Equine-assisted therapy and rehabilitation in mental illness: A longitudinal design

Background

The number of sick leave related to psychiatric diagnoses is increasing in Sweden, as is the pharmacological treatment of mental illness. Mental illness entails an increased risk of somatic morbidity, including premature death, and involves significant suffering for the individual as well as great costs for the society. People with serious and enduring mental illness are often offered a limited range of preventive and health-promoting interventions compared to other groups in the overall population.

From the fall of 2017, Region Halland offers "Green rehabilitation" for patients with moderate depression, anxiety, or stress-related mental health conditions as a supplement in the rehabilitation process that is initiated via their health care centres. Equine-assisted therapy has shown potential to contribute to increased awareness and genuine change in the individual with good results even in the case of serious and lasting mental illness, such as schizophrenia.

Green rehabilitation includes Equine-assisted efforts, but people diagnosed with schizophrenia or similar psychotic conditions are excluded from this rehabilitation supplement as they are deemed to be too far from the labour market to be able to successfully assimilate this type of rehabilitation. The project evaluates experiences and effects of equine-assisted therapy for people with mild to moderate depression, anxiety and stress-related conditions who participated in equine-assisted activities three half-days per week during a twelve-week period within the framework of Green rehabilitation in Region Halland.

Aim

The overall aim is to study Equine-assisted therapy and rehabilitation for individuals with mental health issues using a longitudinal qualitative and quantitative design. Target groups are adults on long-term sick leave associated with moderate depression, anxiety, and stress related mental illness.

The project is also evaluating an Equine-assisted intervention for people diagnosed with Schizophrenia or similar psychotic conditions financed by the Swedish Postal Code Foundation. The intervention for people diagnosed with schizophrenia or similar psychotic conditions is carried out based on the same scheme as the intervention in Green rehabilitation, but with the difference that it is carried out for half a day every fortnight and the participants are included via the user association IFSAP Halmstad.

For both groups, the intervention includes Equine-assisted activities, conversations, and a shared lunch during a 12-week period. The evaluation combines quantitative and qualitative research methods and measurements are carried out at baseline as well as during and after the completed intervention. Ethical Approval is obtained from the Ethical review board in Lund (Dnr 2017/709).

The project intends to contribute to knowledge about the effects of equine-assisted therapy for people with mental illness carried out in small-scale equine enterprises with considerable regard to Sustainable Development and animal welfare. The project is expected to generate four to eight scientific publications and so far, one literature review and two qualitative studies have been published in international scientific journals while one quantitative article have been accepted in the international scientific journal “Issues in Mental Health Nursing” (Accepted 22-11-10).