Co-designing a peer-led model of delivering behavioural activation for people living with depression or low mood in Australian farming communities

Alison J Kennedy; Kate M Gunn; Sonya Duke; Martin Jones; Ellie Brown; Kelly Barnes; Joanna Macdonald; Susan Brumby; Vincent L Versace; Richard Gray

doi:10.1111/ajr.12982

Co-designing a peer-led model of delivering behavioural activation for people living with depression or low mood in Australian farming communities

Aust J Rural Health. 2023 Jun;31(3):556-568. doi: 10.1111/ajr.12982. Epub 2023 Apr 7.

Authors

Alison J Kennedy¹, Kate M Gunn², Sonya Duke³, Martin Jones⁴, Ellie Brown^{5

6}, Kelly Barnes³, Joanna Macdonald¹, Susan Brumby³, Vincent L Versace⁷, Richard Gray⁸

Affiliations

¹ National Centre for Farmer Health, School of Medicine, Deakin University, PO Box 283, Hamilton, Victoria, 3300, Australia.
² Department of Rural Health, University of South Australia, Adelaide, South Australia, Australia.
³ Western District Health Service, Hamilton, Victoria, Australia.
⁴ Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.
⁵ Orygen, Parkville, Victoria, Australia.
⁶ Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
⁷ Deakin Rural Health, Deakin University, Warrnambool, Victoria, Australia.
⁸ Department of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.

PMID: 37026611
DOI: 10.1111/ajr.12982

Abstract

Introduction: Farmers face a range of factors that negatively influence their mental health and suicide risk, yet have limited access to appropriate support. Behavioural activation (BA) is an evidence-based therapy that can be effectively delivered by nonclinical workers. Working with members of farming communities to deliver BA to their peers has the potential to overcome many well-established barriers to mental health help-seeking and improve outcomes for this at-risk group.

Objective: This paper describes the findings of a co-design phase informing the development of a peer (farmer)-led approach for delivering BA for farmers living with depression or low mood.

Design: This qualitative study used a co-design approach involving members of the target community. Focus groups were transcribed and analysed using Thematic Analysis and the Framework approach.

Findings: Ten online focus groups with 22 participants were held over 3 months. Four overarching, interlinked themes were identified: (i) filling the gap in rural mental health support; (ii) alignment with the farming context-tailoring how, where and when we engage about mental health; (iii) the 'messenger' is as important as the message; and (iv) sustainability, governance and support.

Discussion: Findings suggest BA could be a contextually appropriate model of support for the farming community-given its practical and solution-focused approach-and could help improve access to support. Having peer workers deliver the intervention was viewed as appropriate. Ensuring governance structures are developed to support peers to deliver the intervention will be essential to facilitate effectiveness, safety and sustainability.

Conclusion: Insights gained through co-design have been critical to the success of developing this new model of support for members of farming communities experiencing depression or low mood.

MeSH terms

Agriculture*
Australia
Depression* / therapy
Humans
Mental Health*

Grants and funding

Western Victoria Primary Health Network