Friendship Bench by Pauline Reid

Chibanda, Dixon, MD, The Friendship Bench: How Fourteen Grandmothers Inspired a Mental Health Revolution, New World Library, 2025.

Imagine if you will a park bench tucked away amid shady trees in a quiet corner of the neighborhood. You find a grandmother on that bench, with pillows for her comfort and for the comfort of anyone who would like to join her. Maybe she even has a beverage and an extra cup.

This grandmother has lived a life full of experiences, ups and downs, happy times and sad times, taking care of others as well as herself. Life lessons that fill her with empathy, compassion and understanding.

What would it be like to join the grandmother on her bench? To have a conversation with someone who listens as you share the story of your ups and downs, of your fears, angers, anxieties and concerns. Maybe you’ll feel the relief of ‘letting go’ of your feelings to a kind grandmother. Maybe the grandmother, with all her experience, offers you suggestions to help you move forward. Maybe she helps you change your perspective, and you see a way open before you, a way out of your fear or depression or anger, or whatever is holding you ‘down’. Maybe she helps you take the first step forward on that path, even if it is scary. Maybe just her listening, her encouragement, her compassion, starts you on your path to healing.

Welcome to the Friendship Bench.

Dr. Dixon Chibanda, a psychiatrist living in Zimbabwe, developed the idea of the Friendship Bench. Zimbabwe in 2005, with a population of 12 million, had only 7 psychiatrists in the whole country. Years of struggling with the lasting impact of colonialism and the turmoil that followed Zimbabwe’s independence, the devastation of Murambatsvina, HIV/AIDs, poverty and often seeing ‘no way out’, left many Zimbabweans suffering from depression. Indeed, in 2021 the World Health Organization lists Zimbabwe as #7 in countries with the highest suicide rate. (USA is at #31 out of 183 countries.) Add to that the fact that mental health care is expensive, may not be offered in rural communities, and often is considered shameful in Zimbabwe. Even if they could, people might not seek formal mental health care. It was the suicide of one of his patients that led Dr. Chibanda to create the Friendship Bench. He chose to create the program with grandmothers.

Why grandmothers? "These grandmas were actually, you know, the custodians of the local culture and the wisdom, and they were rooted in their communities.”  “…what if we could train them to be the first port of call for anyone needing to talk in a community?" “Grandmothers weave together the fabric of community so that people’s fears, their shame, and their loneliness might be alleviated, so they might realize that the burdens of life are never meant to be carried alone.” Zimbabwe has a tradition of honoring elders and respecting the wisdom they have gained throughout their lives.

The grandmothers (and some grandfathers) are volunteers from the community, without any prior medical or mental health experience. They are trained to counsel people using a cognitive behavioral therapy approach to address 'kufungisisa' – the Shona word closest to depression that means “thinking too much”. Grandmothers typically meet with a person for six 45-minute sessions. The sessions are free.

In his well-written and uplifting book, Dr. Chibanda describes how he found the initial 14 Grandmothers, and how they opened his eyes to new ways and ideas of helping the people of Zimbabwe. Leaving the Western psychological approach behind and focusing on the local culture, the grandmothers taught him that the keys to helping the people of Zimbabwe are to ‘open the mind’, to ‘uplift’ and to ‘strengthen’. Much of this is done by listening, hearing the person’s story with empathy, and helping them connect with community. “…that opening of the mind that came through the power of having one’s story heard and held with compassion and acceptance, leading to a change in a client’s perspective.” Perhaps starting their time on the Friendship Bench with these simple words spoken by Grandma Jack, “I’m here for you. Would you like to share your story with me?”

As of 2023, Friendship Bench has trained over 3,000 “grandmothers” (community health workers), seen more than 623,992 clients, established 739 peer support groups and is active in over 300 primary health care settings. Its impact, published in JAMA, showed 80% reduction in depression and suicide ideation, and a 60% improvement in quality of life.

So far Friendship Bench has been replicated in 9 countries (El Salvador, Botswana, Malawi, Tanzania, Kenya, USA, UK, Colombia, and Vietnam). It partners with organizations and government structures to deliver the model, adapting to the unique cultural needs of each country.

A Friendship Bench. A simple concept. People helping people in their community by listening and hearing in a comfortable, safe setting. It gives me a little bit of hope for the world.