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In this paper we reflect on discussions with people of advanced age in Āotearoa New Zealand, and draw on theoretical frameworks of resilience and place in old age, to explore insights about the ways older people maintain quality of life and health. Twenty community-dwelling people of advanced age (85+) were recruited in 2015–16 from a large multidisciplinary longitudinal study of advanced age. These twenty participated in interviews about health in advanced age, impact of illnesses, interactions with clinicians, access to information, support for managing health, and perceptions of primary care, medications, and other forms of assistance. We use a positioning theory framework drawing on thematic and narrative analysis to understand the dynamic ways people in advanced age position themselves and the ways they age well through speech acts and storylines. People in advanced age saw themselves as challenged, rather than threatened, by adversities, and positioned themselves as able to draw on a lifetime of experience and resourcefulness and collaborations with supporters to deal with challenges. Key strategies include downplaying illness and resisting biomedical discourses of complexity, positioning embodied selves as having agency, and creative adaptation in the face of loss. People in advanced age exhibit resilience, maintaining wellbeing, autonomy and good physical and mental quality of life even while living with challenges such as functional decline and multi-morbidities. These findings have significance for supporters of older people, emphasising the need to move away from a narrow focus on problems to working together WITH people in advanced age to offer a more holistic approach that encourages and enhances adaptation and flexibility, rather than rigid and counterproductive coping patterns. • Older people position themselves as active co-managers in their support arrangements. • Framing problems as challenges not threats facilitates older people's resourcefulness. • People in old age adapt resiliently to health conditions as part of living and ageing. [ABSTRACT FROM AUTHOR]

Abstract: This paper uses Arlie concept of emotion management and “surface” and “deep acting” to explore how sex workers separate and distance themselves from their public role. Experiences of stigmatisation prevail among sex workers and how stigma is resisted or managed has an impact on their health. In-depth interviews were carried out between August 2006 and April 2007 with 58 sex workers in five cities in New Zealand following decriminalisation of the sex industry. Most participants drew on ideas of professionalism in sustaining a psychological distance between their private and public lives. They utilised “deep acting”, transmuting private experiences for use in the work environment, to accredit themselves as professional in their business practices. They also constructed different meanings for sex between public and private relationships with the condom providing an important symbol in separating the two. A few (mostly female street-based) participants were less adept at “deep acting” and relied on drugs to maintain a separation of roles. This paper argues that in an occupation which is highly stigmatised and in which depersonalisation as an aspect of burn-out has been reported as a common occurrence, the ability to draw on strategies which require “deep acting” provides a healthy estrangement between self and role and can be seen as protective. The separation of self from work identity is not damaging as many radical feminists would claim, but an effective strategy to manage emotions. Hochschild, A. (1983). The managed heart: Commercialization of human feeling. Berkeley: University of California Press. [Copyright &y& Elsevier]

General practitioners provide treatment for the majority of people diagnosed as having a mental disorder in New Zealand, but much research suggests that they fail to diagnose many common mental disorders. This paper explores the issue of GP recognition of mental health problems through four discussion groups with GPs from the lower half of the North Island of New Zealand. GPs were asked to consider what they thought their role was in relation to mental health, what facilitated discussion of mental health issues in consultations and what could influence patients to disclose mental health problems. The analysis of the data collected drew on thematic and discourse analysis. Four key domains that had an impact on the consultation were identified, which were categorised as practice pressures, socio-cultural factors, the medico-legal framework and the consultation process. GPs employ a number of strategies to respond to the systemic and social issues influencing the consultation. This research suggests that GPs do recognise mental health problems in patients, but that a number of important factors result in the consultations not being labeled as mental health ones. The paper concludes by offering a framework for the mental health consultation that illustrates the systemic issues that GPs consider when making decisions about mental health consultations. [ABSTRACT FROM AUTHOR]

This paper draws together work on therapeutic assemblages, geographic assemblages, and therapeutic landscapes to develop the concept of "multi-sited therapeutic assemblages." Assemblage theory has been productively used in health research since it achieved prominence in the social sciences two decades ago. One facet that, however, remains as yet under-developed in the literature on "therapeutic assemblages" (as well as their close kin, "health assemblages," "ill-health assemblages," "care assemblages," etc.) is that of the multi-sited therapeutic assemblage. This paper demonstrates the significance of the multi-locality of therapeutic assemblages by mapping the mental health support activities of young New Zealanders. Grounded theory analysis of interviews with 150 New Zealand youth (which took place from 2015 to 2020) about their online and offline engagements in mental health support highlights the importance of the emplacement of therapeutic practices whilst also foregrounding their multi-sitedness. It enables opportunities to examine how therapeutically-meaningful places can be constituted both as independent sites and simultaneously re-made through their fluid, dynamic and temporal relations with one another. Through this analytic perspective, care and other elements of the therapeutic come to be understood as neither anchored to a single site nor constituted through the inter-relation of home and clinic, but defined via a shifting, dynamic, and multi-directional assemblage of multiple places, people, and resources. This has noteworthy implications for how we envisage relationships between a wide variety of therapeutic digital and real-life sites, as well as for examining scholarly and practical understandings of the emplacement of care. • Develops the conceptual framework of multi-sited therapeutic assemblages. • Highlights the multi-spatial dimension of online/offline therapeutic activity. • Expands scholarly approaches to therapeutic landscapes beyond singular sites. • Examines youths' multi-sited, multi-directional engagement in mental health support. • Finds multi-directional support can coincide with de-centring of professional care. [ABSTRACT FROM AUTHOR]

The mental health consumer movement initiated the development of the recovery approach, in which self-determination, human rights and the living of a hopeful life superseded merely symptom management for people living with mental illnesses and addictions. To what degree has this reimagined path to recovery shaped social work practice? In this paper we analyse the perspectives of eleven social workers doing child protection work in Aotearoa New Zealand. We examine also the accounts of thirteen parents living with mental illness or addiction who have been involved in child custody investigations in Aotearoa New Zealand. We ask whether the social workers understand recovery as possible for such parents, and if so, how they see it occurring. We found that there is a substantial difference between the way the social workers and the parents conceived of such ‘recovery’. While parents' descriptions of recovery reflected those of the mental health consumer movement, social workers tended to operate with a focus on clinical intervention, symptom and risk management. [ABSTRACT FROM AUTHOR]

Summary Background This paper identifies positive aspects of nurse experiences during the Canterbury 2010–2011 earthquake sequence and subsequent recovery process. Methods Qualitative semi-structured interviews were undertaken with 11 nurses from the Christchurch area to explore the challenges faced by the nurses during and following the earthquakes. The interviews took place three years after the start of the earthquake experience to enable exploration of the longer term recovery process. The interview transcripts were analysed and coded using a grounded theory approach. Results The data analysis identified that despite the many challenges faced by the nurses during and following the earthquakes they were able to identify positives from their experience. A number of themes were identified that are related to posttraumatic growth, including; improvement in relationships with others, change in perspective/values, changed views of self and acknowledgement of the value of the experience. Conclusions The research indicates that nurses were able to identify positive aspects of their experiences of the earthquakes and recovery process, suggesting that both positive and negative impacts on wellbeing can co-exist. These insights have value for employers designing support processes following disasters as focusing on positive elements could enhance nurse wellbeing during stressful times. [ABSTRACT FROM AUTHOR]

This paper examines how bluespaces inform experiences of place, being aged, and wellbeing among seniors on Waiheke, an island within the greater Auckland area in northern New Zealand. We draw on photo-elicitation interviews with seniors aged 65-94 to argue that bluespaces shape metaphors of 'islandness' that, in turn, help maintain wellbeing. We conclude that, although island settings pose unique challenges for seniors, (e.g. potential isolation, and a lack of advanced care), drawing on the qualities of bluespaces helps maintain a secure sense of self anchored in strong affective ties to place. [ABSTRACT FROM AUTHOR]

Introduction: In 1992, New Zealand's mental health legislation created the distinct concept of a 'restricted patient' - effectively creating a pathway into forensic patient status, but via the civil committal process, without the patient passing through the criminal justice system en route. This regime was aimed at civilly committed patients who present "special difficulties" because of the danger they pose to others. It remains in force but has attracted little scrutiny.Objective: This paper traverses the background to restricted patient status, and the legal regime, before describing and analysing, in anonymous form, the circumstances of all those declared to be restricted patients, and their outcomes, since the regime began. It then considers the continuing appropriateness of this legal regime in light of contemporary human rights principles.Methods: We reviewed the records of every person placed under restricted patient status since the legislation came into force over a nearly 30-year-period.Results: New Zealand's restricted patient status is rarely used. Only eight people have been subject to such orders (seven male, median age 45 years at the making of the order). All had a history of violent offending and had previously been forensic patients. None re-offended after becoming a restricted patient, but they spent longer as compulsory inpatients than patients unfit to stand trial or not guilty by reason of insanity. There is no evidence they were uniquely dangerous. The legal criteria, namely, that the person presented with "special difficulties", are unclear and have been interpreted differently by the judiciary. They have sometimes included the risk of inadequate care being provided by mental health services.Conclusion: Given the rarity with which restricted patient status has been used in New Zealand, the subsequent evolution and development of forensic services providing alternative pathways through care, and its problematic human rights aspects, we would not recommend equivalent restricted patient provisions to other countries. We suggest this hybrid form of civil/forensic compulsory mental health treatment is a form of arbitrary detention and incompatible with human rights norms. It should be omitted from New Zealand's next Mental Health Act. [ABSTRACT FROM AUTHOR]

Abstract: In this paper we consider the potential of autobiographical narratives for accessing ‘storied knowledge’ in research around geographies of health voluntarism. We firstly consider what is meant by elicited autobiography and how the narrative approach has been used in research more broadly. Drawing on fieldwork undertaken in Manchester, UK and Auckland, New Zealand we then demonstrate how this approach has helped us to map out and unpack the career journeys of mental health activists working within and across the voluntary and statutory sectors. Through our autobiographical narratives we illustrate how this approach has enabled us to elicit important insights into the triggers and trajectories underpinning mental health activism and how events and moments in time have provided critical junctures in these trajectories. We consider places as sites of significance in activist career paths; and as central to the researcher-participant gestalt within which the autobiography is elicited and recounted. The autobiographical process, we suggest, offers reflective insights into mental health activism that might not otherwise be gained using more conventional methodologies. [Copyright &y& Elsevier]

Abstract: This paper addresses a gap in the understanding of the geography of deinstitutionalisation: the fate of closed asylums. We contend that the closure process was an exercise in both deinstitutionalisation and welfare state restructuring, and examine discourses surrounding the re-use of two former psychiatric hospitals in New Zealand—Seaview in Hokitika and Kingseat near Auckland. Drawing on an analysis of media coverage and field observation, we consider former asylums as sites of celebrity. We find the shadow of stigma to be prominent, manifested directly in suggestions that the former hospitals be used as prisons and in the partial redevelopment of one as a ‘horror theme park’. Indirectly, we see stigma reflected in the physical deterioration of the asylums prior to closure. While this stigmatising is attributable in the first instance to deinstitutionalisation, the evidence suggests strongly that it was co-opted and exploited by the forces of restructuring. [Copyright &y& Elsevier]

Disasters result in a range of impacts that significantly disrupt the health and wellbeing of those affected. After disasters, a hierarchy of affectedness may be explicitly or implicitly developed, where those affected are compared to each other, and to people affected by disasters in other locations. When an individual's sense of place is so significantly disrupted, these hierarchies are critical to improving the understanding of recovery trajectories, including mental health and well-being outcomes. These hierarchies have practical implications that influence the health outcomes of those affected, including eligibility for disaster aid, support services, and the way that people affected by disasters relate to others in their community. This paper expands the 'hierarchy of affectedness' concept coined by Andersen (2013) using findings from a qualitative study in Australia and New Zealand. Using a letter writing research method, twenty people who had been impacted by a range of disasters in different locations described what they considered helpful and unhelpful in the recovery. One emergent finding in this study was that hierarchies of affectedness are negotiated between impacted individuals, others affected in the same community, and outsiders. These hierarchies served as a helpful sense-making tool for some people impacted by disasters, while causing considerable secondary stress for others. Based on these findings, we offer an expansion to Andersen's existing model of hierarchies of affectedness in post-disaster settings. [ABSTRACT FROM AUTHOR]

This paper provides new evidence on the link between primary and secondary teacher workload and wellbeing for five predominately English-speaking education systems (England, Australia, Alberta-Canada, New Zealand, United States). It illustrates how, by ignoring potential non-linearities and measurement error, previous research may have missed key aspects of the workload-wellbeing relationship. We also demonstrate how the time that teachers spend marking is the key driver of workload stress and poor levels of workplace wellbeing across English-speaking countries. • Longer working hours are associated with higher levels of workload stress. • Much of the previous literature on this issue may have underestimated the strength of this relationship due to measurement error. • The link between working hours and workload stress may be non-linear, with teachers' quality of life declining once they work more than 55 h per week. • The time that teachers spend upon marking is found to be particularly detrimental to their wellbeing. [ABSTRACT FROM AUTHOR]