How can an elderly lady on a bench improve a community's wellbeing? In this episode of our How To Build Community podcast and radio show, we hear about the 'The Friendship Bench', from one of its pioneers, Clinical Psychologist RUTH VERHEY. Click the link above to listen, or you can read the highlights below.
A community's mental health affects all health outcomes. Ruth explained that high levels of anxiety and depression in a community will have a negative impact on things like medication adherence and child development. This is why the University of Harare began the Friendship Bench project to improve mental health provision in Zimbabwe.
You don’t need extensive mental health training to deliver counselling. They used a network that already existed: community health workers, based in local clinics. In Zimbabwe they are usually elderly women – so they became known as the “grandmothers”. They were trained in problem-solving therapy. “These women come with a high authority,” Ruth said. “They're very respected community members, so what they say counts.”
Problem-solving therapy involves opening up about what’s going on in your life. “We don't try to solve everything but we solve one problem at a time.” And it's had great results. “Although problem solving is such a basic approach it does help people to regain a sense of self-respect and confidence.” It also means that many people are now better informed about their mental health. On finding out they are dealing with depression or anxiety, they feel that “now there's a label to it, there's something that can help them, they can feel a change.
A project like this needs to be safe and sustainable. The therapy takes place on benches within the grounds of the primary health care clinics, making it safe for both the clients and the counsellors. Because it is within the country’s healthcare system it isn’t reliant on external funding that could run out. “At first we worried that people would be stigmatised being seen on the bench, but by now it seems to be very popular,” Ruth told us.
The Friendship Bench offers ongoing support once counselling has been delivered. After going to the bench clients are referred to peer support groups, where they talk and make bags for themselves or to sell. “People have always reported how supportive that was for them, to be in that group where people were non-judgmental and they understood each other.” Many of these groups continue running several years later.
The idea has spread! At the time of recording the interview, there were 72 participating clinics across three cities in Zimbabwe, and Friendship Bench programmes also now operate in Lilongwe, Malawi, and in New York City. Ruth’s advice to those wanting to start up their own versions of the programme is to get in touch (find out how at their website) and she says to remember – “we can use people who don't have education in Psychology or Psychiatry, but who have those soft skills, empathy and being able to listen and be non-judgemental.”