Depression is a taboo topic of discussion in Zimbabwe. But, Friendship Bench is an organisation working with grandmothers to encourage people to talk about their mental health.
Defined as Kufungisisa (thinking too much) in Zimbabwe, depression and mental health is often not given the same attention as other medical conditions due to misconceptions. But the Friendship Bench has come up with mechanisms to support and help people with mental health issues.
Screening
To find out if someone is depressed, the grandmothers use a screening tool, known as SSQ14 (a questionnaire with 14 questions).
Answering yes or no, the questionnaire provides critical information for the grandmothers to know if a person is likely to be suffering from depression.
“Every ‘yes’ answer counts one point. To score the questionnaire result, we simply add the ‘yes’ answers. If someone has more than nine points, we know that this person is very likely to suffer from Kufungisisa (Depression),” Friendship Bench, Country Coordinator, Chengetayi Nyamukapa said.
If a person’s questionnaire states they are nine and above, they would be immediately recommended for treatment by Lay Health Workers (LHW), mostly made up of mature ladies or grandmothers who have received training in problem solving therapy (PST).
Depression and Covid-19 in Zimbabwe
According to Nyamukapa, the organisation has dealt with more cases of depression during lockdown, most likely due to the adverse effects of the global COVID-19 pandemic.The grief of loved ones, job losses and the disappearance of normality as we knew it, are among the several reasons why Zimbabweans are suffering depression, Nyamukapa said.
“Cases of depression grew during the Covid-19 period. This was due because many people lost their jobs during the lockdown and many people in Zimbabwe are self-employed and because of the lockdown the business was down.”
The Zimbabwean economy, which was already on a downward spiral before Covid-19, has further taken a knock with millions losing a source of livelihood.
With prices of basic goods and services skyrocketing, unemployment remains at 90 percent - with millions left jobless. Amid worsening economic fortunes, humanitarian organisations have intervened with food aid.
Nyamukapa stated that although economic pressures remain a major cause for depression, domestic violence is also a major trigger. She explains to me, “Domestic violence also increased leading to people being depressed during lockdown.”
Why grandmothers?
Due to the shortage of physiatrists in Zimbabwe, Friendship Bench has come up with unique counselling personnel in the form of grandmothers.
Zimbabwe only has 17 registered physiatrists for a country of 15 million. Furthermore, Zimbabwe only has six psychiatric hospitals. This has created a huge gap between demand and supply of the professionals, and those needing access to mental health resources.
In Zimbabwean culture, grandmothers are well respected for their life experiences and wisdom. They have an excellent ability to understand a wide array of social issues including job stress, family feuds, sexual problems and much more.
Friendship Bench works with 482 grandmothers, who before the Covid-19 pandemic would be stationed at hospitals and clinics around the capital Harare.
“We often refer to them as ‘grandmothers’. We work with the grandmothers because they are a group of people who can be able to understand what people are going through especially from their life experiences and the vast scope of knowledge they have gained from working with different kinds of people in years,” Nyamukapa said.“The other reason could be that a number of people feel more comfortable talking and confiding in older people than younger ones.”
To show support and help for people dealing with mental health issues, the government adopted The Mental Health Strategy, amid concerns that only 0.42 percent of the budget is set aside for mental health.
Virtual benches
Due to the global Covid-19 pandemic, the grandmothers shifted to technology to provide counselling services.
“During lockdown we switched from having physical counselling sessions to having them online using the Whatsapp platform. People had to book for a session and have a therapist assigned to them at the comfort of their homes or environments,” Nyamukapa said.
Nyamukapa revealed through physical counselling sessions, virtual and radio sessions, the initiative has reached 78,000 people since 2016.
In Zimbabwe, people suffering from depression and mental health issues often seek religious or traditional help before approaching medical professionals.
“The Zimbabwean society has little of any understanding of issues to do with depression as a mental health disorder. It is one of the most underrated health issues and people in communities, therefore, do not bother getting help or do not prioritize getting counselling because they believe that all this is spiritual and they feel it has to be dealt with spiritually, hence they approach traditional doctors and prophets first before seeking any medical help,” Nyamukapa said. “People suffering from depression do not try to get help because they feel whatever they are going through will change with time, which might not be the case. Action must be taken for depression to be addressed.”
Organisations such as Friendship Bench are innovative, integral and supportive in helping people with mental health issues. By providing a safe space where people can talk about their mental health, Friendship Bench has helped thousands, especially during the global Covid-19 pandemic. With only 17 physiatrists in the country and still a lack of investment in mental health, individuals like Dr Dixon Chibanda, who began the programme in 2006, are needed more than ever.
For more mental health resources, make an appointment with your local health professionals or visit the MIND charity website.