83. Thinking outside the box to address mental health needs

Rates of depression and anxiety seem to keep climbing higher and higher. Mental health professionals are overwhelmed and unable to keep up with demand, and the shortage of providers is likely to get worse over the next decade. I’ve heard of people being on the waiting list for a therapist for over a year, with no appointment in sight.

Data point of the week
In other countries the shortage of mental health providers is far more dire. Dixon Chibanda is one of only 15 psychiatrists in the entire country of Zimbabwe, which has a population of 16 million. After losing a patient to suicide—because she was unable to travel 160 miles to see him—Chibanda decided he needed to do something to increase access to care.

So, he trained a group of grandmothers to be active listeners, sit on local park benches, and talk with people who needed support. Thus began the friendship bench movement, which has grown exponentially since its start in 2015. Last year alone 60,000 people used the program. (Shout out to Michelle Bowdler for sharing this fantastic article on friendship benches.)

The grandmothers have proven that professionals aren’t the only ones who can provide effective emotional and mental health support. Studies of the program have shown that it reduces mental health symptoms for both the participants and the grandmothers. In fact, after six months, participants who spoke with a grandmother were “better off than those who received therapy from a community mental health nurse or psychologist” on a range of mental health measures.

The author of the article, Kim Samuel, notes that the power of the program “is in how it empowers people to take responsibility for the psychological wellbeing of their community.”

Credit: The Friendship Bench Zimbabwe

Reflection
I love the idea of friendship benches! There will always be a role for mental health professionals … and we need to look for creative solutions to the mental health crisis beyond providing professional 1:1 care. 

Replicating the friendship bench model in its entirely may not work here, but we can learn from its success. What I appreciate about friendship benches is that they:

• Are all about the power of human connection.

• Normalize and de-stigmatize mental health support by taking it out of a clinical environment.

• Increase access by expanding the definition of who offers the support. This increases the numbers of available supporters and allows for more localized options.

• Provide a meaningful role for people in the community. Supporters may feel more valued because they are providing a valuable service.

ProjectConnect embodies many of these elements as well. While the program doesn’t explicitly offer mental health support (participants aren’t necessarily talking about their problems), it does create supportive peer connections, which protect against depression. And by training peers as facilitators, it expands access to listeners, offers facilitators a chance to contribute to their community in a meaningful way, and builds connection.  

If we want to reverse rising rates of depression and anxiety, we need to look for creative solutions that distribute responsibility for mental health beyond the caring professions.

Connection Skill & Action Step: Offer Support
On an individual level, we can offer support to family, friends, and co-workers who may be struggling. Is there someone in your life who could use a listening ear? A word of encouragement? Some time together? Don’t underestimate the value of simply showing up/being there for someone is going through a hard time.

If you’re supporting someone in an ongoing way—or have a lot of people who look to you for support— be mindful of your emotional resources to avoid burning out. Can send a quick thinking-of-you text, or schedule a time to talk when you know you’ll have energy?


Questions. Please share your responses in the comments.
What creative ideas do you have for how we can make a dent in (or reverse!) rising rates of loneliness, depression, and anxiety?

How can we redistribute responsibility for the mental health and wellbeing of our communities, so it doesn’t fall solely on mental health professionals?