New Zimbabwean mental health therapy spreads abroad

HARARE, Zimbabwe (AP) — After her son was arrested last year, Tambudzai Tembo, the sole breadwinner, spiraled into a nervous breakdown. In Zimbabwe, where mental health services are scarce, her chances of getting professional help were slim. She even considered suicide.

“I didn’t want to live anymore. People who saw me thought everything was fine. But inside, my head was spinning,” the 57-year-old said. “I was left to my own devices.”

A wooden bench and an empathetic grandmother saved her.

Older people are at the centre of a local form of mental health therapy in Zimbabwe that is now being adopted in countries including the United States.

The approach involves setting up benches in quiet, discreet corners of community clinics, some churches, poor neighborhoods, and a university. An elderly woman with basic training in problem-solving therapy sits patiently, ready to listen and engage in one-on-one conversation.

The therapy is inspired by a traditional practice in Zimbabwe, where grandmothers were the people to turn to for wisdom in difficult times. This practice was abandoned with urbanization, the breakdown of extended families and the advent of modern technology. It is now proving useful again as mental health needs increase.

“Grandmothers are the keepers of local culture and wisdom. They are embedded in their community,” said Dixon Chibanda, a professor of psychiatry and founder of the initiative. “They never leave, and what’s more, they have an amazing ability to use what we call ‘expressed empathy’ … to make people feel respected and understood.”

Last year, Chibanda won a $150,000 prize from the US-based McNulty Foundation for revolutionising mental health care. Chibanda said the concept has taken root in parts of Vietnam, Botswana, Malawi, Kenya and Tanzania and is in “early training stages” in London.

In New York City, the new mental health plan launched last year is inspired by what it calls the Friendship Bench to help combat risk factors such as social isolation. The orange benches are now in neighborhoods including Harlem, Brooklyn and the Bronx.

In Washington, HelpAge USA is piloting the concept as part of the DC Grandparents for Mental Health initiative, which began in 2022 as a COVID-19 support group for people 60 and older.

So far, 20 grandmothers committed to “ending the stigma around mental health and making it acceptable to talk about your feelings” have been trained by a team from Friendship Bench Zimbabwe to listen, empathize and empower others to address their issues, said Cindy Cox-Roman, president and CEO of HelpAge USA.

Benches will be installed in places of worship, schools and wellness centers in low-income communities across Washington, where there are people who “have been historically marginalized and more likely to suffer from mental health issues,” she said.

Cox-Roman cited fear and distrust of the medical system, lack of social support and stigma as some of the factors limiting access to treatment.

“People are hurting, and a grandmother can always make you feel better,” she said.

“We have so much wisdom in our elders and we can open our arms to them. I reject ageism. Sometimes age brings wisdom that you only learn as you get older,” one of the grandmothers, Barbara Allen, 81, said in a promotional video.

According to the National Institute of Mental Health, more than one in five American adults suffers from a mental illness.

“The mental health crisis is real. The crisis has been real since the pandemic, because many doctors have left their jobs,” said Dr. Jehan El-Mayoumi, an expert with HelpAge USA and founding director of the Rodham Institute for Health Equity at Georgetown University. She has struggled to find psychiatrists for acute suicidal patients.

El-Mayoumi said the Zimbabwean concept offers people “someone you can trust, someone you can open your heart to, someone you can confide your deepest secrets to (and) that requires trust, that’s what’s so wonderful about the Friendship Bench.”

The idea was born out of tragedy. Chibanda was a young psychiatrist, one of ten in Zimbabwe in 2005. One of his patients desperately wanted to see him, but she couldn’t afford the $15 bus fare. Chibanda later learned she had committed suicide.

“I realized that I needed to strengthen my presence in the community,” Chibanda said. “I realized that actually one of the most valuable resources are these grandmothers, the keepers of local culture.”

He recruited 14 grandmothers from the neighbourhood near the hospital where he worked in the capital, Harare, and trained them. In Zimbabwe, they receive $25 a month to help pay for transport and phone bills.

The network, which now collaborates with the Ministry of Health and the World Health Organization, now has more than 2,000 grandmothers across the country. According to the network, more than 200,000 Zimbabweans sat on a bench to receive therapy from a trained grandmother in 2023.

Siridzayi Dzukwa, the grandmother who convinced Tembo not to commit suicide, recently made a follow-up home visit. Using a written questionnaire, she checked on Tembo’s progress. She listened as Tembo talked about how she found a new lease on life and now sells vegetables to make ends meet.

Dzukwa has become a recognizable figure in the area. People stop to greet her and thank her for her help. Some ask for a house call or write down her number.

“People are no longer ashamed or afraid to openly approach us on the street and ask us to talk,” she said. “Mental health is no longer something to be ashamed of.”

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