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, alongside with the prescription of pharmacological preparations for the treatment of mental illness. Mental illness entails an increased risk of somatic morbidity, including premature death, and entails significant suffering for the individual as well as great costs for society. People with serious and long lasting mental illness are often offered a limited range of preventive and health-promoting interventions compared to other groups in the population.

From the fall of 2017, Region Halland offered "green rehabilitation" as a supplement in the rehabilitation process, initiated via the health centres for patients with moderate depression, anxiety or a stress-related conditions. Equine-assisted therapy has shown the 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 with schizophrenia or similar conditions are exempt from such rehabilitation supplement as they are considered to be too far from the labour market to be able to successfully assimilate this type of rehabilitation.

Purpose

The overall aim of the study is to study equine-assisted therapy and rehabilitation for individuals with mental illness using a longitudinal qualitative and quantitative design. The project evaluates experiences and effects of equine-assisted therapy for people with mild to moderate depression, anxiety and stress-related mental illness, who participated in equine-assisted activities three half-days per week during a twelve-week period within the framework of Green rehabilitation.

The project is also evaluating an equivalent but less extensive equine-assisted intervention for people with schizophrenia or similar conditions financed by the Swedish Postal Code Foundation. The intervention for people with schizophrenia 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 horse-assisted activities, conversations and shared lunch during a 12-week period. The evaluation combines quantitative and qualitative methods and measurements are carried out at baseline as well as during and after the intervention. The project has received ethical approval from the regional ethical review board (EPN) in Lund (Dnr 2017/709).

The project intends to contribute to knowledge about the effects of horse-assisted therapy for people with mental illness carried out in small-scale horse businesses with regard to sustainable development and animal welfare. The project is expected to generate seven to eight scientific publications. So far, one literature review, three qualitative studies and one quantitative study have been published in international scientific journals. A 5-year follow-up of quantitative and qualitative data is ongoing.

The research group works to:

• to further develop a multidisciplinary research environment in ​​equine-assisted interventions for health, learning and recovery from mental illness at all ages. The research group promotes development in the field and provides equal opportunities for of people irrespective of genders, ethnicities or functional capacity.
• to develop long-term collaborations and co-production with national and international universities, companies and the public sector regarding ​​equine-assisted innovations to strengthen health-promoting and recovery-oriented health care, school, and nursing.
• to bring valuable knowledge to society with high quality research, education and collaboration. The research group deals with research issues from multidisciplinary perspectives to generate an evidence-base for continued research and education and contributes to deeper understanding, new knowledge and innovations in society.

The conference The 5th Nordic Research Seminar on Equine-assisted Interventions 2024 was arranged by the research group in September of 2024.