A system dynamics model for understanding poor mental health outcomes among rural Queenslanders
Context
The annual Tackling Regional Adversity through Integrated Care (TRAIC) grants program provides around $600,000 to community organisations that have local ideas to boost the mental health of those affected by drought and disasters. This year, another $400,000 was added through a $2 million drought package to help parts of the state most impacted by drought. The community organisations involved have some great ideas for projects and activities that build resilience, raise awareness of mental health issues, bring people together, break down stigma, and encourage people to seek help if needed. However, the evidence-base for and impact of these activities is not always apparent.
Additionally, there can be issues related to the assumption that individuals have the capacity to follow health-related advice, which is profoundly impacted by opportunity structures, social determinants, and service access, all of which are often deficient among those in rural areas affected by drought and/or severe weather events. It is essential to acknowledge the societal-level contexts and constraints and the many feedback loops and reciprocities characterising dynamic systems and real lives.
To address this, the study of environmental change and mental health could benefit from systems modelling, a process used to help describe a complex set of interacting factors, which can be used to predict interactions and formulate interventions to achieve desired results.
System dynamics modelling
Systems modelling is methodologically approached using causal loop diagrams and system dynamics (SD) simulation modelling. It is based on a five-step approach 1 involving problem articulation, qualitative understanding of the system and simulation model building. Systems modelling also facilitates stakeholder engagement, providing a platform for participant ‘buy-in’, reducing conflict, building trust, capacity building (in the participants) and facilitating increased support of goals and outcomes 2,3.
This five-step systems modelling process will enable us to elicit and understand the key drivers of poor mental health outcomes in rural Queenslanders and identify intervention points that may lie outside of the health sector. Systems modelling is a scientific method for understanding complex systems and their behaviour 4 by making systems’ structures and interactions explicit throughout the modelling process and by simulating the outcomes of novel interventions based on the identification of hidden leverage points and potential unintended consequences. Developing an SD model facilitates the engagement of (diverse) relevant sectors, bringing together collective experiences and expertise to form a combined understanding on all aspects of the system – this is a key strength of systems modelling . We believe that this approach provides a highly cost-effective way of evaluating the efficacy and economic costs and benefits of interventions and policies for reducing poor mental health outcomes. It also provides information on the likelihood of unintended consequences 4.
Aims
This project aims to evaluate existing and identify new intervention targets for reducing poor mental health outcomes among rural Queenslanders.