Zimbabwe’s new mental health therapy is spreading overseas

After her son, the family’s shining light and sole breadwinner, was arrested last year, Tambudzai Tembo had a meltdown. In Zimbabwe, where clinical mental health services are scarce, her chances of getting professional help were slim to none. She considered suicide.

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

A wooden bench and a sympathetic grandmother saved her.

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

The approach involves placing benches in quiet, discreet corners of community clinics and in some churches, poor neighborhoods, and at a university. An older 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 traditional practice in Zimbabwe, where grandmothers were the people you turned to for wisdom in difficult times. It was abandoned by urbanization, the breakdown of close extended families and modern technology. Now it is proving useful again, as mental health needs increase.

“Grandmothers are the keepers of local culture and wisdom. They are rooted in their communities,” said Dixon Chibanda, a professor of psychiatry and founder of the initiative. “They don’t go away and they have an amazing ability to use what we call ‘expressed empathy’ … to make people feel respected and understood.”

Last year, Chibanda was named the winner of a $150,000 prize by the US-based McNulty Foundation for revolutionizing mental health care. Chibanda said the concept has taken root in parts of Vietnam, Botswana, Malawi, Kenya and Tanzania and is in “preliminary formative work” in London.

In New York, the city’s new mental health plan launched last year says it “takes inspiration” from what it calls the Friendship Bench to address risk factors like social isolation. The orange benches are now in areas including Harlem, Brooklyn and the Bronx.

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

So far, 20 grandmothers determined to “break the stigma around mental health and make it okay to talk about feelings” have been trained by a team from Friendship Bench Zimbabwe to listen, show empathy and encourage others to work through their issues, said Cindy Cox-Roman, president and CEO of HelpAge US.

Benches will be placed at places of worship, schools and wellness centers in Washington’s poor communities, which are intended for people who “have historically been marginalized and are more likely to experience mental health issues,” she said.

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

“People are going through hard times and a grandma can always make you feel better,” she said.

“We have so much wisdom in our senior population and arms that can open. I reject ageism. Sometimes age brings wisdom that you don’t learn until you’re old,” one of the grandmothers, 81-year-old Barbara Allen, said in a promotional video.

According to the National Institute of Mental Health, more than one in five adults in the US lives with a mental illness.

“The mental health crisis is real. The real crisis after the pandemic is that many clinicians have left the workforce,” said Dr. Jehan El-Mayoumi, an expert at HelpAge US and a founding director of the Health Equity Rodham Institute at Georgetown University. She has struggled to find psychiatrists to care for acutely suicidal patients.

According to El-Mayoumi, the Zimbabwean concept offers people “someone you can trust, someone you can open your heart to, someone you can tell your deepest secrets to (and) that requires trust. That’s what makes the Friendship Bank so great.”

The idea was born out of tragedy. Chibanda was a young psychiatrist, one of more than 10 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 that she had committed suicide.

“I realized I needed to have a stronger presence in the community,” Chibanda said. “I realized that one of the most valuable resources is actually these grandmothers, the keepers of the local culture.”

He recruited and trained 14 grandmothers near the hospital where he worked in the capital Harare. In Zimbabwe, they receive $25 a month to help with transportation and phone bills.

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

Siridzayi Dzukwa, the grandmother who stopped Tembo from committing suicide, recently made a follow-up visit to the home. Using a written questionnaire, she checked on Tembo’s progress. She listened as Tembo told how she had found a new 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 home visit or take her number.

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

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