Mental Health in Zimbabwe: The Friendship Bench Project

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HARARE, Zimbabwe — Mental health is something that is often easy to overlook, especially if you come from a low-income background. The intersection of mental health and poverty interests many social scientists, yet it is a relatively new comparison. Several studies show that living in an impoverished setting makes one more likely to experience mental illness such as depression or anxiety. With many impoverished countries lacking the resources needed to provide substantial help for those affected by mental illness. Programs like the Friendship Bench Project, who are working to improve mental health in Zimbabwe, are making a big impact.

Important Facts About Mental Health in Zimbabwe

  1. One in four Zimbabweans suffers from a common mental disorder (CMD), i.e. depression or anxiety.
  2. In a population of 13 million, there are only 11 psychiatrists and 20 clinical psychologists. That’s fewer than one psychiatrist per one million people.
  3. Only two of the nine mental health institutions in the country have psychiatrists.

In a country with only eleven psychiatrists where one in four citizens have a CMD, it’s easy to wonder if there is anything being done to help improve mental health in Zimbabwe. That’s where the Friendship Bench Project comes in.

The Friendship Bench Project

Dr. Dixon Chibanda is the founder of the Friendship Bench Project and one of the eleven psychiatrists in Zimbabwe. During a Ted Talk, he explained he started this project because there just weren’t enough psychiatric resources in Zimbabwe to provide the aid for those who needed it. He decided to do something about it. He says that “One of the most reliable resources we have in Africa are grandmothers… there are hundreds of them… and they don’t leave their communities.” Using this knowledge, he came to the conclusion that these grandmothers can be trained to provide the necessary support for individuals who need it.

The Friendship Bench Project is an intervention of sorts that is based on problem-solving therapy where a patient and a trained community grandmother come together to identify issues affecting the patient and brainstorm ways of solving them. It is unlike conventional therapy in which the patient is diagnosed with an issue or symptom and is then treated based on their diagnosis.

Community grandmothers are trained to listen, show empathy and are empowered with the skills needed to provide behavior activation and schedule activities. Technically, they are trained as lay health workers, but patients who go to see them recognize them only as the community grandmothers that they have always been. They are seen as someone to talk to, and as someone who will listen. Together, over several sessions sitting on a park bench outside of a community health clinic, the grandmother and patient talk and work through the issues that are most affecting the patient.

The Impact of the Friendship Bench Project

A randomized clinical trial was conducted in order to see if these friendship bench sessions were working to improve the mental health in Zimbabwe. The trial split 573 patients into two groups. One group would receive psychological intervention from the community grandmothers. The other group (the control group) would receive the usual mental care from mental health professionals.

The trial found that patients who worked with the grandmothers displayed symptom scores (as measured on two symptom scales) that were lower than those who worked with doctors. This means that they had fewer symptoms of common mental disorders when they worked with community grandmothers than when they worked with mental health professionals.

As of right now, there are 400 grandmothers working on 70 benches located throughout Zimbabwe, helping 35,000 people through the Friendship Bench Project. These women are changing mental health in Zimbabwe for the better. While the Friendship Bench Project is currently centered in Zimbabwe, it’s an innovative solution to combating mental health that could soon be used worldwide. In fact, Dr. Chibanda’s next goal is to do just that.

CJ Sternfels
Photo: Flickr
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