Depression affects millions of people every year. Depressed individuals suffer from depressed mood, loss of interest and enjoyment, reduced energy, diminished activity, reduced attention and concentration and reduced self-esteem. The consequences are substantial both for each individual and for society, with depression as a major cause for sick leave and work disability. A wide range of treatments and health care pathways is needed, and within the agricultural sector a new service has developed, which could act as a supplementary treatment. Green care is a service which involves interventions implemented via normal farming activities. All parts of the farm are utilized, creating a diversity of interventions with one common basis; the use of nature and natural environment to promote health and well-being. Farm animals are a common part of the farm milieu, and the main aim of the present research was to examine change in mental health of persons with clinical depression participating in a twelve week farm animal-assisted intervention.
A randomized controlled trial was carried out with participants randomly assigned to a farm animal-assisted intervention at a dairy farm or a waiting-list control group. The intervention consisted of work and interaction with farm animals twice a week for twelve weeks. The intervention group experienced statistically significant decline in depression and improved self-efficacy, and a close to significant reduction in state anxiety from recruitment to the end of the intervention. Participants kept their gains at three-month follow-up. In the control group no significant changes were obtained. However, the differences between the groups were not statistically significant. Nine of 16 participants in the intervention group and 3 of 13 participants in the control group had a reliable change in depression, and clinical significant change was achieved by 6 of 16 participants in the intervention group and only one participant in the control group.
An objective was to examine associations between various work tasks during the intervention and change in mental health. Fourteen participants were video-recorded for a whole session early and late in the intervention. Different work tasks conducted in the cow shed and all animal contact and dialog with the farmer were classified into behavioral categories. Pair-wise correlations between average time spent in various categories and changes in depression, anxiety and self-efficacy were calculated. Change in mental health scores were favorably correlated to time spent with milking procedures, feeding, cleaning, moving animals and dialog with farmer, and unfavorably correlated with mucking, grooming, sole animal contact and inactivity.
A last aim was to examine the participants’ experiences with the intervention and what they perceived as important factors related to their mental health. Eight persons, who had completed the intervention, were interviewed. Central elements in the intervention were the possibility to experience an ordinary work life, but also the importance of distraction from their illness. Furthermore, the flexibility of the intervention made it possible for the participants to experience coping,
A non-standardized intervention, as in this study, provides participants with the possibility to do individual choices, and the participants considered flexibility to be an important element in the intervention. On the other hand, results do provide some evidence of different outcomes depending on the intervention content. Participants who more frequently performed challenging and complex work tasks, showed a larger improvement in mental health. Progress in work skills seemed important, possibly connected to increase in coping, which was a factor the participants perceived as important. On this basis, the participants’ mastery experience could be essential for improvement in mental health.