Harare, Zimbabwe (AP) — When Tambudzai Tembo’s son, the family’s sole provider, was arrested last year, she fell into despair. In a country where clinical mental health services are scarce, Tembo’s chances of receiving professional help were nearly nonexistent. She contemplated suicide.
“I didn’t want to live anymore. People who saw me would think everything was okay. But inside, my head was spinning,” said the 57-year-old. “I was on my own.”
A simple wooden bench and an empathetic grandmother saved her.
In Zimbabwe, older individuals are at the heart of a unique mental health therapy now being adopted internationally, including in the United States. The approach involves setting up benches in quiet, discreet corners of community clinics, churches, poor neighborhoods, and a university. An older woman, with basic training in problem-solving therapy, sits there ready to listen and engage in one-on-one conversations.
This therapy draws inspiration from Zimbabwean traditions where grandmothers were the go-to people for wisdom during difficult times. Urbanization, the breakdown of extended families, and modern technology had diminished this practice. However, it is now proving invaluable as mental health needs grow.
“Grandmothers are the custodians of local culture and wisdom. They are rooted in their communities,” said Dixon Chibanda, a psychiatry professor and founder of the initiative. “They don’t leave, and they have an amazing ability to use ‘expressed empathy’ to make people feel respected and understood.”
Last year, Chibanda won a $150,000 prize from the U.S.-based McNulty Foundation for revolutionizing mental healthcare. His concept has taken root in parts of Vietnam, Botswana, Malawi, Kenya, Tanzania, and is in preliminary stages in London.
In New York, the city’s new mental health plan launched last year is “drawing inspiration” from what it calls the Friendship Bench to address risk factors such as social isolation. The distinctive orange benches are now found in areas including Harlem, Brooklyn, and the Bronx.
In Washington, HelpAge USA is piloting the concept through the DC Grandparents for Mental Health initiative, which started in 2022 as a COVID-19 support group for people 60 and above.
So far, 20 grandmothers, determined to “stop the stigma around mental health and make it okay to talk about feelings,” have been trained by a team from Friendship Bench Zimbabwe. They listen, empathize, and empower others to solve their problems, said Cindy Cox-Roman, president and CEO of HelpAge USA.
Benches will be set up at places of worship, schools, and wellness centers in Washington’s low-income communities, where people have been historically marginalized and are more likely to experience mental health problems, she said.
Cox-Roman cited fear and distrust in the medical system, lack of social support, and stigma as 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 older population and arms that can open. I reject ageism. Sometimes age brings wisdom that you don’t learn until you get old,” said Barbara Allen, an 81-year-old grandmother featured in a promotional video.
More than one in five U.S. adults live with a mental illness, according to the National Institute of Mental Health.
“The mental health crisis is real. After the pandemic, many clinicians have dropped out of the workforce,” 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 acutely suicidal patients.
El-Mayoumi praised the Zimbabwean concept for providing people with “someone you can trust, open up your heart to, and share your deepest secrets with. That requires trust, and that’s what’s so wonderful about the Friendship Bench.”
The idea emerged from tragedy. In 2005, Chibanda, then a young psychiatrist and one of just over 10 in Zimbabwe, learned that a patient had killed herself because she couldn’t afford the $15 bus fare to see him.
“I realized that I needed to have a stronger presence in the community,” Chibanda said. “One of the most valuable resources are these grandmothers, the custodians of local culture.”
He initially recruited 14 grandmothers from the neighborhood near his hospital in Harare and trained them. They receive $25 a month to cover transport and phone bills.
The network, now partnering with the health ministry and the World Health Organization, has grown to over 2,000 grandmothers across Zimbabwe. In 2023, more than 200,000 Zimbabweans received therapy from a trained grandmother, according to the network.
Siridzayi Dzukwa, the grandmother who helped Tembo, recently made a follow-up visit. Using a written questionnaire, she checked on Tembo’s progress. Tembo, now selling vegetables to make ends meet, spoke of finding a new lease on life.
Dzukwa is a well-known figure in her area, often stopped by people thanking her for her help or requesting her contact information.
“Mental health is no longer something to be ashamed of,” she said. “People are no longer ashamed or afraid of openly asking us to talk.”
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