Dr Dickson Chibanda
The Friendship Bench
When Dr Dickson Chibanda lost a patient to suicide, he was motivated to tackle the issue of mental health access in Zimbabwe. Part of the problem his patient faced was that they did not have $15 to pay for a follow-up consultation. With an over-stretched public health system in Zimbabwe, an innovative approach to mental health provision was needed.
The Friendship Bench trains the elderly to perform basic problem-solving therapy, helping to reduce pressure on the public health system. The sessions are hosted on benches outside primary healthcare facilities, reducing the need for expensive buildings. The screening questionnaire, known as the Shona Symptom Questionnaire (SSQ-14), uses indigenous idioms and expressions to identify mental health challenges. The model has been expanded to focus on youth and people in rural areas, and now uses technology like Whatsapp to reach more people.
Friendship Benches make mental health services more accessible. Basic services are provided to the poor in their own language by people who understand their culture, allowing specialists to focus on more complex cases. The elderly volunteer lay health workers are provided with an opportunity to play an active role in society in their latter years.
By reducing the need for indoor clinic facilities, less materials and energy are required to deliver mental health services.
The Shona Symptom Questionnaire (SSQ-14) has been instrumental in the success of the Friendship Bench approach as it is highly customised to the local context.
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