For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews
Urgent reform needed to address mental health crisis in NZ construction - expert
Urgent reform needed to address mental health crisis in NZ construction - expert

More needs to be done to address the high rates of suicide in the construction industry, according to the head of one of the world’s largest mentoring services for the sector.
Recent research shows New Zealand's construction sector is facing a mental health crisis, with suicide rates 25% higher than other sectors and Maori, Pasifika, female, migrant workers, apprentices and labourers among those at higher risk. This is due to a number of factors including financial instability, low pay and lack of mental health support.1
Marti Amos (Ngapuhi), a former marketing lecturer at Otago University and the New Zealand-based head of The Professional Builder, says these issues are amplified by the industry's boom-and-bust cycle, cost-of-living crisis and a training model that prioritises trade skills over business acumen.2
“Kiwi tradespeople are trained to excel on-site, they are underprepared to manage the multimillion-dollar business aspects of their work, with dire consequences for their mental wellbeing.
“Our construction workers account for about 7% of working-age male suicides - with nearly one worker losing his life to suicide each week and the avoidable burden and impact of suicide in the NZ construction industry has been estimated at $1.1 billion per annum,” he says.
Amos, whose coaching service has supported over 2,500 building companies worldwide over the past 21 years, says the growing mental health crisis among Kiwi builders requires a radical overhaul of the country’s traditional construction model - with greater emphasis on financial literacy a priority.
“The New Zealand building industry is seeing its lowest levels of annual growth over a decade with a rate of just 0.6% in the second quarter of 2024 - a factor that is likely to exacerbate mental health concerns for many in the trade.
“Kiwi builders have been taught how to create outstanding projects, they’re brilliant with the tools – but no one has taught them how to build a great business.
“In New Zealand and Australia, builders often employ their own teams and handle every aspect of a project themselves. This contrasts sharply with the U.S. model, where general contractors delegate tasks - reducing the burden on the individual,” he says.
Amos says his concerns extend beyond the daily operational stresses that plague many builders.
He says that without a proper understanding of financial management, many are left grappling with severe cashflow challenges, working long hours and sacrificing their personal lives - a situation that has, in many cases, led to overwhelming stress and deteriorating mental health.
“When you’re constantly worrying about how to pay your subcontractors or secure payroll for the next week, it isn’t just your business that suffers - it’s your whole life,” he says.
Amos says demand for targeted support from builders around the world is growing rapidly and his service, The Professional Builder (TPB), which started with a team of three people in 2004, has expanded to 56 and is projected to reach 100 employees within the next 18 months. Company revenue is also projected to double to $30 million within the same timeframe.
He says TPB operates in five main countries: the US, Canada, the UK, New Zealand and their fastest growing market - Australia.
The company has launched an expansion programme to grow the US market, with plans to increase their physical presence there and establish partnerships with hardware wholesalers, similar to their relationships with Carters, ITM and Mitre 10 in New Zealand.
Amos says as part of a move to improve financial management in the sector he has now authored a book, The Profitable Builders Playbook, which is aimed at equipping builders with the business acumen needed to navigate these challenges.
“At the moment they’re stuck on the builder’s ‘hamster wheel’, caught in the weeds of daily operations without the skills to manage the large sums of money and complex challenges that come with running a construction company.
“What we need is to implement business training into apprenticeship programmes to ensure that our future generations of builders are as adept at managing large-scale financial responsibilities as they are at delivering quality craftsmanship.
“With a vital sector at risk and the mental health of thousands hanging in the balance, my message is clear: reform is essential.
“As New Zealand’s construction industry stands at a crossroads, stakeholders must adopt a more balanced training model - one that nurtures not only technical excellence but also financial literacy and sustainable business practices.
“This call for change is more than an economic imperative; it is a matter of safeguarding the well-being of those who build our nation,” he says.