• The Friendship Bench: changing lives in Mbare and beyond

Since 2010, ZHTS has been supporting the “Friendship Bench” in Mbare township, Harare.

In Zimbabwe there are no community mental health services provided by the government and the country only has a handful of trained psychiatrists in government practice. However, more than 25% of people using primary health care in Zimbabwe suffer from common mental disorders. Mental illness is among the top five leading causes of disability worldwide, but the problem can rarely be tackled in isolation. For example, depression is more common in people living with HIV, and is associated with accelerated disease progression and poor outcomes.

Mbare Township in Harare is characterised by poverty and high unemployment. It has the highest rate of TB in the city, and childhood malnourishment is common.

Yet, Mbare is leading the way on mental health care. This is thanks to the Friendship Bench, supported by ZHTS. The Friendship Bench is a group of all-female lay workers empowered by Mbare’s government health clinics to deliver community health education and chronic disease support.

Known locally as “ambuya utano” (grandmother health providers), the Friendship Bench volunteers have received training in the screening and management of psychosocial problems and depression. Supervised by a case manager with training in systemic counselling and experience of social work, the workers are able to offer clients a structured intervention based on simple cognitive-behavioural therapy, with access to a psychologist, psychiatrist and community support as needed. Home visits are also undertaken.

ZHTS has helped finance the training and supervision of the lay health workers and supported project expansion to support the mental health needs of pregnant and post natal women.

Since 2006 over 5000 people have been seen and supported with good outcomes.

From 2016, the Friendship Bench and the training model is being scaled up to support the needs of other communities in Zimbabwe and beyond.