title: Farm-based interventions for people with mental disorders: a systematic review of literature.
abstract: OBJECTIVE
  Farms are increasingly used in mental healthcare. This study aimed to systematically review the evidence on the effectiveness of farm-based interventions for patients with mental disorders.
  
  
  METHODS
  Controlled and uncontrolled studies of farm-based interventions were included. Within- and between group effect sizes were calculated. Qualitative data were summarized using thematic synthesis. The review followed the PRISMA, Cochrane and COREQ standards.
  
  
  RESULTS
  The eleven articles included reported results of five studies, three of which were randomized control trials (RCTs). Overall, 223 patients with depressive disorders, schizophrenia or heterogeneous mental disorders attended three types of farms-based interventions. Favourable effects on clinical status variables were found in one study in patients with depressive disorders that did not respond to medication and/or psychotherapy, and in one RCT in patients with schizophrenia. Assessment of rehabilitative effects (functioning and quality of life) was limited and yielded conflicting results. Patients' experiences revealed that social and occupational components of interventions were perceived as beneficial, and provided insights into how farm-based interventions may facilitate recovery.
  
  
  CONCLUSIONS
  Our results suggest that the farm environment should be considered, especially for patients with mental disorders who do not achieve an adequate response with other treatment options. Further research is needed to clarify potential social and occupational benefits.
authors: ATHENA Institute, Department of Innovation in the Health and Life Sciences, VU University Amsterdam , the Netherlands and.
authors: Sorana C
authors: SC
authors: Iancu
authors: Adriaan W
authors: AW
authors: Hoogendoorn
authors: Marjolein B M
authors: MB
authors: Zweekhorst
authors: Dick J
authors: DJ
authors: Veltman
authors: Joske F G
authors: JF
authors: Bunders
authors: Anton J L M
authors: AJ
authors: van Balkom
mesh_terms: D000383:Agriculture; D003866:Depressive Disorder / Q000628:therapy*; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D011613:Psychotherapy / Q000379:methods*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012559:Schizophrenia / Q000628:therapy*
keywords: Depression; farm-based interventions mental disorders; schizophrenia