In “Five Who Spread Hope in 2019,” Tina Rosenberg profiles five people who are changing the world for the better, despite it being a year of many dispiriting headlines. The article includes the story of Dr. Dixon Chibanda, who is transforming global mental health care:
Depression occurs everywhere. By some measures, it’s the world’s most debilitating disease.
But treatment is not everywhere. Even in New York City, less than 40 percent of people with depression get treatment. In poor countries, it’s closer to zero percent.
So what can be done in places with no public mental health care and only a tiny number of mental health professionals?
As with medical care, the answer is training nonprofessionals.
Every health clinic in Harare, Zimbabwe, has a “friendship bench” in its yard. It’s an ordinary wooden bench. Seated on it is a community health worker with a few weeks’ training in problem-solving therapy.
Patients go to the bench, talk to the health worker about their problems and come up with possible solutions. They go home and try them, and return.
The friendship bench was invented in 2006 by a psychiatrist, Dixon Chibanda, after a patient committed suicide. He had asked her to come see him at Harare Central Hospital, but she lived in another city and didn’t have bus fare.
Dr. Chibanda decided to bring treatment for depression to Harare’s health clinics. At first he wanted to train nurses and put offices inside the buildings, but the nurses had not enough time and clinics had not enough space. But what seemed like a setback is what has allowed the program to spread.
Now, there’s a bench in the yard of every government-run health clinic in Harare, and the practice is spreading throughout Zimbabwe and to other African countries. In a different form, the strategy has also reached New York.
Research shows that friendship benches are effective at treating depression. And what makes them even more valuable is that they are cheap and piggyback on government services. They provide a treatment that works — and that could reach anyone.
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