Objectives: To determine the independent associations of labour force status and socioeconomic position with death by suicide. Design: Cohort study assembled by anonymous and probabilistic record linkage of census and mortality records. Participants: 2.04 million respondents to the New Zealand 1991 census aged 18-64 years. Main outcome measure: Suicide in the three years after census night. Results: The age adjusted odds ratios (95% confidence intervals) of death by suicide among 25 to 64 year olds who were unemployed compared with employed were 2.46 (1.10 to 5.49) for women and 2.63 (1.87 to 3.70) for men. Similarly increased odds ratios were observed for the non-active labour force compared with the employed. Strong age only adjusted associations of suicide death with the socioeconomic factors of education (men only), car access, and household income were observed. Compared with those who were married on census night, the non-married had odds ratios of suicide of 1.81 (1.22 to 2.69) for women and 2.08 (1.66 to 2.61) for men. In a multivariable model the association of socioeconomic factors with suicide reduced to the null. However, marital status and labour force status remained strong predictors of suicide death. Unemployment was also strongly associated with suicide death among 18-24 year old men. Sensitivity analyses suggested that confounding by mental illness might explain about half, but not all, of the association between unemployment and suicide. Conclusions: Being unemployed was associated with a twofold to threefold increased relative risk of death by suicide, compared with being employed. About half of this association might be attributable to confounding by mental illness. : unemployment may confer vulnerability by increasing the impact of stressful life events; it may indirectly cause suicide by increasing the risk of factors that precipitate suicide (for example, mental illness, financial difficulties); or it may be a non-causal association because of confounding or selection by factors that predict both unemployment status and suicide risk.Studies controlling for confounding by social factors find an approximately twofold excess suicide risk among the unemployed, 4 5 but the possibility remains of health selection or residual confounding. Health selection is where poor health precedes and predicts both unemployment and death causing a spurious association of unemployment with suicide. Data from the British general household survey on the prevalence of limiting longstanding illness by labour force status were consistent with health selection into the non-active labour force (that is, excluding both the employed and unemployed), but not into the unemployed category (that is, actively seeking and available for work). 6 Another test of health selection is that a weaker association of unemployment with poor health would be expected in times of high background unemployment rates, as a greater proportion of "ordinary" people (that is, not just people with poor health or other characteristics conferring...

Men’s mental health has remained undertheorized, particularly in terms of the gendered nature of men’s social relations. While the importance of social connections and strong supportive networks for improving mental health and well-being is well documented, we know little about men’s social support networks or how men go about seeking or mobilizing social support. An in-depth understanding of the gendered nature of men’s social connections and the ways in which the interplay between masculinity and men’s social connections can impact men’s mental health is needed. Fifteen life history interviews were undertaken with men in the community. A theoretical framework of gender relations was used to analyze the men’s interviews. The findings provide rich insights into men’s diverse patterns of practice in regards to seeking or mobilizing social support. While some men differentiated between their social connections with men and women, others experienced difficulties in mobilizing support from existing connections. Some men maintained a desire to be independent, rejecting the need for social support, whereas others established support networks from which they could actively seek support. Overall, the findings suggest that patterns of social connectedness among men are diverse, challenging the social science literature that frames all men’s social relationships as being largely instrumental, and men as less able and less interested than women in building emotional and supportive relationships with others. The implications of these findings for promoting men’s social connectedness and mental health are discussed.

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Long-term outcome studies for people suffering from bulimia nervosa are few. Ten years after presentation, we followed up 50 patients (49 women, 1 man) who were originally involved in a double-blind, controlled trial of the antidepressant mianserin. Standardised interviews and questionnaires were used to assess eating attitudes and behaviour, psychiatric status and social functioning. A DSM-III-R diagnosis was given where appropriate. Sufficient information to make a diagnosis was obtained for 44 subjects (88%). Of patients traced, 52% had recovered fully and only 9% continued to suffer the full syndrome; 39% continued to experience some symptoms. Significant predictors of favourable outcome were younger age at onset, higher social class and a family history of alcohol abuse. Outcome for bulimia nervosa continues to improve over ten years with the majority of patients eventually making a full recovery or suffering only moderate abnormalities in eating attitudes. Although predictors of recovery were few, it would appear that intervention has a significant impact on ultimate outcome.

This article examines 110 reported incidents from an online survey of 26 women from each of the eight universities in New Zealand. They responded to questions asking them to describe times when work and non-work situations have helped or hindered their advancement in university leadership roles. Five key themes, incorporating a range of factors, emerged as making a difference to advancement as leaders. These themes are: work relationships; university environment; invisible rules; proactivity; and personal circumstances. This research is part of the L-SHIP (LeadershipSupporting Higher Intent & Practice) project and has two main aims. First, to identify factors in universities that help and hinder women's advancement as leaders, as reported by women; second, to provide useful evidence to underpin the development of programmes supporting women's advancement in university leadership roles. This research is a first step in the development of the L-SHIP Toolkit for good practice in leadership development in higher education.