INTRODUCTION: Connections between environmental factors and mental health issues have been postulated in many different countries around the world. Previously undertaken research has shown many possible connections between these fields, especially in relation to air quality and extreme weather events. However, research on this subject is lacking in New Zealand, which is difficult to analyse as an overall nation due to its many micro-climates and regional differences.OBJECTIVES: The aim of this study and subsequent analysis is to explore the associations between environmental factors and poor mental health outcomes in New Zealand by region and predict the number of people with mental health-related illnesses corresponding to the environmental influence.METHODS: Data are collected from various public-available sources, e.g., Stats NZ and Coronial services of New Zealand, which comprised four environmental factors of our interest and two mental health indicators data ranging from 2016 up until 2020. The four environmental factors are air pollution, earthquakes, rainfall and temperature. Two mental health indicators include the number of people seen by District Health Boards (DHBs) for mental health reasons and the statistics on suicide deaths. The initial analysis is carried out on which regions were most affected by the chosen environmental factors. Further analysis using Auto-Regressive Integrated Moving Average(ARIMA) creates a model based on time series of environmental data to generate estimation for the next two years and mental health projected from the ridge regression.RESULTS: In our initial analysis, the environmental data was graphed along with mental health outcomes in regional charts to identify possible associations. Different regions of New Zealand demonstrate quite different relationships between the environmental data and mental health outcomes. The result of later analysis predicts that the suicide rate and DHB mental health visits may increase in Wellington, drop-in Hawke's Bay and slightly increase in Canterbury for the year 2021 and 2022 with different environmental factors considered.CONCLUSION: It is evident that the relationship between environmental and mental health factors is regional and not national due to the many micro-climates that exist around the nation. However, it was observed that not all factors displayed a good relationship between the regions. We conclude that our hypotheses were partially correct, in that increased air pollution was found to correlate to increased mental health-related DHB visits. Rainfall was also highly correlated to some mental health outcomes. Higher levels of rainfall reduced DHB visits and suicide rates in some areas of the country.
Background: There has been a psychopathology focus in disaster research examining adolescent mental health and wellbeing, but recently studies have begun to also examine wellbeing-related constructs. Although an increased risk of posttraumatic stress disorder has been established in disaster-exposed adolescents, comparatively little is known about how disasters impact adolescent wellbeing, nor how factors within the post-disaster environment interact to influence holistic adolescent mental health and wellbeing. Objective: The objective of this study was to describe the holistic mental health and wellbeing of adolescents living in an earthquake-struck city by considering a range of mental health and wellbeing indicators, as well as risk and protective factors hypothesised to influence mental health and wellbeing. The dual-factor model of mental health was used as a framework to guide this study. Method: A survey of Christchurch secondary school students was used to gather data about their subjective wellbeing, risk of low wellbeing, psychological distress, quality of life, exposure to Adverse Childhood Experiences, social support from friends and family, school connectedness, and expectations about future quality of life. Results: A slim majority of students reported good subjective wellbeing (52.3%) and high current quality of life (56.4%), whereas a larger majority reported low risk of psychological distress (79%). An equal proportion of students reported high and low risk of low wellbeing. There were no statistically significant differences in any of the variables measured between adolescents who did and did not live through the Christchurch earthquakes. Regression analyses identified that school connectedness, social support from friends and family, and future expectations of quality of life significantly predicted subjective wellbeing, risk of low wellbeing, risk of psychological distress, and current quality of life. The number of Adverse Childhood Experiences significantly predicted only risk of psychological distress when the effects of other variables were controlled for. Conclusion: The findings of this study indicate that there is a low mean level of wellbeing and quality of life in this sample of adolescents living in a severely earthquake- affected community. School connectedness, social support from family and friends, and expectations about future quality of life were shown to significantly predict variance in subjective wellbeing, quality of life, and psychological distress. This suggests that there are social and environmental factors that can be targeted to improve holistic mental health and wellbeing in disaster-affected adolescents who have experienced high levels of trauma. Conclusions in this study are limited by the representativeness of the sample, the cross- sectional nature of the study, and potential sampling bias.
Background: There has been a psychopathology focus in disaster research examining adolescent mental health and wellbeing, but recently studies have begun to also examine wellbeing-related constructs. Although an increased risk of posttraumatic stress disorder has been established in disaster-exposed adolescents, comparatively little is known about how disasters impact adolescent wellbeing, nor how factors within the post-disaster environment interact to influence holistic adolescent mental health and wellbeing. Objective: The objective of this study was to describe the holistic mental health and wellbeing of adolescents living in an earthquake-struck city by considering a range of mental health and wellbeing indicators, as well as risk and protective factors hypothesised to influence mental health and wellbeing. The dual-factor model of mental health was used as a framework to guide this study. Method: A survey of Christchurch secondary school students was used to gather data about their subjective wellbeing, risk of low wellbeing, psychological distress, quality of life, exposure to Adverse Childhood Experiences, social support from friends and family, school connectedness, and expectations about future quality of life. Results: A slim majority of students reported good subjective wellbeing (52.3%) and high current quality of life (56.4%), whereas a larger majority reported low risk of psychological distress (79%). An equal proportion of students reported high and low risk of low wellbeing. There were no statistically significant differences in any of the variables measured between adolescents who did and did not live through the Christchurch earthquakes. Regression analyses identified that school connectedness, social support from friends and family, and future expectations of quality of life significantly predicted subjective wellbeing, risk of low wellbeing, risk of psychological distress, and current quality of life. The number of Adverse Childhood Experiences significantly predicted only risk of psychological distress when the effects of other variables were controlled for. Conclusion: The findings of this study indicate that there is a low mean level of wellbeing and quality of life in this sample of adolescents living in a severely earthquake-affected community. School connectedness, social support from family and friends, and expectations about future quality of life were shown to significantly predict variance in subjective wellbeing, quality of life, and psychological distress. This suggests that there are social and environmental factors that can be targeted to improve holistic mental health and wellbeing in disaster-affected adolescents who have experienced high levels of trauma. Conclusions in this study are limited by the representativeness of the sample, the cross-sectional nature of the study, and potential sampling bias.
Background: There has been a psychopathology focus in disaster research examining adolescent mental health and wellbeing, but recently studies have begun to also examine wellbeing-related constructs. Although an increased risk of posttraumatic stress disorder has been established in disaster-exposed adolescents, comparatively little is known about how disasters impact adolescent wellbeing, nor how factors within the post-disaster environment interact to influence holistic adolescent mental health and wellbeing. Objective: The objective of this study was to describe the holistic mental health and wellbeing of adolescents living in an earthquake-struck city by considering a range of mental health and wellbeing indicators, as well as risk and protective factors hypothesised to influence mental health and wellbeing. The dual-factor model of mental health was used as a framework to guide this study. Method: A survey of Christchurch secondary school students was used to gather data about their subjective wellbeing, risk of low wellbeing, psychological distress, quality of life, exposure to Adverse Childhood Experiences, social support from friends and family, school connectedness, and expectations about future quality of life. Results: A slim majority of students reported good subjective wellbeing (52.3%) and high current quality of life (56.4%), whereas a larger majority reported low risk of psychological distress (79%). An equal proportion of students reported high and low risk of low wellbeing. There were no statistically significant differences in any of the variables measured between adolescents who did and did not live through the Christchurch earthquakes. Regression analyses identified that school connectedness, social support from friends and family, and future expectations of quality of life significantly predicted subjective wellbeing, risk of low wellbeing, risk of psychological distress, and current quality of life. The number of Adverse Childhood Experiences significantly predicted only risk of psychological distress when the effects of other variables were controlled for. Conclusion: The findings of this study indicate that there is a low mean level of wellbeing and quality of life in this sample of adolescents living in a severely earthquake- affected community. School connectedness, social support from family and friends, and expectations about future quality of life were shown to significantly predict variance in subjective wellbeing, quality of life, and psychological distress. This suggests that there are social and environmental factors that can be targeted to improve holistic mental health and wellbeing in disaster-affected adolescents who have experienced high levels of trauma. Conclusions in this study are limited by the representativeness of the sample, the cross- sectional nature of the study, and potential sampling bias.
The aim of this thesis was to examine the spatial and the temporal patterns of anxiety and chest pain resulting from the Canterbury, New Zealand earthquaeks. Three research objectives were identified: examine any spatial or termporal clusters of anxiety and chest pain; examine the associations between anxiety, chest pain and damage to neighbourhood; and determine any statistically significant difference in counts of anxiety and chest pain after each earthquake or aftershock which resulted in severe damage. Measures of the extent of liquefaction the location of CERA red-zones were used as proxy measures for earthquake damage. Cases of those who presented to Christchurch Public Hospital Emergency Department with either anxiety or chest pain between May 2010 and April 2012 were aggregated to census area unit (CAU) level for analysis. This thesis has taken a unique approach to examining the spatial and spatio-temporal variations of anxiety and chest pain after an earthquake and offers unique results. This is the first study of its kind to use a GIS approach when examining Canterbury specific earthquake damage and health variables at a CAU level after the earthquakes. Through the use of spatio-termporal scan modelling, negative and linear regression modelling and temporal linear modelling with dummy variables this research was able to conclude there are significant spatial and temporal variations in anxiety and chest pain resulting from the earthquakes. The spatio-termporal scan modelling identified a hot cluster of both anxiety and chest pain within Christchurch at the same time the earthquakes occurred. The negative binomial model found liquefaction to be a stronger predictor of anxiety than the Canterbury Earthquake Recovery Authority's (CERA) land zones. The linear regression model foun chest pain to be positively associated with all measures of earthquake damage with the exception of being in the red-zone. The temporal modelling identified a significant increase in anxiety cases one month after a major earthquake, and chest pain cases spiked two weeks after an earthquake and gradually decreased over the following five weeks. This research was limited by lack of control period data, limited measures of earthquake damage, ethical restrictions, and the need for population tracking data. The findings of this research will be useful in the planning and allocation of mental wellbeing resources should another similar event like the Canterbury Earthquakes occur in New Zealand.
Worldwide, the numbers of people living with chronic conditions are rapidly on the rise. Chronic illnesses are enduring and often cannot be cured, requiring a strategy for long term management and intervention to prevent further exacerbation. Globally, there has been an increase in interventions using telecommunications technologies to aid patients in their home setting to manage chronic illnesses. Such interventions have often been delivered by nurses. The purpose of this research was to assess whether a particular intervention that had been successfully implemented in the United Kingdom could also be implemented in Canterbury. In particular, this research assessed the perspectives of Canterbury based practice nurses and district nurses. The findings suggest that a majority of both district and practice nurses did not view the service as compatible with their current work situation. Existing workload and concerns over funding of the proposed service were identified as potential barriers. However, the service was perceived as potentially beneficial for some, with the elderly based in rural areas, or patients with chronic mental health needs identified as more likely to benefit than others. Practice nurses expressed strong views on who should deliver such services. Given that it was identified that practice nurses already have in-depth knowledge of their patients’ health, while valuing the strong relationships established with their communities, it was suggested that patients would most benefit from locally based nurses to deliver any community based health services in the future. It was also found that teletriaging is currently widely used by practice nurses across Canterbury to meet a range of health needs, including chronic mental health needs. This suggests that the scope of teletriaging in community health and its potential and full implications are currently not well understood in New Zealand. Significant events, such as the Christchurch earthquakes indicate the potential role of teletriaging in addressing mental health issues, thereby reducing the chronic health burden in the community.
Natural hazard disasters often have large area-wide impacts, which can cause adverse stress-related mental health outcomes in exposed populations. As a result, increased treatment-seeking may be observed, which puts a strain on the limited public health care resources particularly in the aftermath of a disaster. It is therefore important for public health care planners to know whom to target, but also where and when to initiate intervention programs that promote emotional wellbeing and prevent the development of mental disorders after catastrophic events. A large body of literature assesses factors that predict and mitigate disaster-related mental disorders at various time periods, but the spatial component has rarely been investigated in disaster mental health research. This thesis uses spatial and spatio-temporal analysis techniques to examine when and where higher and lower than expected mood and anxiety symptom treatments occurred in the severely affected Christchurch urban area (New Zealand) after the 2010/11 Canterbury earthquakes. High-risk groups are identified and a possible relationship between exposure to the earthquakes and their physical impacts and mood and anxiety symptom treatments is assessed. The main research aim is to test the hypothesis that more severely affected Christchurch residents were more likely to show mood and anxiety symptoms when seeking treatment than less affected ones, in essence, testing for a dose-response relationship. The data consisted of mood and anxiety symptom treatment information from the New Zealand Ministry of Health’s administrative databases and demographic information from the National Health Index (NHI) register, when combined built a unique and rich source for identifying publically funded stress-related treatments for mood and anxiety symptoms in almost the whole population of the study area. The Christchurch urban area within the Christchurch City Council (CCC) boundary was the area of interest in which spatial variations in these treatments were assessed. Spatial and spatio-temporal analyses were done by applying retrospective space-time and spatial variation in temporal trends analysis using SaTScan™ software, and Bayesian hierarchical modelling techniques for disease mapping using WinBUGS software. The thesis identified an overall earthquake-exposure effect on mood and anxiety symptom treatments among Christchurch residents in the context of the earthquakes as they experienced stronger increases in the risk of being treated especially shortly after the catastrophic 2011 Christchurch earthquake compared to the rest of New Zealand. High-risk groups included females, elderly, children and those with a pre-existing mental illness with elderly and children especially at-risk in the context of the earthquakes. Looking at the spatio-temporal distribution of mood and anxiety symptom treatments in the Christchurch urban area, a high rates cluster ranging from the severely affected central city to the southeast was found post-disaster. Analysing residential exposure to various earthquake impacts found that living in closer proximity to more affected areas was identified as a risk factor for mood and anxiety symptom treatments, which largely confirms a dose-response relationship between level of affectedness and mood and anxiety symptom treatments. However, little changes in the spatial distribution of mood and anxiety symptom treatments occurred in the Christchurch urban area over time indicating that these results may have been biased by pre-existing spatial disparities. Additionally, the post-disaster mobility activity from severely affected eastern to the generally less affected western and northern parts of the city seemed to have played an important role as the strongest increases in treatment rates occurred in less affected northern areas of the city, whereas the severely affected eastern areas tended to show the lowest increases. An investigation into the different effects of mobility confirmed that within-city movers and temporary relocatees were generally more likely to receive care or treatment for mood or anxiety symptoms, but moving within the city was identified as a protective factor over time. In contrast, moving out of the city from minor, moderately or severely damaged plain areas of the city, which are generally less affluent than Port Hills areas, was identified as a risk factor in the second year post-disaster. Moreover, residents from less damaged plain areas of the city showed a decrease in the likelihood of receiving care or treatment for mood or anxiety symptoms compared to those from undamaged plain areas over time, which also contradicts a possible dose-response relationship. Finally, the effects of the social and physical environment, as well as community resilience on mood and anxiety symptom treatments among long-term stayers from Christchurch communities indicate an exacerbation of pre-existing mood and anxiety symptom treatment disparities in the city, whereas exposure to ‘felt’ earthquake intensities did not show a statistically significant effect. The findings of this thesis highlight the complex relationship between different levels of exposure to a severe natural disaster and adverse mental health outcomes in a severely affected region. It is one of the few studies that have access to area-wide health and impact information, are able to do a pre-disaster / post-disaster comparison and track their sample population to apply spatial and spatio-temporal analysis techniques for exposure assessment. Thus, this thesis enhances knowledge about the spatio-temporal distribution of adverse mental health outcomes in the context of a severe natural disaster and informs public health care planners, not only about high-risk groups, but also where and when to target health interventions. The results indicate that such programs should broadly target residents living in more affected areas as they are likely to face daily hardship by living in a disrupted environment and may have already been the most vulnerable ones before the disaster. Special attention should be focussed on women, elderly, children and people with pre-existing mental illnesses as they are most likely to receive care or treatment for stress-related mental health symptoms. Moreover, permanent relocatees from affected areas and temporarily relocatees shortly after the disaster may need special attention as they face additional stressors due to the relocation that may lead to the development of adverse mental health outcomes needing treatment.
This analysis employs both qualitative and quantitative approaches to identify how young adults in New Zealand aged 18-25 years old have engaged with All Right? campaign material. A survey targeting young adults returned 51 viable out of 117 responses due to participation prerequisites. From the survey, five participants elaborated on their thoughts in an in-depth interview voluntarily. Interviews were conducted with key personnel from All Right? to craft broader understanding of the initiative whilst enhancing knowledge of mental health frameworks and their application. Ciaran Fox, Lucy Daeth and Sara Epperson, who have been imperative to the success of the campaign, shared their working experience in the community and public health sector and how this intertwines to their current roles at All Right?. Discussions of key frameworks, community conversations, the development of communication strategies and how All Right? approached Canterbury publics in a post-earthquake setting provided insight to the importance of understanding community circumstance in initial crisis and the correlated secondary stressors.
Social and natural capital are fundamental to people’s wellbeing, often within the context of local community. Developing communities and linking people together provide benefits in terms of mental well-being, physical activity and other associated health outcomes. The research presented here was carried out in Christchurch - Ōtautahi, New Zealand, a city currently re-building, after a series of devastating earthquakes in 2010 and 2011. Poor mental health has been shown to be a significant post-earthquake problem, and social connection has been postulated as part of a solution. By curating a disparate set of community services, activities and facilities, organised into a Geographic Information Systems (GIS) database, we created i) an accessibility analysis of 11 health and well-being services, ii) a mobility scenario analysis focusing on 4 general well-being services and iii) a location-allocation model focusing on 3 primary health care and welfare location optimisation. Our results demonstrate that overall, the majority of neighbourhoods in Christchurch benefit from a high level of accessibility to almost all the services; but with an urban-rural gradient (the further away from the centre, the less services are available, as is expected). The noticeable exception to this trend, is that the more deprived eastern suburbs have poorer accessibility, suggesting social inequity in accessibility. The findings presented here show the potential of optimisation modelling and database curation for urban and community facility planning purposes.
Abstract. Natural (e.g., earthquake, flood, wildfires) and human-made (e.g., terrorism, civil strife) disasters are inevitable, can cause extensive disruption, and produce chronic and disabling psychological injuries leading to formal diagnoses (e.g., post-traumatic stress disorder [PTSD]). Following natural disasters of earthquake (Christchurch, Aotearoa/New Zealand, 2010–11) and flood (Calgary, Canada, 2013), controlled research showed statistically and clinically significant reductions in psychological distress for survivors who consumed minerals and vitamins (micronutrients) in the following months. Following a mass shooting in Christchurch (March 15, 2019), where a gunman entered mosques during Friday prayers and killed and injured many people, micronutrients were offered to survivors as a clinical service based on translational science principles and adapted to be culturally appropriate. In this first translational science study in the area of nutrition and disasters, clinical results were reported for 24 clients who completed the Impact of Event Scale – Revised (IES-R), the Depression Anxiety Stress Scales (DASS), and the Modified-Clinical Global Impression (M-CGI-I). The findings clearly replicated prior controlled research. The IES-R Cohen’s d ESs were 1.1 (earthquake), 1.2 (flood), and 1.13 (massacre). Effect sizes (ESs) for the DASS subscales were also consistently positive across all three events. The M-CGI-I identified 58% of the survivors as “responders” (i.e., self-reported as “much” to “very much” improved), in line with those reported in the earthquake (42%) and flood (57%) randomized controlled trials, and PTSD risk reduced from 75% to 17%. Given ease of use and large ESs, this evidence supports the routine use of micronutrients by disaster survivors as part of governmental response.
One of the great challenges facing human systems today is how to prepare for, manage, and adapt successfully to the profound and rapid changes wreaked by disasters. Wellington, New Zealand, is a capital city at significant risk of devastating earthquake and tsunami, potentially requiring mass evacuations with little or short notice. Subsequent hardship and suffering due to widespread property damage and infrastructure failure could cause large areas of the Wellington Region to become uninhabitable for weeks to months. Previous research has shown that positive health and well-being are associated with disaster-resilient outcomes. Preventing adverse outcomes before disaster strikes, through developing strengths-based skill sets in health-protective attitudes and behaviours, is increasingly advocated in disaster research, practise, and management. This study hypothesised that well-being constructs involving an affective heuristic play vital roles in pathways to resilience as proximal determinants of health-protective behaviours. Specifically, this study examined the importance of health-related quality of life and subjective well-being in motivating evacuation preparedness, measured in a community sample (n=695) drawn from the general adult population of Wellington’s isolated eastern suburbs. Using a quantitative epidemiological approach, the study measured the prevalence of key quality of life indicators (physical and mental health, emotional well-being or “Sense of Coherence”, spiritual well-being, social well-being, and life satisfaction) using validated psychometric scales; analysed the strengths of association between these indicators and the level of evacuation preparedness at categorical and continuous levels of measurement; and tested the predictive power of the model to explain the variance in evacuation preparedness activity. This is the first study known to examine multi-dimensional positive health and global well-being as resilient processes for engaging in evacuation preparedness behaviour. A cross-sectional study design and quantitative survey were used to collect self-report data on the study variables; a postal questionnaire was fielded between November 2008 and March 2009 to a sampling frame developed through multi-stage cluster randomisation. The survey response rate was 28.5%, yielding a margin of error of +/- 3.8% with 95% confidence and 80% statistical power to detect a true correlation coefficient of 0.11 or greater. In addition to the primary study variables, data were collected on demographic and ancillary variables relating to contextual factors in the physical environment (risk perception of physical and personal vulnerability to disaster) and the social environment (through the construct of self-determination), and other measures of disaster preparedness. These data are reserved for future analyses. Results of correlational and regression analyses for the primary study variables show that Wellingtonians are highly individualistic in how their well-being influences their preparedness, and a majority are taking inadequate action to build their resilience to future disaster from earthquake- or tsunami-triggered evacuation. At a population level, the conceptual multi-dimensional model of health-related quality of life and global well-being tested in this study shows a positive association with evacuation preparedness at statistically significant levels. However, it must be emphasised that the strength of this relationship is weak, accounting for only 5-7% of the variability in evacuation preparedness. No single dimension of health-related quality of life or well-being stands out as a strong predictor of preparedness. The strongest associations for preparedness are in a positive direction for spiritual well-being, emotional well-being, and life satisfaction; all involve a sense of existential meaningfulness. Spiritual well-being is the only quality of life variable making a statistically significant unique contribution to explaining the variance observed in the regression models. Physical health status is weakly associated with preparedness in a negative direction at a continuous level of measurement. No association was found at statistically significant levels for mental health status and social well-being. These findings indicate that engaging in evacuation preparedness is a very complex, holistic, yet individualised decision-making process, and likely involves highly subjective considerations for what is personally relevant. Gender is not a factor. Those 18-24 years of age are least likely to prepare and evacuation preparedness increases with age. Multidimensional health and global well-being are important constructs to consider in disaster resilience for both pre-event and post-event timeframes. This work indicates a need for promoting self-management of risk and building resilience by incorporating a sense of personal meaning and importance into preparedness actions, and for future research into further understanding preparedness motivations.
Abstract The original intention for the Partnership Community Worker (PCW) project in 2006 was for it to be an extension of the Pegasus Health General Practice and furthermore to be a bridge between the community and primary healthcare. It was believed that a close working relationship between the Practice Nurse and the PCW would help the target population of Māori, Pacifica and low income people to address and overcome their perceived barriers to healthcare which included: finance, transport, anxiety, cultural issues, communication, or lack of knowledge. Seven years later although the PCW project has been deemed a success in the Canterbury District Health Board annual reports (2013-14) and community and government agencies, including the Christchurch Resettlement Service (2012), many of the Pegasus Health General Practices have not utilised the project to its full extent, hence the need for this research. I was interested in finding out in the first instance if the model had changed and, if so why, and in the second instance if the promotional material currently distributed by Pegasus Health Primary Health Organisation reflected the daily practice of the PCW. A combination of methods were used including: surveys to the Pegasus Health General Practices, interviews with PCWs, interviews with managers of both the PCW host organisations and referring agencies to the PCW project. All the questions asked of all the participants in this research were focussed on their own perception of the role of the PCW. Results showed that the model has changed and although the publications were not reflecting the original intention of the project they did reflect the daily practice of the PCWs who are now struggling to meet much wider community expectations and needs. Key Results: Partnership Community Worker (PCW) interviews: Seventeen PCWs of the 19 employed were interviewed face to face. A number expressed interest in more culturally specific training and some are pursuing qualifications in social work; for many pay parity is an issue. In addition, many felt overwhelmed by the expectations around clients with mental health issues and housing issues now, post-earthquakes. Medical Practice surveys: Surveys were sent to eighty-two Pegasus Health medical practices and of these twenty five were completed. Results showed the full capacity of the PCW role was not clearly understood by all with many believing it was mostly a transport service. Those who did understand the full complexity of the role were very satisfied with the outcomes. PCW Host Community Manager Interviews: Of the ten out of twelve managers interviewed, some wished for more communication with Pegasus Health management because they felt aspects of both the PCW role and their own role as managers had become blurred over time. Referring organisations: Fifteen of the fifty referring community or government organisations participated. The overall satisfaction of the service was high and some acknowledged the continuing need for PCWs to be placed in communities where they were well known and trusted. Moreover results also showed that both the Canterbury earthquakes 2010-2011 and the amalgamation of Partnership Health PHO and Pegasus Health Charitable Limited in 2013 have contributed to the change of the model. Further future research may also be needed to examine the long term effects on the people of Canterbury involved in community work during the 2011-2014 years.
For the people of Christchurch and its wider environs of Canterbury in New Zealand, the 4th of September 2010 earthquake and the subsequent aftershocks were daunting. To then experience a more deadly earthquake five months later on the 22nd of February 2011 was, for the majority, overwhelming. A total of 185 people were killed and the earthquake and continuing aftershocks caused widespread damage to properties, especially in the central city and eastern suburbs. A growing body of literature consistently documents the negative impact of experiencing natural disasters on existing psychological disorders. As well, several studies have identified positive coping strategies which can be used in response to adversities, including reliance on spiritual and cultural beliefs as well as developing resilience and social support. The lifetime prevalence of severe mental health disorders such as posttraumatic stress disorder (PTSD) occurring as a result of experiencing natural disasters in the general population is low. However, members of refugee communities who were among those affected by these earthquakes, as well as having a past history of experiencing traumatic events, were likely to have an increased vulnerability. The current study was undertaken to investigate the relevance to Canterbury refugee communities of the recent Canterbury Earthquake Recovery Authority (CERA) draft recovery strategy for Christchurch post-earthquakes. This was accomplished by interviewing key informants who worked closely with refugee communities. These participants were drawn from different agencies in Christchurch including Refugee Resettlement Services, the Canterbury Refugee Council, CERA, and health promotion and primary healthcare organisations, in order to obtain the views of people who have comprehensive knowledge of refugee communities as well as expertise in local mainstream services. The findings from the semi-structured interviews were analysed using qualitative thematic analysis to identify common themes raised by the participants. The key informants described CERA’s draft recovery strategy as a significant document which highlighted the key aspects of recovery post disaster. Many key informants identified concerns regarding the practicality of the draft recovery strategy. For the refugee communities, some of those concerns included the short consultation period for the implementation phase of the draft recovery strategy, and issues surrounding communication and collaboration between refugee agencies involved in the recovery. This study draws attention to the importance of communication and collaboration during recovery, especially in the social reconstruction phase following a disaster, for all citizens but most especially for refugee communities.
There is a growing body of research into the effects of micronutrients on human mental health. There is evidence that multi-ingredient formulas are beneficial especially in relation to serious mental health disorders such as mood and anxiety disorders, attention-deficit hyperactivity disorder and obsessive-compulsive disorders. However there is almost no scientific research which looks at the effects of these formulas in an animal population. Therefore the aim of this study was to investigate the effects of a micronutrient formula, EMPowerplus, on anxiety behaviour in rats, and whether there is a relationship between dose and anxiolytic effect. In order to investigate this 40 male and 40 female rats received a diet consisting of either 0%, 1.25%, 2.5% or 5% EMP+ from when they were weaned (post natal day 30) until the end of testing 141 days later. Animals were tested in a Y maze, a light-dark emergence box and an open field at mid-adulthood (PND 136-138) and late adulthood (PND 186-188). Results found that animals receiving the 5% supplemented diet occupied the centre squares the most, occupied the corner squares the least and ambulated the most in the open field compared to the other experimental groups and control groups. No significant differences were found in the Y maze or Light-dark box. Animals were found to display more anxiety-like behaviour at time 2 than at time 1 regardless of receiving a supplemented diet or not. Overall a higher dose of EMP+ was associated with the greatest reduction in anxiety related behaviour. Due to the impact of the September 4th, 2010 Canterbury Earthquake caution should be taken when interpreting these results.
Over the last six years, Canterbury residents have lived through two major earthquakes and thousands of aftershocks, with such events negatively impacting psychological health. Research shows rates of post-traumatic stress symptoms in children have doubled post-quake, and a classroom containing children who are experiencing chronically high physiological arousal has been shown to be a stressful environment for teachers. Such stress therefore negatively impacts teachers’ ability to sleep well, meaning many Christchurch teachers may suffer from insomnia, a debilitating condition leading to psychological distress and often comorbid with other mental health conditions. The present research sought to investigate the use of a broadspectrum micronutrient formula called EMPowerplus (EMP+) for chronic insomnia in teachers. This study examined the effect of EMP+ over an 8-10 week period using a multiple-baseline design with placebo. Seventeen teachers were randomized to one of three baseline sequences where they completed a one week baseline period, before receiving five, nine, or 14 days, of placebo as well as 8-10 weeks of the micronutrient formula. After completion of the trial, a three-month follow up was conducted. All participants completed the trial, and results showed a statistically reliable and clinically significant decrease in insomnia severity (Cohen’s dav = - 1.37), on at least one or more aspects of the sleep diary, and on emotional exhaustion (Cohen’s dav = -1.08). EMP+ also statistically significantly reduced insomnia severity compared to placebo (Cohen’s dav = -0.66). Statistically significant reduction was not seen in stress, anxiety and depression scores as compared to placebo, and these levels were not generally clinically raised to begin with. Sixteen out of 17 participants were compliant, and side effects were generally mild and transitory. The current study provides evidence for the beneficial effect of micronutrient supplementation on chronic insomnia in Christchurch teachers working in a stressful environment. Future research incorporating measurement of nutritional intake and proinflammatory biomarkers, as well as conducting comparisons to other conventional treatments, is recommended.
This research attempts to understand how the Christchurch rebuild is promoting urban liveability in the Central City, focussing on the influence of communities and neighbourhoods in this area. To do this, gathering the perceptions of Christchurch residents through surveys, a focus group and semi-structured interviews was carried out to see what aspects they believe contribute to creating more liveable places. These methods revealed that there are pockets of neighbourhoods and communities in the inner-city, but no overall sense of community. Results from the semi-structured interviews reinforced this; the current buyers of inner-city property are in the financial position to be able to do this, and they seem to be purchasing in this area due to convenience and investment rather than to join the existing communities in the area. Analysing the survey responses from Central City residents revealed contrasting results. Those currently living in the area felt there is a sense of community in the inner-city, but these are found in pockets of neighbourhoods around the Central City rather than in the overall area. The focus group revealed that community is further prioritised later in life, and that many of the community groups in the inner-city predominantly consist of those who have lived there since before the Christchurch Earthquake Series. However, participants of all three methods believed that the Central City is slowly becoming a lively and vibrant place. To improve urban liveability in the inner-city, it seems that prioritisation of the needs of current inner-city residents is required. Improving these neighbourhoods, whether it be through the implementation of services or providing more communal spaces, is needed to create stronger communities. The feelings of place, connectedness, and belonging that arise from being part of a community or well-connected neighbourhood can improve mental health and wellbeing, ultimately enhancing the overall health of the population as well as the perceived urban liveability of the area.
From 2010, Canterbury, a province of Aotearoa New Zealand, experienced three major disaster events. This study considers the socio-ecological impacts on cross-sectoral suicide prevention agencies and their service users of the 2010 – 2016 Canterbury earthquake sequence, the 2019 Christchurch mosque attacks and the COVID-19 pandemic in Canterbury. This study found the prolonged stress caused by these events contributed to a rise in suicide risk factors including anxiety, fear, trauma, distress, alcohol misuse, relationship breakdown, childhood adversity, economic loss and deprivation. The prolonged negative comment by the media on wellbeing in Canterbury was also unhelpful and affected morale. The legacy of these impacts was a rise in referrals to mental health services that has not diminished. This adversity in the socio-ecological system also produced post-traumatic growth, allowing Cantabrians to acquire resilience and help-seeking abilities to support them psychologically through the COVID-19 pandemic. Supporting parental and teacher responses, intergenerational support and targeted public health campaigns, as well as Māori family-centred programmes, strengthened wellbeing. The rise in suicide risk led to the question of what services were required and being delivered in Canterbury and how to enable effective cross-sectoral suicide prevention in Canterbury, deemed essential in all international and national suicide prevention strategies. Components from both the World Health Organisation Suicide Prevention Framework (WHO, 2012; WHO 2021) and the Collective Impact model (Hanleybrown et al., 2012) were considered by participants. The effectiveness of dynamic leadership and the essential conditions of resourcing a supporting agency were found as were the importance of processes that supported equity, lived experience and the partnership of Māori and non-Māori stakeholders. Cross-sectoral suicide prevention was found to enhance the wellbeing of participants, hastening learning, supporting innovation and raising awareness across sectors which might lower stigma. Effective communication was essential in all areas of cross-sectoral suicide prevention and clear action plans enabled measurement of progress. Identified components were combined to create a Collective Impact Suicide Prevention framework that strengthens suicide prevention implementation and can be applied at a local, regional and national level. This study contributes to cross-sectoral suicide prevention planning by considering the socio- ecological, policy and practice mitigations required to lower suicide risk and to increase wellbeing and post-traumatic growth, post-disaster. This study also adds to the growing awareness of the contribution that social work can provide to suicide prevention and conceptualises an alternative governance framework and practice and policy suggestions to support effective cross-sectoral suicide prevention.
The question of whether forced relocation is beneficial or detrimental to the displaced households is a controversial and important policy question. After the 2011 earthquake in Christchurch, the government designated some of the worst affected areas as Residential Red Zones. Around 20,000 people were forced to move out of these Residential Red Zone areas, and were compensated for that. The objective of this paper is twofold. First, we aim to estimate the impact of relocation on the displaced households in terms of their income, employment, and their mental and physical health. Second, we evaluate whether the impact of relocation varies by the timing of to move, the destination (remaining within the Canterbury region or moving out of it) and demographic factors (gender, age, ethnicity). StatisticsNZ’s Integrated Data Infrastructure (IDI) from 2008 to 2017, which includes data on all households in Canterbury, and a difference-in-difference (DID) technique is used to answer these questions. We find that relocation has a negative impact on the income of the displaced household group. This adverse impact is more severe for later movers. Compared to the control group (that was not relocated), the income of relocated households was reduced by 3% for people who moved immediately after the earthquake in 2011, and 14% for people who moved much later in 2015.
Post-traumatic stress symptoms are a common reaction to experiencing a traumatic event such as a natural disaster. Young children may be at an increased risk for such mental health problems as these catastrophic events may coincide with developmentally sensitive periods of development. Treatments currently recommended for children with post-traumatic stress symptoms insufficiently acknowledge the role of neurobiological stress related systems responsible for these symptoms. As such, alternative approaches to the treatment of posttraumatic symptoms have been explored, with nature-based interventions offering a potential alternative based on two different theories that uphold the stress reducing benefits of natural environments. To date, there are a limited number of experimental studies that have explored the use of nature-based interventions with children, and no known research that has used a simulated nature experience with child participants. The purpose of this study was to investigate the effects of a simulated nature experience on the physiological and behavioural responses of children with post-traumatic stress symptoms that experienced the Christchurch earthquakes. A single-case research design with repeated measures of heart rate and teacherreported behaviour was gathered across a 20-day period. Heart rate data was collected before and after participants watched a 10-minute nature video, while data from a teacher rating scale provided information about the participants’ behaviours in the 30-minute period after they watched the nature video. Comparisons made to data collected during two different baseline phases indicated that the nature video intervention had no recognisable effects on the participants’ physiological and behavioural stress responses. Limitations to the current study are discussed as possible reasons for the incompatibility between the current study’s results and the findings from previous research. Suggestions are made for any future replications of the study.
Following a natural disaster, children are prone to various reactions and maladaptive responses as a result of exposure to a highly stressful and potentially traumatic event. Children’s responses can range from an acute stress response to post-traumatic-stress disorder or may fall somewhere in between. While responses to highly stressful events vary, a common finding is that children will develop sleep problems. This was found following the Christchurch September 2010 and February 2011 earthquakes. The purpose of this study was to investigate the context and phenomenology of the sleep problems of a small number of children experiencing these and the 2016 Kaikoura earthquakes, including possible mechanisms of effect. Participants were four families, including four mothers, one father and four children. The design of this study was unique. Interview data was subjected to a content analysis, extracted themes were organised according to an ecological-transactional framework and then the factors were subject to an analysis, based on the principles of clinical reasoning, in order to identify possible mechanisms of effect. Parents reported 16 different sleep problems across children, as well as other behaviours possibly indicative of post-traumatic stress response. In total, 34 themes and 26 interactions were extracted in relation to factors identified across participants about the children’s sleep and the families’ earthquake experiences. This demonstrated how complex it is to explore the development of sleep problems in the context of disaster. Key factors identified by parents that likely played a key role in the development and perpetuation of sleep problems included earthquake related anxiety, parental mental health and conflict, the child’s emotional and behavioural problems and other negative life events following the earthquakes. The clinical implications of the analysis included being aware that such families, may not have had access to specialized support around their children’s sleep. This was much needed due to the strain such problems place on the family, especially in a post-disaster community such as Christchurch.
