A group of grandmothers and a bench are changing mental health care. They call it the 'Friendship bench'

This group of grandmothers from Zimbabwe is reshaping the norms of mental health. Founded by a psychiatrist in Zimbabwe named Dixon Chibanda, who was on a life-changing journey after a patient took her own life because she could not afford to go to a hospital. It was then that he decided that psychiatry should be taken out of the hospital and into the community. He wanted to develop a "community-based approach to therapy that leverages the power, compassion and accessibility of grandmothers," according to McKinsey. Chibanda and Kana Enomoto, director of brain health at the McKinsey Health Institute (MHI), discussed something called the "Friendship Bench."

When asked about it, Chibanda explained: "The Friendship Bench in really simple terms is a brief psychological therapy, or talk therapy, that is delivered predominantly by community grandmothers who are trained in the very basics of cognitive behavioral therapy. After that training, which normally takes a month, they are allocated a wooden park bench in their communities. Our team then facilitates referrals to those benches through social media, primary healthcare facilities, schools, and police stations. The grandmothers then screen everyone who is referred to them using a locally validated screening tool."

He adds: "Selected cases go on to receive this structured therapy on the bench, and, after two to four sessions, they are invited to join a support group within the community where they begin to collectively problem solve around common challenges. Friendship Bench starts as a one-on-one therapy between a grandmother and a client, then goes on to a peer support system that can go on and on. We have groups that have been running for more than eight years." Moreover, research on this creative approach showed significant improvement in patients with depression who received therapy from a trained grandmother. As for the idea behind it, which was born out of a personal tragedy of his own, Chibanda says: "I was hit hard by the realization that I had taken for granted that people who needed my services could find me at the hospital."

To empower the communities who find it hard to afford mental health, Chibanda switched the name from "Mental Health Bench" to "Friendship Bench." He says that it has enabled him to remove the medicalization and build confidence among people." The grandmothers approached me and said, “That is stigmatizing. You need to change the name.” We changed it to Friendship Bench—and people started coming to the Friendship Bench. The services we provided were the same. So the names that we attach to certain conditions, certain interventions, are critical. It can make or break the work that we do in the global mental health space." Chibanda also encourages people to replace clinical terms with “uplifting” and “strengthening” words.

Terms like depression, bipolar disorders and schizophrenia create a division in society and among patients, which results in difficulty while properly helping a patient. "There is certainly room for those terms when we are communicating as clinicians. But within communities, I’ve found that you get better results when you remove all those labels and simply look at the human being and listen to their story," remarks Chibanda. He also shares some insightful advice for both medical experts and people, saying that "empathy" is the first building block. "Anchor your expressed empathy in the now. Because it’s only “the now” that we have. We spend a lot of time in the future and in the past. But if you bring expressed empathy into the now and anchor that into the present moment, healing begins."