The Friendship Bench: Bringing talk therapy into underserved communities

Dr. Dixon Chibanda remembers like yesterday the moment in 2005 that changed his life. “During my formative years working as a psychiatrist, I lost a patient of mine to suicide. Erica was her name. She had hanged herself from a mango tree in the family garden.”

Erica was just 25 years old.

Chibanda, a psychiatrist based in Harare, Zimbabwe, says her family knew she needed help. “They lived some 200 miles away from where I worked,” he said. “And they just didn’t have the equivalent of US$15 to get onto a bus to come to the hospital.”

At the time, there were only 10 psychiatrists serving 13 million people in Zimbabwe. So, Chibanda came up with an idea involving grandmothers: “These grandmas were actually, you know, the custodians of the local culture and the wisdom, and they were rooted in their communities. And I was like, what if we could train them to be the first port of call for anyone needing to talk in a community?”

So, in 2006, Chibanda introduced the “Friendship Bench,” a talk therapy program that brings mental healthcare directly into underserved communities. The program is free, and the grandmothers were happy to donate their time.

He chronicled this journey in a new book: “The Friendship Bench: How Fourteen Grandmothers Inspired a Mental Health Revolution” (New World Library). 

“When I first started this, in fact we called it the Mental Health Bench,” he said. “Interestingly, nobody came to the Mental Health Bench, because of the stigma, until the grandmas said, ‘You know, why don’t you turn it into a Friendship Bench?'”

During that first year, 14 volunteer grandmothers shared a Friendship Bench with several hundred visitors in that one suburb. Chibanda says the program has since expanded beyond grandmothers to include over 3,000 older listeners who last year saw more than 300,000 people all over Zimbabwe.

He said, “There are a lot of people out there who are struggling to just connect with another human being. And this gives them that opportunity, to be able to sit down with someone who is empathic.”

Globally, just under 300 million people are struggling with depression, according to the World Health Organization. Only about one-third of them receive any treatment. And at a time when we’re facing an epidemic of loneliness and isolation affecting 1 in 5 American adults (according to a 2024 Gallup poll), the Friendship Bench is hitting the road, expanding to vulnerable communities in 9 countries and counting, including the United States.

At the Washington Seniors Wellness Center, in our nation’s capital, the program is being piloted by the nonprofit organization HelpAge USA, which focuses on the inclusion of older people.

Seventy-four-year-old Arnette Ibitayo says she was struggling with the deaths of her son and brother. “My son’s was sudden; he had a heart attack at 44,” she said. “And then my brother had COVID.” 

She turned to the Friendship Bench. “So I’m, you know, feeling down, depressed,” she said. “I think I need to talk to somebody, because I felt like isolating and staying home. And it was very comforting to get it out. And I wasn’t judged, and I was able to speak freely, and the person gave me some helpful advice.”

That person was Theresa Kelly, a retired schoolteacher, who listened to Ibitayo’s story. “We don’t solve problems for them,” Kelly said. “Sometimes you don’t realize that you can be your own problem solver. And when they finish, we want them to leave empowered.”

A screening process refers more serious cases to professionals. For almost 20 years now, Dr. Chibanda has been using his medical training to help analyze and improve the program. “The Friendship Bench is actually rooted in a lot of research,” he said. “These grandmas were a lot more effective than trained mental health professionals at alleviating symptoms of both depression and generalized anxiety disorders.”

Arnette Ibitayo said she felt better after just one session with Kelly: “I was more at ease. It worked. It was working.”

“You feel a little less depressed now?” I asked.

“Yes, uh-huh. There’s hope that things are going to be better.”

So, what’s the special sauce when it comes to grandparents? According to Chibanda, it is “the natural abilities that come with having a long-lived life on the planet. They’ve seen a lot. They’ve experienced a lot. They have, you know, the battle scars of life, which they bring to the bench. All we’re doing as Friendship Bench is helping them to use those stories, those experiences, to help others.”

And the bench is giving them something back. Theresa Kelly said, “I love helping people, empowering people. It makes me feel good. Makes me feel that [I have] still another purpose, that after retirement there’s still something, you know, that I can do that can help others, that it’s not over.”

       
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Story produced by Robbyn McFadden. Editor: Joseph Frandino. 

If you or someone you know is in emotional distress or a suicidal crisis, you can reach the 988 Suicide & Crisis Lifeline by calling or texting 988. You can also chat with the 988 Suicide & Crisis Lifeline here.

For more information about mental health care resources and support, The National Alliance on Mental Illness (NAMI) HelpLine can be reached Monday through Friday, 10 a.m.–10 p.m. ET, at 1-800-950-NAMI (6264) or email info@nami.org.

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