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Understanding the relationship between alcohol and suicide in New Zealand

Dr Rose Crossin

An Update from Dr Rose Crossin on her Research

The objective of my research was to quantify and characterise the relationship between alcohol and suicide in New Zealand. Two specific questions were addressed:

  • How prevalent is alcohol intoxication within suicide deaths in New Zealand and what are the characteristics of suicides involving alcohol?
  • Is there a causal link between alcohol misuse and suicidal ideation in a New Zealand birth cohort?

My rationale for this project was that despite a growing body of international evidence that alcohol plays a significant role in suicide, there is limited attention paid to alcohol harm reduction strategies as a means of suicide prevention. This represents a missed opportunity from a policy and health promotion perspective, whereby a significant modifiable risk factor for suicide is being overlooked.

By quantifying and characterising the relationship between alcohol and suicide in New Zealand, it was hoped that this project would provide targets for intervention, including alcohol policy, primary prevention, health promotion, and clinical intervention strategies.

The Whau Mental Health Research Foundation supported this research with a grant. This provided operational costs for the research and also enabled me to employ an Assistant Research Fellow to help with the research.

Whilst our findings for New Zealand were broadly consistent with the international literature, one of the important findings was that women in New Zealand had an equivalent risk of alcohol involving suicide, as males. This was in contrast to international studies, all of which had shown males to be at substantially higher risk.

The grant from the Foundation was integral to the success of this project and I would not have been able to conduct it without the funding.

The research findings have been really impactful, for policy makers, health advocates, and the wider public. When the studies were released they received significant media attention, which highlighted the importance of alcohol as a risk factor for suicide. The most recent draft of the National Suicide Prevention Action Plan cited this research, as part of the evidence based for change.

This project provides baseline knowledge for New Zealand about alcohol within the context of mental health and suicide, which can be built in into the future.

I felt very well supported by the Foundation and as a researcher, they were easy to work with, and had clear processes and goals.

Introducing Our New Hero Image by Illustrator Sara Moana

Whau Foundation

As part of our rebrand from Oakley to Whau Mental Health Research Foundation, we wanted to develop new hero imagery that not only reflected our mission, but also told the story of our origins and journey. We collaborated with talented artist and illustrator Sara Moana to create imagery that reflected our mission and journey. Sara’s personal experiences with mental health deeply influence her art, making this collaboration especially meaningful.

The final artwork beautifully captures the essence of our rebrand, symbolising both our transition and commitment to advancing mental health in Aotearoa. It highlights elements such as the Whau River (reflecting our origins), the Whau tree (a symbol of growth and shelter), and themes of community, generosity, and hope.

We asked Sara a few questions about her creative process and what this project meant to her:

Can you share the inspiration behind the image you created?

I was inspired to create an illustration that both resonates with Whau Foundation’s kaupapa and to also acknowledge the next chapter for the foundation.

How did the Foundation’s mission and values influence your artistic direction?

As I worked with the Foundation for this piece, it influenced the illustration by exploring their kaupapa towards mental health and their community. Their approach is to extend a helping hand to others, welcoming anyone who seeks support, and making it less intimidating to discuss mental health, which can often be a challenging topic. I found I resonate well with that kaupapa, so I enjoyed creating an illustration that links to making connections with others.

Were there any themes you wanted to highlight?

A theme that carries across the illustration is awareness, specifically for the viewer itself that will see the image when they visit the website. Creating a welcoming gesture for the viewer was a focus for the mahi.

What is your creative process?

When creating for projects like Whau Foundation, my process is seeing the mahi toi (artwork) as more of a collaboration. Working with Sophie (Head of Marketing and Fundraising), I gathered all of the elements that make Whau Foundation: reflecting on past, their goals today, and the future of the foundation inspired my process greatly.

How do you hope viewers will feel when they see this image?

Welcomed, and at peace.

What role do you think art plays in storytelling, especially in the context of mental health?

In my own art practice as an Illustrator, art is simply another way to communicate with the viewer. Another medium that can convey a message or a headspace. A message I wanted to convey with this particular illustration is to make your journey with mental health to be an encouraging experience, compared to the heaviness of taking about mental health.

What does this artwork mean to you personally?

I enjoyed the entire process of creating this mahi toi and creating an illustration that focuses on mental health while also having an uplifting perspective.

Tribute to Judge Phil Recordon

Kua hinga he totara i te wao nui a Tane – A totara has fallen in the forest of Tane

Phil Recordon

The Whau Mental Health Research Foundation would like to honour the legacy of Phil Recordon, who left an indelible mark on the Foundation and the community.

Phil Recordon served on the board of the Foundation from 2015 until his passing in 2024 and was a long-time supporter of mental health.

Phil practised as a lawyer in South Auckland for 30 years before being appointed to the District Court Bench in 2003. He was originally at the Waitakere District Court and then the Manukau District Court. Phil worked in a variety of areas of the law, particularly family law, disability law, criminal law and youth law. Phil’s passion for mental health advocacy was evident in his role as a District Inspector for Mental Health for 20 years. He also dedicated his time to various trusts focused on mental health and Maori health, leaving a lasting impact on the community he served. 

The Foundation is deeply grateful for Phil’s invaluable contributions and will remember him for his kindness, dedication and remarkable spirit.

Refugees as Survivors NZ (RASNZ) – COVID-19 Study

The Oakley Foundation Grant to Refugees as Survivors NZ (RASNZ) is a greatly appreciated contribution towards our research programme. The research project completed, informs our future service provision to ensure we are providing the best possible support for clients from refugee backgrounds during COVID 19.

Annette Mortensen

New Zealand research in the area of refugee mental health is limited. As a small specialist mental health NGO, we are very keen to contribute to the expansion of services for people from refugee and asylum seeker backgrounds and to increase an understanding of this population’s mental health and wellbeing needs.

During the COVID 19 lockdowns, RASNZ has had to switch from face to face therapeutic modalities to online tele-mental health services. This has provided an opportunity for us to learn more about reaching the communities we serve, and in particular our hard to reach clients, including solo mothers, older people, young people, and asylum seekers.

The funding has allowed us to research the challenges and benefits of working remotely with clients from former refugee and asylum seeker backgrounds. Most importantly, we have found that for many clients who have trouble accessing our service, online contact has been more convenient. We will continue to provide a remote service for our Auckland based clients and hope to expand our services to other parts of New Zealand where specialist mental health services for people from refugee backgrounds are not available.

The RASNZ COVID 19 response study summary and full reports can be found on the RASNZ website resource pages:

RASNZ COVID-19 Response study: Remote psychosocial service provision to former refugee and asylum seeker communities in Auckland during lockdown. (August, 2020). 

Summary report: https://rasnz.co.nz/resources/

RASNZ COVID-19 Response study: Remote psychosocial service provision to former refugee and asylum seeker communities in Auckland during lockdown. (August, 2020). Full report: https://rasnz.co.nz/wp-content/uploads/2020/08/RASNZ-COVID-19-Response-Study-2020.pdf

The reports are being disseminated to the following sectors:

  • RASNZ Board and funders: CMDHB and MoH
  • Available on the RASNZ website to stakeholder organisations, former refugee communities and sector contacts
  • RASNZ Clinical teams, Cross Cultural Facilitators, Youth Teams and Family Services
  • Refugee Resettlement Sector agencies including: Red Cross Refugee Services, Belong Aotearoa, Aotearoa Resettled Community Coalition (ARCC)
  • Immigration NZ Refugee Services Branch
  • The Mental Health sector including: the Mental Health Foundation, Te Pou o te Whakaaro Nui
  • DHB Refugee Service Providers
  • Asian, Migrant and Refugee research centres eg AUT Centre for Migrant and Refugee Research, University of Auckland, Centre for Asia Pacific Refugee Studies (CAPRS)
  • Ministry of Social Development- E Tu Whanau, Refugee and Migrant Services
  • Ministry of Education- Senior Advisors: Refugee and Migrant Support

We wish to sincerely thank you for the support you have given us which has enabled us to complete the study and to gain valuable insights into how best to respond during COVID-19 to the children, young people, parents and adults who use our services.

  • Annette Mortensen, Manager Research and Training, Refugees as Survivors NZ

Pharmacological Approaches to Methamphetamine Treatment

Funding for addiction-related research is hard to obtain. Bruce Russell is particularly grateful for the support Whau has given for his team for studies on pharmacological approaches to methamphetamine treatment. 

Bruce explained, “I think mental health – in particular addictions – tends to get overlooked in New Zealand unless it is something to do with smoking or alcohol. With methamphetamine addiction it is treated as a law and order problem rather than mental illness. 

“There are a lot of clinicians that view people with methamphetamine and alcohol in the same way. They think it is just a social problem. ‘Just harden up and stop taking the stuff’. It isn’t that easy because addiction does cause long term changes in the brain and those changes don’t go away. 

Funded by the Whau Mental Health Research Foundation, the research by Russell and his team at The University of Auckland’s School of Pharmacy, looked at whether methylphenidate could be used in replacement therapy for people with methamphetamine or P addiction, in a similar way to which methadone is used as a replacement for opiate addiction. 

“The Whau Foundation made a huge difference. Whau gave us nearly $20,000 and helped us recruit a research nurse for six to eight months. We completed the trial and got some useful results.” The study’s findings were published in Addiction in July 2013. 

Bruce says that there are currently no pharmaceutical treatments for addiction, which is a big problem in New Zealand. With Whau funding the research team was able to release statistical results demonstrating that methylphenidate showed potential as a methamphetamine substitute, although probably at higher doses than those used in the trial. 

“International researchers have since picked up on the research and have recently shown that methylphenidate is actually quite a useful substitute therapy in the way that methadone is for opiates. In terms of assisting with mental health, that is one very good example of trying to treat addictions when there are no currently available treatments.” 

Bruce is the recipient of another Whau Foundation grant for a related study looking at damage done to the brains of methamphetamine addicts, using magnetic residence imagining (MRI). 

The second study came about when his team recruited active methamphetamine users for the first study. When he performed MRI scans on their brains, he didn’t find the damage he was expecting and that other researchers said occurred. 

They realised that the main difference was that other research had been done with abstinent methamphetamine users, while theirs involved active users and they are currently working with the idea that some of the brain damage occurs post-withdrawal. 

“Most of the community support and treatment programmes involve sudden or rapid withdrawal. Usually you go to a centre for two or four weeks and you stay there and abstain. I think the rapid withdrawal might be causing some of the damage that other people are finding.” 

Whau Foundation funding is supporting a study with active users to test whether a treatment programme, rather than rapid withdrawal, may lessen some of the damage that occurs. 

Bruce appreciates the on-going support of the Whau Foundation, which helped establish his reputation as a researcher. 

“When I started work with the University of Auckland at the start of 2005 I had some research experience but most of my working life since finishing my PhD had been as a pharmacist in a completely different field overseas. I was an unknown quantity as far as the funding in New Zealand was concerned. The Whau Foundation kindly gave me that money, which helped raise my profile as a successful researcher, which is useful to other funders and the public in general.” 

Links

Investigating the microstructural and neurochemical environment within the basal ganglia of current methamphetamine abusers. Drug and Alcohol Dependence doi:10.1016/j.drugalcdep.2015.01.026 2015 

The effects of methylphenidate on cognitive control in active methamphetamine dependence using functional magnetic resonance imaging Frontiers in Psychiatry, Mar 6;5:20.
doi: 10.3389/fpsyt.2014.00020 2014 

Extended release methylphenidate for treatment of amphetamine/methamphetamine dependence: a randomised, double-blind, placebo controlled trial. Addiction; Jan 8. doi: 10.1111/add.12109. 2013 

Proteomics and Alzheimer’s Disease

‘The little snowball that rolled off the top of the mountain and kept on growing’ is how Garth Cooper describes his group’s research into links between Alzheimer’s Disease and protein levels in the brain. 

Funded by Whau Foundation, the research looked at the new methods of proteomics, which analyses the protein content of the brain, and compared results from those with Alzheimer’s disease, schizophrenia, and control subjects. 

Working with Richard Faull at the Brain Bank in Auckland, Garth and his team developed the methodologies for applying proteomic to both diseases. 

The research had a major international impact as the first significant application of proteomics to the origins of chronic mental disease in patients. 

Their work was taken up by the National Institutes of Health (The National Institute of Neurological Diseases and Stroke) – one of the world’s leading medical research facilities – in the United States. The study, which was published in 2001, was one of the pivotal studies used by the Institute as evidence to set up their global neuroproteomics platform. 

As part of this Garth was invited to go the NIH and gave a lecture on the approach, which is now being used all over the world. 

“The study also provided substantive evidence for understanding the pathological mechanism of Alzheimer’s disease. 

It has been cited more than 190 times and has had an important impact on the whole development of the literature in the field. It was really successful.” 

With further support from the Whau Foundation, Garth and his team are again working with Richard Faull looking at the blood vessels in the brain and links between Type 2 Diabetes and Alzheimer’s disease. 

“We are starting to follow up now on strong potential links to the mechanisms of Alzheimer disease and Type Two Diabetes.” 

“It is now increasingly recognised that the two diseases have a lot in common. The work is leading to conclusions that I believe will probably drive clinical interventions quite soon.” 

Garth says the major international impacts can be traced back to the initial funding support from the Whau Foundation. 

“We wouldn’t have been able to do the work without them – it was completely enabling. The Whau Foundation has funded important studies that would not otherwise get done and it does that by focussing on its areas of interest. These are very important areas that would otherwise be neglected. If the Whau Foundation wasn’t there this research wouldn’t have happened.”