Mental health in remote and rural farming communities

Research question

To what extent do clients report clinical improvement as a result of using the SMS e-mental health services?

Can conversation text be used to calculate (or forecast) the probable condition and its severity to aid intervention and prevention?

What is this research about?

This study will investigate whether an e-mental health short message service (SMS) has similar outcomes as face-to-face psychological interventions and whether it is cost effective. This is particularly important in the Australian rural context, where farmers facing physical and psychological challenges due to drought and other factors do not typically have the same level of access to mental health services as those living in metropolitan regions.

We will investigate the application of e-mental health services delivered primarily via SMS for the prevention of common mental health problems while promoting good mental health in rural and remote farming communities.

A recent horizon scan of scientific literature suggested a gap when it comes to using SMS as a platform for counselling or ‘active’ forms of engagement between clients and health care professionals.

This project will therefore fulfil a critical research need - the evaluation of an SMS e-mental health service, while working in partnership with an existing Australian e-mental health service provider, targeting rural and remote farming communities.

A broad range of factors will be explored such as clinical effectiveness, characteristics of clients, reach and whether clients’ and/or interventionists’ language use is correlated with clinical outcomes.

What will the researchers do?

    The current study will investigate features of e-mental health delivered to rural and remote farming communities for common mental health concerns, with a focus on SMS, although other modes of e-mental health delivery will also be examined. We will explore a broad range of factors related to e-mental health including:

  • clinical effectiveness.
  • characteristics of farmers.
  • reach and analysis of conversational text to identify indicators or patterns to predict mental health state and behaviours.
  • The study will be carried out in three phases.

    Phase 1 – Program description and logic

    The Virtual Psychologist service will be described and program logic provided. That is, the logical theory that explains how the program’s activities are related to clear, identified, and achievable outcomes will be described. During this phase, Human Research Ethics approval will be sought.

    Phase 2 - Systematic literature review

    A systematic literature review will be undertaken with an overall aim to build knowledge about the benefits of using health information technology as a tool for mental health promotion and the prevention of mental health problems in rural and remote farming communities.

    Phase 3 – Clinical effectiveness

    We will investigate:

  • Clinical effectiveness; improvements as a result of the use of the e-mental health services.
  • Patterns of presenting conditions - analyse the conversation text and associated information for patterns that calculate (or forecast) the probable condition and its severity to aid intervention and prevention.
  • Patterns of clients’ and/or interventionists’ language use that are correlated with clinical outcomes.

Research partners and stakeholders

Virtual Psychologist

The MARCS Institute for Brain, Behaviour and Development


Project commenced: December 2018

Project completion: October 2020

Want to know more?

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Further reading

  1. Andersson, G. and Titov, N. (2014) Advantages and limitations of Internet-based interventions for common mental disorders. World Psychiatry,13,4–11.
  2. Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77-101.
  3. Pennebaker, J.W., Francis, M.E.., Mayne T. (1997). Linguistic predictors of adaptive bereavement. Journal of Personality and Social Psychology, 72(4), 863-871.
  4. Proctor, E.,et al. (2011). Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health, 38(2), 65-76.
  5. Van der Zanden, A.P., Kramer, J.J., Cuijpers, P. (2011). Effectiveness of an online group course for adolescents and young adults with depressive symptoms: study protocol for a randomized controlled trial. Trials 2011;12:196.
  6. Zijlstra, H., Van Middendorp, H. Van Meerveld, T. Geenen, R. (2005). Validiteit van de Nederlandse versie van de Linguistic Enquiry and Word Count (LIWC). Een experimentele studie onder vrouwelijke studenten. Netherlands Journal of Psychology, 60, 50-58.