The final research report can be found here.

Research questions

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.

Timeline

This project has been completed. The findings of the project can be found here.

What did the researchers look at?

This study investigated 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 were also examined. We explored 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.

Outcomes

Australians living in rural and remote areas face a unique combination of stressors, placing them at higher risk of mental health problems. They also have poorer access to mental health services than those living in Australian cities. Compounding the problem of fewer available services are barriers to help-seeking, such as shame and a "she'll be right" attitude.

We investigated whether computational linguistic techniques can be applied to text-based communications with the goal of identifying a client’s mental health status. The results confirmed that word use patterns could be used to differentiate whether a client had one of the top three presenting problems (depression, anxiety, or stress), as well as prospectively to predict their self-rated mental health after counselling had concluded.

These findings suggest that language use patterns are useful both for researchers and for clinicians trying to identify individuals at risk of mental health problems, with potential applications in screening and targeted intervention.

Research partners and stakeholders

Virtual Psychologist

The MARCS Institute for Brain, Behaviour and Development

Want to know more?

To work with the Centre, or stay up to date with our research, head to our Engage with us page.

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.