been conducted in collaboration with the Intersex Trust of Aotearoa/New Zealand (ITANZ).
This PhD research was original and innovative in three ways: it demonstrated close collaboration between activists and academics through all stages of the research design and conduct; it provided a unique 360-degree perspective integrating the views of health professionals, parents and young people (possible because of the small size of New Zealand); and it fills a gap in the literature by capturing the voice of young people currently living with a VSC.
13 Reasons Why: Dangerous sensationalism or opening up the suicide conversation? Examining young people's perspectives (2018)
Dr Sarah McKenzie, Dr Gabrielle Jenkin, Professor Sunny Collings
The Netflix drama 13 Reasons Why focusing on the suicide of an adolescent girl became a global phenomenon and was accompanied by intense public debate around the risks of exposing youth to fictional portrayals of suicide.
This study explored the views and perspectives of 25 New Zealand adolescents who had watched the first season about their understanding of the suicide storyline in Netflix series. This research contributes a youth perspective which has been missing from the debate on 13 Reasons Why and highlights the way that youth, when given the opportunity, can articulate a nuanced understanding of the representation of adolescent suicide in 13 Reasons Why. Many viewed it as entertainment rather than a realistic depiction that added little in terms of suicide awareness and generated minimal opportunities for in-depth discussions with parents or other adults. This study was funded by a University of Otago Research Grant.
See: McKenzie, S. K., Jenkin, G., Steers, D., Magill, R., & Collings, S. (2021). Young people's perspectives and understanding of the suicide story in 13 Reasons Why: A qualitative study. Crisis, 42, 64-70. doi: 10.1027/0227-5910/a000688
'Liking' working with suicidal patients: A mixed methods research investigation of clinicians' positive inclination to patients at risk for suicide and the effect of this on the therapeutic encounter (2018)
Dr Tess Soulie
A strong therapeutic relationship is associated with better outcome in therapy/treatment, including with patients at risk for suicide (PRS). However, to build a strong therapeutic relationship with PRS, clinicians' need to manage the emotional responses, also called countertransference (CT), that PRS tend to elicit in them. Conversely, evidence shows that positive CT, such as feeling of closeness and affiliation towards patients, are associated with better outcomes in therapy/treatment. However, such positive inclination from clinicians is rarely studied in relation to PRS, which represents an important knowledge gap.
This PhD research project aimed to advance knowledge in clinical suicidology by studying the stance of clinicians who feel positively inclined towards, or “like working” with PRS using mixed methods design.
Motivational interviewing for adolescent engagement in group transdiagnostic cognitive behavioural therapy: a randomised clinical trial (2018)
Dr Shaystah Dean
Anxiety and mood disorders are prevalent, chronic and highly comorbid in adolescence, with detrimental personal, societal and economic outcomes. Given the high rates of attrition and limited resources available in psychiatric settings, the importance of engaging adolescents in evidence-based treatments cannot be overstated. Barriers to treatment access include: (a) the availability of effective and efficient delivery of psychological treatment, such as Cognitive Behavioural Therapy (CBT), and (b) lost opportunity to offer such treatment packages to adolescents due to poor engagement.
This PhD research project examined the efficacy of Motivational Interviewing (MI), as a brief pre-treatment intervention, to enhance treatment engagement in an evidence-based treatment (group cognitive behavioural therapy; gCBT) for adolescents with anxiety and mood disorders. The secondary aim was to evaluate whether there was a net effect of MI on clinical and quality of life outcomes following gCBT, and to gain some insight into the experience of participants and referring clinicians
Understanding men's mental health: Gender relations and mental well-being (2017)
Dr Sarah McKenzie
Men's mental health has remained understudied and undertheorised. Much of the early research on men's mental health comes from large scale quantitative studies focusing on gender differences in mental illness. It is only in recent years that the influence of gender as a social construct has become the focus for researchers interested in men's mental health, particularly depression.
This PhD research project used a life history method underpinned by gender relations theory to explore how men's everyday social practices can help or hinder mental well-being. Life history interviews were undertaken with fifteen New Zealand men aged between twenty and forty years. The interviews explored participant's emotional lives, work lives, family and social relationships, and how they engaged with their mental health on a day-to-day basis. Gender relations theory was used to examine the complex interplay between masculinity and mental health within each man's life story.
The suicide and serious self-harm risk of 'Mixed Presenters' to emergency departments (2017)
Dr Silke Kuehl, Professor Sunny Collings, Dr James Stanley, Dr Katherine Nelson
Suicide is a major health and social concern in New Zealand. A small group of people who present to emergency departments (ED) with intentional self-harm (ISH) also present for other causes ('Mixed Presenters'). These people experience significant psychological distress, poor physical health status and may have a suicide risk higher than the risk conferred by ISH alone.
This PhD research project was an extension of the existing MISP study. It used the unique opportunity to examine all ED presentations in detail in 4 District Health Boards (DHBs) from this study. This data was used to estimate the relative risk of suicide and serious ISH events between Mixed Presenters and the 'ISH Only Presenters'; and to identify service gaps. Mixed Presenters were interviewed to explore how best to enhance their health outcomes when presenting to ED. This research was funded by the Health Research Council.
Mental health services in Aotearoa/New Zealand: Delivering sustainable services to meet the needs of Pacific populations (2017)
Dr Nandika Currey
Pacific peoples have been found to experience mental disorders at higher levels than the general population. This disproportionate mental health burden is met with service trends of: low utilisation, late presentation, high rates of emergency referral, longer stays and the highest average cost of adult inpatient and community episodes. Current evidence points to the limits of existing services to respond effectively to the Pacific mental health context.
It has been recognised that building responsive services for Pacific peoples who are affected by mental illness is of high priority. Also of high importance is the need for services to be resilient, flexible and sustainable in light of resource constraints.
This PhD research project sought to investigate the sustainability of mental health services in meeting the needs of Pacific peoples. This project was funded by the Ministry of Health.
Suicide inquests: interviews with New Zealand Coroners (2016)
Dr Gabrielle Jenkin, Professor Sunny Collings, Dr Justin Canty
Little is known about the perspectives, experiences and decision-making processes of New Zealand coroners as they go about their business of investigating deaths by suicide and making recommendations. This study, based on interviews with NZ coroners, aimed to uncover how suicide inquests are conducted in New Zealand. It examined how coroners go about their investigations, what factors influence their decision-making and recommendations and, coroners' perspectives on these processes and suicide in general. This research was funded by a University of Otago Research Grant.
See: Jenkin, G., Canty, J., Ernst, S., & Collings, S. (2022). Investigating suspected suicides: New Zealand coroners' experiences. Death Studies, 46(2), 314-322. doi: 10.1080/07481187.2019.1699205
Health outcomes for mental health service users – exploring the case of cancer (2016)
Dr Ruth Cunningham, Professor Sunny Collings, Dr Debbie Peterson, Dr Diana Sarfati, Dr James Stanley
The overall aim of this PhD study was to investigate the role of general health services in mortality and morbidity differences in those with severe mental illness compared to the general population, using cancer care as an example. The hypothesis was that differences in the quantity and quality of general health service care contribute to worse outcomes for people with severe mental illness. This study was funded by the Health Research Council.
Children, social media, and the trouble with “bullying”: A child-centred investigation of definitions (2016)
Dr Justin Canty
Bullying troubles parents, teachers, and children themselves. The emergence of bullying in children's use of social media, often referred to as cyberbullying, has heightened concern for children's social and emotional wellbeing. Bullying is troublesome in the context of how it is defined and identified in children's social interactions with peers. The “trouble” with bullying for this PhD project was that the common definitions and models of bullying are adult-generated, and children's perspectives are often missing in existing bullying literature. This project involved developing a child-centred approach to deconstruct assumptions in adult-generated definitions of bullying. It argues that marginalisation of children's perspectives is a problem and present one approach to redressing the balance.
Suicide Mortality Review Feasibility Study (2015)
Professor Sunny Collings, Dr Gabrielle Jenkin, Dr Sarah McKenzie, Dr Debbie Peterson, June Atkinson
The primary objective of the Suicide Mortality Review Feasibility Study was to evaluate the feasibility and potential benefits of setting up a national suicide mortality review process. In particular, whether such a process could provide additional information about factors contributing to suicide (for specific groups), and potential points of intervention for suicide prevention. These could be at individual, family, whānau, community, government agency or health systems levels. This research was funded by the Health Quality and Safety Commission.
Ngā Rāhui Hau Kura (Suicide Mortality Review Committee Feasibility Study 2014–15
On 26 July 2017 Health Minister Jonathan Coleman announced the Government would be extending funding for the Suicide Mortality Review Committee to continue its work beyond its trial period.
https://www.beehive.govt.nz/release/funding-suicide-mortality-review-committee
The effects of change in coronial attitude and practice on suicide news reporting in New Zealand (2014)
Dr Gabrielle Jenkin and Professor Sunny Collings
The portrayal of suicide in the media is known to have an influence on suicide rates. Because of this, there are best practice guidelines restricting aspects of suicide reporting by the media. However, in August of 2010, the Chief Coroner suggested that there was a need to 'open up' the issue of suicide. This comment led to a controversial debate over the reporting of suicide in the media. This research investigated this debate and assessed its impact on the reporting of suicide by the New Zealand news media. This research was funded by a University of Otago Research Grant.
MISP – Multi-level Interventions to reduce suicidal behaviour: a New Zealand controlled community intervention project (2009-2012)
Professor Sunny Collings, Dr Nandika Currey, Dr Silke Kuehl, Ms June Atkinson, Dr James Stanley, Professor Diego De Leo, Dr Sarah Mckenzie, Dr Simon Hatcher
MISP was a 25 month Multi-level community Intervention for Suicide Prevention designed for and implemented in New Zealand (MISP-NZ) between 01 June 2010 and 30 June 2012 with the aim of reducing rates of suicidal behaviours. Its design was based on a cluster randomised controlled trial (cluster RCT) with eight District Health Boards (hospital) regions matched into four pairs (based on key socio-demographic factors) randomised to either the intervention or practice as usual (PAU) i.e. control arm of the study. Each intervention region received 25 months of interventions (01 June 2010 to 30 June 2012) which can be categorised broadly as: 1) training in the recognition of suicide risk factors; 2) workshops on various mental health issues; 3) community based interventions; 4) work with the media on the safe reporting of suicide; and 5) distribution of print based material and information on web based resources. The main outcome was the annual rate per 100,000 of suicidal behaviours (intentional self-harm (ISH) and self-inflicted deaths) evaluated over the study period. This trial is registered by the Australian New Zealand Clinical Trials Registry (ACTRN12613000399796). This trial was funded by the Ministry of Health.
See: Collings, S., Jenkin, G., Stanley, J., McKenzie, S., & Hatcher, S. (2018). Preventing suicidal behaviours with a multilevel intervention: A cluster randomised controlled trial. BMC Public Health, 18, 140. doi: 10.1186/s12889-018-5032-6
Found in translation: implementing a toolkit for Primary Mental Health Care Development (2013)
Professor Sunny Collings, Dr Sarah Mckenzie, Professor Tony Dowell, Philip Gandar,David Rees, Dr Nandika Currey
In this HRC funded project we worked in an existing partnership with Valley Primary Health Organisation and Hutt Valley District Health Board to investigate the adoption and implementation of a newly developed New Zealand based Toolkit for primary mental health care development. Using an explanatory case study design we determined the structural and non-structural characteristics of the organisations that influenced adoption and implementation, and whether or not adoption of the Toolkit led to any measurable changes in service provision or use. We also assessed the sustainability of the Toolkit use and the transferability of our findings to other health contexts.
The Toolkit was developed by the University of Otago Wellington and Synergia Ltd. in partnership with providers in four DHB localities during an 18-month DHBRF/HRC funded project (2009-2010).
Māori Adaption of an Ultra-brief Intervention for Common Mental Health Syndromes in Primary Care (2012)
Ms Fiona Mathieson,Professor Sunny Collings, Professor Tony Dowell, Dr Kara Mihaere
Many people who attend primary care have significant psychological symptoms and distress that cause problems in day-to-day life. These are often not defined as mental disorders, which means that often these people are not eligible for treatment. However, the people with this 'subthreshold syndrome' experience genuine suffering and impairment in functioning. Those with depressive symptoms may go on to develop a disorder. We developed a very brief psychological treatment and adapted it for use with Māori participants to determine whether it is acceptable to patients and to primary care nurses and other clinical staff based in General Practices. Funded by the Oakley Foundation and a University of Otago Research Grant.
Experiences of Treatment Pressure in Community Mental Health Care in New Zealand (2012)
Professor Sunny Collings, Dr Richard Mullen, Professor John Dawson, Dr Gavin Cape, Dr James Stanley, Dr Ruth Cunningham, Ms Natasha Taylor, Ms Denise Steers, Ms Kim Dobchuk
The aim of this project was to investigate the ways in which mental health consumers are encouraged or pressured to participate in treatment, and to determine how common these experiences are in NZ community mental health services. Information was collected from mental health consumers/tangata whaiora and their case managers/clinicians.
Where agreement cannot be reached between clinicians and mental health consumers, there are a variety of ways in which clinicians might seek to persuade people to take treatment, which might sometimes include the use of pressure such as incentives or threats. Others such as family/whānau and those involved in the legal system may also exert pressure to encourage mental health consumers to do what they want in terms of taking treatment. This project did not take the position that pressure to take treatment is a good or a bad thing. This was a project that was driven by clinicians who were interested in finding out more about what happens and what those who apply and experience this pressure feel about it. Funded by the Health Research Council.
Understanding the mental health status of sole parents (2012)
Professor Sunny Collings, Dr Gabrielle Jenkin, Dr Kristie Carter
Sole parent families account for 30% of families with children in NZ. Sole parents are predominantly women (84%) and Maori and Pacific families are particularly overrepresented. Research has revealed that sole parents have considerably poorer socioeconomic resources and poorer mental health than couple parent families. The poorer mental health of sole parents is a significant health issue for sole parents and their children. Children of sole parents are more likely to have mental health problems and mental health problems amongst children are strongly correlated with poorer mental health in adulthood.
This research aimed to untangle these associations using cross-sectional data from the Survey of Families, Income and Employment (SoFIE) conducted in NZ from 2002-2010 by Statistics New Zealand. Funded by a University of Otago Research Grant.
Community reintegration of male Pacific prisoners with mental illness: A Public Health perspective (2012)
Mr Sione Feki, Professor Sunny Collings, Dr Nandika Currey
Prisoner reintegration is a widely used term for defining ex-prisoners re-entry, transition and resettlement from prison to the community. It is centred on social and personal disadvantages that create obstacles to successful participation to the community. The reintegration framework suggests that the risk of re-offending is high if social and personal barriers are not reduced and removed. Reintegration promotes social inclusion and the adoption of positive lifestyle that leads to successful return from prison and becoming a productive member of the society.
The Masters research project examined the obstacles to the community reintegration of Pacific prisoners (males) with mental illness, when they are released from Rimutaka prison to the Wellington region.
This Research was funded by the University of Otago.
Suicidality and mental illness: From self-stigma to self-management (2012)
Dr Debbie Peterson, Professor Sunny Collings
The role of self-management of suicidality was investigated among people with experience of mental illness in New Zealand. The study interviewed 27 people with experience of mental illness and suicidality to understand how people self-manage suicidality, why they self-manage and the effects that self-management may have on suicidal thoughts and behaviours. This study was funded by the University of Otago.
Media influences on suicidal behaviour: An interview study of young people in New Zealand (2010)
Professor Sunny Collings, Professor Keith Hawton, Dr Sarah Fortune, Ms Denise Steers, Ms Nandika Currey
This study aimed to provide a detailed understanding of the mechanisms by which the media may have influenced episodes of self-harm by adolescents who have harmed themselves and attend child and adolescent mental health services. While there exists a body of literature about media effects at a population level we understand very little about the mechanisms underlying these effects at the individual level. This was a qualitative survey study using in-depth interviews to generate the data, followed by systematic coding for categories of media and associated themes. The interview and method have been piloted in Oxford, England with 12 people aged 17-23 years who had self-harmed. This research was funded by Te Pou.
Influences of the virtual social environment on suicide and self-harm: a qualitative investigation of the perspectives of young male adult website users (2010)
Ms Susan Knox, Professor Sunny Collings, Dr Sarah Fortune
This Masters research was an extension of an existing study 'Media influences on suicidal behaviour: an interview study of young people'. The primary aim of this study was to investigate how young men interact and engage with electronic media to increase our understanding of how media influences behaviour. This study provided an opportunity increase understanding of media influences on self-harm and suicide. This research was funded by Te Pou
Locations and Methods of Suicide in New Zealand (2010)
Barry Taylor, Professor Sunny Collings
This study aimed to identify changes in patterns of locations using data from 1997-1998 and 2005-2006, report on emerging methods that may have been noted anecdotally but which are not discernible in the current ICD reporting system and contribute to prevention policy and programme development in respect of restriction of access to locations and means. Using simple descriptive methods we applied these aims to two datasets, the Ministry of Health Mortality Data Collection 1997-1998 and 2005-2006, and the Coroners' Files 2005-2006. The analyses looked for any differences by gender, age and ethnicity. The study was funded by Te Pou.