By Susan Winter Fledderus
I recently read a BBC article about a team of grandmothers in Zimbabwe who are remarkably effective at treating depression. The treatment consists of conversations on a bench.
Often uneducated, these grandmothers are community volunteers with only some basic training in helping people talk about issues in ways that help them arrive at their own solutions. These grandmothers are often resilient survivors of the same social traumas as those they speak with.
The Friendship Bench program was developed by psychiatrist Dixon Chibanda, who realized that he and the few other psychiatrists in Zimbabwe are unable to meet the mental health needs of all those in his country through traditional psychiatric treatments. He recognized the need to find helpers who were accessible in every community across the country.
In his 2017 TED Talk entitled Why I Train Grandmothers to Treat Depression, he describes how he teaches grandmothers some skills in listening, empathy and basic cognitive behavioural therapy approaches. His research shows that the grandmothers are more effective at treating depression than doctors. He has a vision of creating a global network of grandmothers all over the world to reduce the treatment gap for mental heath disorders.
The Friendship Bench program has been so effective at reducing the symptoms of depression that it has spread to other communities, including Malawi, Zanzibar and New York City, where not just grandmothers, but a wide range of people provide conversations on a bench in their communities.
In communities where so many have trouble accessing care, whether in low-income countries like Zimbabwe or wealthy countries like Canada where so many still have trouble accessing timely and affordable mental health treatment, the Friendship Bench program is a model we could all benefit from.
The model is spreading. There are yellow Friendship Benches popping up locally, with one at McMaster University, and two at schools in Burlington. In fact, there is a growing list of yellow bench locations at schools across Canada.
I’m imagining that spending time on such a bench when initial symptoms of depression or anxiety first show up could prevent a more significant mental health crisis for many, leaving the formal crisis and psychiatric services better able to serve those who need their more specialized care. As I was thinking about the implications of this, I imagined the yellow bench movement growing beyond just schools, and spreading across Hamilton, Ontario and Canada.
But then I imagined something else. What if we were all a little more equipped to have such conversations on benches? What if we all felt comfortable enough to talk about things like depression, anxiety, addiction, trauma and suicide? What if we all had some ability to listen with empathy, and ask a few good questions to help a friend or family member find their next steps on a difficult path? What if we knew enough about emotional and mental health to recognize the signs when further support or care from a professional is needed, and knew how to help make that connection?
Because really, how good are we at talking about mental health? I hear from many people who feel very isolated when depression creeps into their lives, who find friends drop away or don’t know how to talk with them. I hear from those with anxiety struggling with unhelpful messages of “just get over it” that they hear from well-meaning partners. I hear of teens who text their friends at 2 a.m. when they are feeling distraught or suicidal, because they don’t see their parents as safe people to confide in. I hear of those who find the things co-workers, siblings, faith leaders and others say more hurtful than helpful when they are struggling emotionally.
But what if those friends weren’t scared off by depression, and partners knew exactly what to say to help their loved one through a panic attack? What if the youth being texted at 2 a.m. has the ability to respond well to help their friend through a difficult night and get to some additional help in the morning? And what if parents were able to send their kids signals that they are always ready to have conversations about the hard stuff? What if there were at least a few people in each of our social circles that are equipped to have such Friendship Bench conversations?
The good news is that there are ways to get that training! Programs such as Mental Health First Aid are already in place and have trained more than 400,000 Canadians since 2007. Their basic, 12-hour course can give anyone a framework for having a confident conversation about mental health with family, friends, colleagues and strangers.
Similarly, LivingWorks offers training to help people notice and respond effectively to cues about suicide risk, with programs such as the half-day SafeTALK training, two-day ASIST training and even an online esuicideTALK course available.
Whether you are a person people naturally talk to about difficult things, or whether you can’t even imagine going there yet, you too could become an important resource for your family and friends. By taking a bit of training, we all can be ready to have better conversations about mental health, just like the grandmothers on benches in Zimbabwe.
Susan Winter Fledderus is a Clinical Therapist with Shalem Mental Health Network