Barriers and drivers for suicide during coronavirus disease 2019 in New Zealand: a narrative review

Introduction

The psychological repercussions of the coronavirus disease 2019 (COVID-19) pandemic pertaining to the complex mix of infection dread and the social and economic effects of public health limitations are becoming more widely recognized (1). Despite the declaration of the pandemic, the timing of public health and control efforts differs for each country. Preventive and control measures taken include blocking international borders, domestic travel restrictions, imposing strict self-isolation for individuals with symptoms and at risk, social distancing, and wearing face masks in public. New Zealand’s “bubble” system, which involves limited interaction within households, was also implemented (2). These control measures caused severe mental health impacts on New Zealanders, putting them at risk for suicide and suicidal behaviours.

The well-being and psychological state during the pandemic

The COVID-19 pandemic, with its emerging limitations and stay-at-home lockdown policies, has a variety of societal consequences. Depression, anxiety, and the fear of contagion caused by the pandemic can both have a direct impact on a person’s mental state and well-being (3). The disruption of daily activities without the certainty of how long posed a grave threat to the public’s mental health. According to a study by Sher [2020], vulnerable populations such as those with pre-existing psychiatric disorders, those who live in high COVID-19 prevalence areas, those with strict lockdown measures, and those who experience financial difficulties trigger the development of depressive thoughts, substance use, and other psychiatric disorders that may lead to suicide (4). Moreover, the likelihood of suicide attempts and suicide death rates remains high due to these changes in daily routine and stressors caused by the pandemic (5).

On the other hand, a study by Yang et al. [2024] that was conducted in China states that despite the fact that stress due to the pandemic is closely associated with high levels of anxiety and depression, the lockdown is linked to improved well-being. These contradict worries expressed at the beginning of the pandemic, where it was found that lockdown had little to no effect on mental health compared to pre-pandemic levels, even an improvement in their well-being (6). Another study by Every-Palmer et al. [2020] discovered that most of the residents in New Zealand valued having extra time to spend with their families during the pandemic (7).

Pandemic-related stressors that triggered suicidal thoughts

People worldwide have experienced major disruptions to their daily lives because of the global adoption of containment measures brought upon by the COVID-19 pandemic. There are many reasons that can justify the pandemic as a major threat to mental health and well-being. For instance, isolation can worsen pre-existing anxiety and trigger depressive thoughts, which have harmful implications for people who have already experienced mental discomfort. It has been previously discovered that suicidal behaviour has been closely linked to decreased social interaction. According to a study by Schluter et al. [2022], during the COVID-19 era, suicide ideation is common and has been on the rise over time and it varies greatly between nations (7,8). Many studies have looked into the broad impacts of COVID-19 on the mental health of people’s lives. Many factors contribute to suicide including biological, psychological, and societal aspects. The abrupt lifestyle changes and pressures brought upon by the pandemic raised the possibility of an increase in suicide attempts and suicide deaths (5). The public health protocols and safety measures during the pandemic including social isolation, lockdowns, and travel restrictions endanger mental health and exacerbate risk factors for suicide (4). An identified stressor that caused almost all of the cases of attempted suicide and suicide deaths discovered during the COVID-19 lockdown in the Kingdom of Saudi Arabia was psychological distress, interpersonal issues, domestic violence, job loss, financial struggles, and the fear of contracting an infection. Furthermore, depression and financial issues were identified as the primary sources of mental stress in their study (5).

Future support and coping mechanisms

Coping mechanisms or strategies are acts that encourage efficient approaches to address certain issues that people use during difficult situations, such as the COVID-19 pandemic. The term “coping” describes a range of responses people employ when faced with a difficult situation (9). The U.S. has seen an increase in suicide rates, especially when the pandemic struck (10). For this matter, preventive measures must be implemented at a universal and selective level. Regardless of an individual’s risk of suicide, universal suicide prevention strategies are necessary for the population as a whole. Recommended preventive measures relate to individuals who are at high risk of committing suicide (10). A study by Joseph [2022] said that the World Psychiatric Association (WPA) offered evidence-based suicide prevention strategies that focus mainly on the COVID-19 pandemic (11). In addition, limiting access to weapons, insecticides, and prescription drugs are among the preventive measures implemented during the pandemic that are all deadly means of suicide. The World Health Organisation (WHO) suggested four key interventions in relation to suicide: limiting access to means, collaborating with the media to ensure responsible reporting of suicide, providing assistance to young people in learning the coping mechanisms, early detection, and management of individuals who attempted suicide, and maintaining both long- and short-term follow-up (10). Targeting socioeconomically challenged individuals who are known to be vulnerable, such as the front liners, as well as those greatly affected by COVID-19 who have been deprived of funerals and last-minute contact with loved ones, should all be included in selective interventions (12). In another study by Wasserman et al. [2020], chain of care and follow-up are also important to reduce the future risk of suicide and suicidal behaviours (13). The chain of care is an integrated paradigm in which there is overall coordination between various services and activities to ensure the effectiveness of care given. Moreover, continuous and functioning care with sufficient patient follow-up can effectively lower the risk of suicide in people who are at risk (14). Strengthened and enhanced execution of prevention measures both during and after the COVID-19 pandemic is important and suicide preventive measures should be a priority for policymakers.

Purpose and significance of this study

This literature review aims to determine how the COVID-19 pandemic control measures affected the mental health state and well-being of New Zealanders. This research also investigates the factors that increase the likelihood of committing suicide during the pandemic. The findings of this research have significant implications for society and suicide programmes, as it will offer recommendations on how to manage depressive and anxiety symptoms for suicide management and prevention. Additionally, it can also aid in the discovery of new approaches to reducing the risk of suicide attempts and suicide deaths. Additionally, other researchers can get a better grasp on the impacts of a pandemic such as COVID-19, on the general population of New Zealand. Medical professionals such as psychiatrists and psychologists can also use the findings from this research to better comprehend, recognize, and respond to the warning symptoms of depression and anxiety in patients in order to take accurate clinical impressions and preventive actions.

To provide a robust theoretical foundation for our analysis, this review is framed within the integrated motivational-volitional (IMV) model of suicidal behaviour (15). The IMV model is a contemporary, tripartite framework that delineates the factors leading to suicide ideation and behaviour into three phases: first, the pre-motivational phase, involving background factors and triggering events; second, the motivational phase, where suicide ideation develops based on feelings of entrapment and threat to self-moderated by thwarted belongingness and perceived burdensomeness; and third, the volitional phase, where ideation is translated into behaviour, facilitated by access to means, impulsivity, and exposure to suicidal behaviour. This model provides an ideal structure to categorize and understand the complex interplay of the drivers (motivational phase facilitators), protective factors (motivational phase buffers), and coping strategies (volitional phase moderators) identified in our thematic analysis. We present this article in accordance with the Narrative Review reporting checklist (available at https://jphe.amegroups.com/article/view/10.21037/jphe-25-27/rc).

Methods

Since the pandemic, pandemic-related stressors such as financial hardship, social isolation, and limited access to healthcare services may promote suicidal behaviours. However, there was not much evidence demonstrating the pandemic’s impact on suicide rates in New Zealand. In this regard, further information on the effects of COVID-19 on the mental health state and well-being of New Zealanders is crucial to suggest potential approaches to reduce suicide risks in the future. This research review provides findings from previous studies that were conducted with the motive to answer the question, “what impact does COVID-19 have on the mental health state of New Zealanders that increased risk for suicide and suicide attempts?”. A literature search was carried out using widely known electronic databases to search for pertinent publications such as PubMed, ProQuest Central, ScienceDirect, Sage Journals, and Embase. Key terms were established to find relevant articles. Table 1 outlines the search strategy developed.

After limiting the search tool to only include suicide and suicide ideation during the pandemic in New Zealand, 7,134 results from ProQuest Central, 282 from Sage Journals, 128 from PubMed, 108 from ScienceDirect, and 2 from Embase were obtained from the first search of electronic databases, which produced 7,654 results in total. Twelve most pertinent articles were evaluated and reviewed in this research; these include six cross-sectional studies, two cohort studies, one commentary study, and three mixed-method approach studies, which can be seen in Figure 1.

Figure 1 Flowchart of the literature search and selection process.

A systematic search strategy was developed, and the reporting of the search and selection process was guided by elements of the PRISMA framework to ensure transparency. The search strategy utilised a core set of concepts: suicide, COVID-19, and New Zealand. To ensure comprehensiveness and cultural relevance, an expanded list of keywords and subject headings was used for each concept, including: (“suicide” OR “suicidal ideation” OR “self-harm” OR “self-injurious behaviour” [MeSH]) AND (“COVID-19” OR “SARS-CoV-2” OR “pandemic” OR “lockdown” OR “restrictions”) AND (“New Zealand” OR “Aotearoa” OR “Māori” OR “Pasifika” OR “whānau”). The search was conducted in the title and abstract fields for ProQuest Central, Sage Journals, ScienceDirect, and Web of Science. For PubMed and Embase, MeSH and Emtree terms were exploited accordingly. The full search strings for each database are available in Table 3. Table 2 provides details of criteria for the inclusion and exclusion of articles for this review.

A sensitivity analysis was performed by comparing results from the original and expanded search strategies. The expanded search yielded a 15% higher initial yield but did not identify any additional studies that met the inclusion criteria upon screening, confirming the robustness of the final included article set

The methodological quality of the included studies was assessed using the Critical Appraisal Skills Programme (CASP) checklists, selecting the appropriate tool for each study design (e.g., cohort study, qualitative study). The appraisal was conducted independently by two reviewers (M.K.Y.R. and S.M.S.). Discrepancies were resolved through discussion until consensus was reached. Studies were not excluded based on quality scores alone to ensure a comprehensive narrative synthesis; however, the findings were interpreted with consideration of the quality assessment results. Each study was rated as having low-, moderate-, or high-risk of bias. A sensitivity analysis, excluding studies with a high-risk of bias, was conducted and confirmed that their exclusion did not alter the overall thematic conclusions of the review, supporting the robustness of the synthesis. This narrative review used elements of the PRISMA guidelines to ensure transparency in the search and selection process.

The narrative synthesis and data analysis were carried out by contrasting, comparing, and critically assessing the final literature findings in line with the research question, aim, and objectives. The main themes and subthemes of the impacts of the COVID-19 pandemic related to suicide among New Zealanders during that time are discussed. In addition, this study found three main themes: the barriers, the drivers, and the coping strategies for suicide during the COVID-19 pandemic.

Throughout the analysis, a number of subthemes were identified. These subthemes are associated with the factors affecting New Zealanders’ mental health and well-being during the pandemic that led to suicide and suicide attempts. Table 4 provides a summary of the selected articles for this narrative review.

To triangulate the findings from the narrative synthesis, a supplementary Latent Dirichlet Allocation (LDA) topic modelling analysis was conducted on the abstracts of the 12 included studies using the Gensim library in Python. This computational approach was used to identify latent thematic patterns and validate the themes derived from manual coding.

Discussion

Drivers for suicide

The strict measures used to prevent and manage the spread of COVID-19 caused mental health issues globally. Experts have speculated that an increase in suicide behaviour could result from the behavioural, emotional, mental, and economic problems brought about by the pandemic. All twelve articles indicated that pandemic-related stressors could trigger an individual to commit suicide. The subthemes of these drivers mentioned in most of the selected articles include extended isolation, economic distress, lack of support, pre-existing mental conditions, and loss of a loved one.

Extended isolation

Although quarantine is an efficient approach to manage the spread of COVID-19, understanding the detrimental effects of these control measures is equally important because being in prolonged isolation can lead to severe emotional and psychological issues (2). People who went through quarantine described it as the worst experience and caused the feeling of uncertainty, loneliness, and detachment that can trigger suicidal behaviours or suicide. In a study by Bell et al. [2021], mentioned that there is an increasing psychological implication during the pandemic, particularly in relation to the fear of infection and the negative social and economic consequences of public health limitations (16). Additionally, the quick and strict suppression strategies of New Zealand in eliminating COVID-19 have brought a psychological burden to its population that led to suicidal thoughts and behaviours (25). Furthermore, the findings from the selected articles in this review showed that the most common psychological difficulties that New Zealanders experienced during the pandemic were anxiety, depression, and distress.

Economic distress

The financial suffering caused by the pandemic had a significant impact on the mental health and well-being of New Zealanders. According to Gasteiger et al. [2021], New Zealanders who felt extreme financial struggle scored higher on the Kessler Psychological Distress Scale (K10) and Generalised Disorder Assessment Scale (GAD-7) depression and anxiety scales (2). Siegert et al. [2023] made similar findings on Maori and Pacific people who reported experiencing housing issues and economic pressure, as well as loss of employment which are also linked to worse well-being (23). In another study by Schluter et al. [2022], the mental health burden of the COVID-19 pandemic due to economic distress led to much lower income-generating individuals in New Zealand, causing more stress and anxiety in people with families leading to suicide attempts (8).

Lack of support

During the pandemic, emotional and mental support is crucial in keeping one’s sanity. In a study by Bell et al. [2021], during the lockdown period, nearly one in ten participants reported experiencing family harm such as physical or sexual assault, harassment, and threatening behaviour (16). Additionally, the most often mentioned challenges were being alone most of the time with no one to talk to and having poor relationships with other household members. A similar study by Officer et al. [2022] discussed that emotional suppression and lack of familial or government support indicate a worse mental health state, leading to suicide ideation or death (3). Furthermore, the lack of access to mental health facilities is challenged by unpreparedness, overworked mental health services, a rise in the frequency of mental health problems, and interrupted mental health services delivery due to lockdown and isolation measures.

Pre-existing mental conditions

The COVID-19 outbreak and the restrictions on public health posed a significant threat to those individuals with existing mental health conditions. A study conducted by Bell et al. [2021], mentioned that compared to those individuals without prior mental conditions, those with a history of mental illness reported higher rates of negative psychological effects during the pandemic (16). These findings are also consistent with the findings of a study by Gasteiger et al. [2021], where it was discovered that people with mental illnesses are one of the most vulnerable groups to develop anxiety attacks, depression, poor well-being, and suicide (2). In addition to this, in a survey conducted in New Zealand, individuals who had been previously diagnosed with mental illness were shown to express greater concern for their own and others’ well-being, triggering more panic attacks that could lead to severe mental stress, suicide or suicide attempts.

Loss of a loved one

One of twelve of the selected articles discussed the loss of a loved one or someone close as a driver for suicide during the COVID-19 era. According to a study by Drucker et al. [2025], many people lost a family member or someone close to them during the COVID-19 pandemic (17). Due to the circumstances of grief during the isolation period and social distancing, such loss has detrimental psychological effects. The loss of a loved one or someone close appears to trigger a traumatic response called complicated grief (CG) and depression is the most common predictor of CG. The findings of this study presented an elevated prevalence of suicide and suicide ideation among New Zealanders experiencing CG during the pandemic.

In this regard, stressful events, such as the COVID-19 pandemic, are a risk factor for developing CG that could lead to suicidal thoughts and behaviour.

Barriers to suicide

As part of an early response to the pandemic, New Zealand imposed a strict lockdown that stopped COVID-19 from spreading throughout the community. However, financial and social costs are associated with this accomplishment. There are many evidence-based studies that isolation can worsen anxiety and depression, which may lead to fatal outcomes such as suicide, though not every study indicates this. Based on the selected articles, this narrative analysis identified two protective factors against suicide that also led to the successful elimination of COVID-19 as well as the attempt to commit suicide among New Zealanders: strengthened family bonds and silver linings and self-reflection (25).

Strengthened bonds

A study by Officer et al. [2022] found that some individuals were happy to have more time to spend with family during the lockdown period, especially between generations. Relationships, social support, and emotional support can help ease mental suffering by reinforcing a feeling of belongingness, security, and lessening fear (3). Moreover, the findings from this study noted the considerable positive impact of lockdown measures that helped people improve their relationships within the household and with family members.

Working from home is a convenient way to sustain financial needs and an opportunity to live in a cleaner and quieter environment. It is considered a positive outcome of lockdown measures (16). Also discovered that the pandemic paved the way for the development and improvement of the healthcare system and services in New Zealand to increase accessibility (18).

Silver linings and self-reflection

The COVID-19 pandemic and the public health measures implemented to contain and manage it have had an influence on people’s mental health and well-being. New Zealand has recorded higher levels of psychological distress, anxiety, and depressive symptoms (16). However, it was also discovered that post-traumatic growth occurs after a challenging life event; therefore, not all psychological effects of potentially traumatic events, such as the pandemic, are bad (26,27). When faced with stressful situations, people often use one of many coping mechanisms. Problem-focused coping and emotion-focused are examples of self-coping strategies mentioned in another study (3). Furthermore, the benefit of finding silver linings and self-reflection can help people grow after a difficult situation and lessen the psychological effects of stressful situations such as the pandemic.

Coping strategies

During periods of lockdown isolation, the majority of people living in New Zealand used social and physical engagement as coping techniques and strategies, particularly in the context of the COVID-19 pandemic. Watching movies, conversing with loved ones, working out at home, and taking up new hobbies proved to be beneficial. In this regard, three common COVID-19 coping strategies were found in this narrative review: physical exercise, social support, and family support.

Physical exercise

The worldwide COVID-19 outbreak containment measures created a new norm that affected people’s work and school lives and decreased opportunities for physical activity. The study by O’Brien et al. [2021] revealed that one way to cope with strict home isolation is through physical exercise (21). Additionally, the likelihood of higher well-being scores was nearly three times higher for those who reported being involved in physical exercise or home workouts among New Zealanders. These findings from the same study provided evidence that regular physical activity is closely linked to improved mental health during the pandemic (28).

Social support

An individual’s mental health can greatly improve by having a strong social support network. According to a study by Pavlova et al. [2021], the COVID-19 pandemic and related interventions may have had an impact on mental health and associated health services (16,22). Concerning this matter, there is an increased need for helplines and online community groups related to mental health issues in New Zealand. Ludin et al. [2022] discovered that it is feasible to develop a chatbot-based digital mental health support in response to unexpected circumstances such as the pandemic that can greatly aid in reducing mental health issues and eventually suicide risk behaviours. Social support and services are a good form of coping strategy for individuals experiencing mental breakdowns (20).

In another study by Kulshrestha et al. [2022], mental health initiatives such as “Like Mind, Like Mine”, work to improve the mental health and inclusion of New Zealanders who deal with mental health-related challenges are a useful tool in managing global health issues such as suicide (19). Moreover, it was noted that those who were willing to seek professional help when necessary are unlikely to develop depression and anxiety (22).

Family support

Familial relationships have also been altered by COVID-19, affecting children’s school, employment status, financial security, the mental health state of each family member, and the well-being of the family, which can result in a higher risk of developing anxiety attacks and depression. The study by Werkmeister et al. [2023] emphasised the importance of family support in maintaining family well-being such as keeping open lines of communication, handling disagreements, and spending more quality time together, regardless of the circumstance (24). In addition to that, maintaining healthy relationships and controlling parenting stress during COVID-19 reduces mental stress and boosts confidence in coping with the pandemic’s challenges (27-29).

Our thematic findings align coherently with the IMV model of suicidal behaviour (15), providing a theoretical structure to the drivers, protective factors, and coping strategies we identified. The drivers for suicide such as extended isolation (thwarted belongingness), economic distress (perceived burdensomeness), and pre-existing mental conditions (background factor) act as primary contributors in the pre-motivational and motivational phases, creating the feelings of entrapment that are central to the development of suicide ideation. Conversely, the protective factors, including strengthened family bonds (enhanced belongingness) and self-reflection (reduced entrapment), function as buffers in the motivational phase, mitigating the progression from defeat to entrapment and ideation. Finally, the coping strategies of physical exercise, social support, and family support can be seen as volitional phase moderators, impacting the capability for suicide and providing alternative pathways to self-harm, thereby reducing the transition from ideation to enactment.

While this review focuses on New Zealand, situating the findings within the international context reveals important nuances. Our findings, which indicate significant mental health distress and identified drivers for suicide, contrast with findings from some countries. For instance, a study from Japan found no significant change in the number or characteristics of suicidal patients presenting to emergency departments during the pandemic (30). This discrepancy may be attributed to New Zealand’s uniquely strict and prolonged lockdown measures compared to many other nations (18). Furthermore, cultural factors, such as the collectivist nature of many Asian societies, may have provided stronger inherent buffers against isolation (6). Conversely, studies from the U.S. and the UK reported increases in suicide ideation, particularly among young adults, aligning more closely with the stressors identified in our review (8,31). This comparison underscores that the mental health impact of the pandemic was not uniform but was profoundly mediated by national public health responses, pre-existing social support structures, and cultural contexts. The robustness of the thematic structure derived from narrative synthesis was further supported by a supplementary topic modelling analysis (LDA) of the included abstracts. The computationally identified topics demonstrated strong concordance with the manually derived themes of drivers, barriers, and coping strategies, thereby strengthening the validity of our findings.

Strengths and limitations of this review

This narrative review presents a timely and relevant exploration of the psychosocial impacts of COVID-19 restrictions on suicide risk among New Zealanders. The study’s strength lies in its comprehensive thematic analysis, which systematically categorizes key factors influencing suicide risk (drivers, barriers, and coping strategies). The use of PRISMA guidelines and CASP tool for article selection and quality assessment enhances methodological rigor. Additionally, the inclusion of both negative and positive mental health outcomes (e.g., strengthened family bonds, self-reflection) provides a balanced perspective on pandemic-related stressors. The focus on New Zealand, a country with a unique pandemic response adds valuable regional insights to the global discourse on mental health during COVID-19. The review also highlights critical gaps in mental health service accessibility, offering practical implications for policymakers and healthcare providers.

The limitations pertaining to the study methodology and the sources investigated can be used to classify the limits of this research. A narrative review methodology was utilised to gather and compile the information for this study. One of the key weaknesses of narrative literature review methodology is selection bias. However, some fundamental principles from the systematic review method were employed to reduce bias and improve the quality of the selection process for the final twelve articles. Another limitation of this review is the inability to obtain pertinent information on the impacts of the pandemic on suicide other than the New Zealand population in general. Lastly, an inadequate number of the primary articles (twelve) included in this analysis suggest further research on the topic chosen.

Conclusions

This study examined the impacts of COVID-19 restrictions on the mental health and well-being of New Zealanders that triggered suicide and suicidal behaviours using a narrative literature review methodology. Twelve articles were selected using several methods that were thought to be highly relevant to the topic. As a result, this review determined three important themes: drivers for suicide, protective factors against suicide, and coping strategies developed and used during the COVID-19 restrictions. Extended isolation, economic pressure, lack of support, pre-existing mental conditions, loss of a loved one, strengthened bonds, silver linings, physical exercise, social and familial support were identified as subthemes. Moreover, the data gathered from the examined studies revealed that New Zealanders experienced a range of pandemic-related stressors, leading to significant levels of anxiety, stress, and depression during the lockdown and triggering suicidal behaviours. Consequently, the research’s conclusions gave mental health services and community support groups useful knowledge they could use to improve existing programmes that would help the public deal with the current global health issue.

To build on this study, future research should employ longitudinal designs to assess sustained mental health impacts post-pandemic. Comparative studies across countries with varying lockdown stringency could elucidate cultural and policy influences on suicide risk. Expanding research to include marginalized groups (e.g., Indigenous Māori communities) would address disparities in mental health access. Policymakers should prioritize scalable interventions, such as teletherapy and community-based support networks, particularly for high-risk groups (youth, bereaved individuals, and those with pre-existing conditions). Public health campaigns promoting coping strategies (e.g., physical activity, digital mental health tools) should be reinforced. Finally, integrating real-time suicide surveillance data with economic and social indicators could enhance early intervention strategies in future crises. Overall, this review provides a foundational understanding of COVID-19’s mental health consequences in New Zealand and underscores the need for targeted, equitable suicide prevention measures.

Acknowledgments

None.

Footnote

Reporting Checklist: The authors have completed the Narrative Review reporting checklist. Available at https://jphe.amegroups.com/article/view/10.21037/jphe-25-27/rc

Peer Review File: Available at https://jphe.amegroups.com/article/view/10.21037/jphe-25-27/prf

Funding: None.

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://jphe.amegroups.com/article/view/10.21037/jphe-25-27/coif). S.M.S. serves as an unpaid editorial board member of Journal of Public Health and Emergency from December 2024 to November 2026. The other author has no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

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