Dear Editor,
The Caribbean Voice is thrilled that the Friendship Bench concept for mental health has finally been introduced in Guyana. The Rotary Club of Garden City (Georgetown) must be commended for taking the lead in bring to Guyana a concept for which The Caribbean Voice has been lobbying for years.
Launched in Zimbabwe by psychiatrist Dixon Chibanda in 2007 in the township of Mbare, after the suicide of a patient, Erica, the focus of the Friendship Bench concept was on developing a community-based approach to therapy that leverages the power, compassion, and accessibility—of grandmothers. It was developed over a twenty-year period from community research and today, has been replicated around the world.
In an interview with the McKinsey Health Institute in 2022, Chibanda explained the origins of concept, “I think the real tragedy about Erica’s loss was that she knew she needed help; her parents knew she needed help; but they did not have the $15 bus fare to come [from their remote village] to the hospital where I worked, some 200 miles away, for a follow-up. And I was hit hard by the realization that I had taken for granted that people who needed my services could find me at the hospital. That was really the beginning of a soul-searching journey to find my place in the world, as a psychiatrist but also as a human being. I realized I had to take psychiatry out of the hospital, into the community”.
He also detailed how the concept works, “The Friendship Bench—in really simple terms—is a brief psychological therapy, or talk therapy, that is delivered predominantly by community grandmothers who are trained in the very basics of cognitive behavioral therapy. After that training, which normally takes a month, they are allocated a wooden park bench in their communities. Our team then facilitates referrals to those benches through social media, primary healthcare facilities, schools, and police stations. The grandmothers then screen everyone who is referred to them using a locally validated screening tool. Selected cases go on to receive this structured therapy on the bench, and, after two to four sessions, they are invited to join a support group within the community where they begin to collectively problem-solve around common challenges. Friendship Bench starts off as a one-on-one therapy between a grandmother and a client, then goes on to a peer support system that can go on and on.”
Now that this concept has touched the shores of Guyana it must be replicated in all communities. Benches can be built by local businesses and various other organizations within each community and located in appropriate surroundings to foster the comfort, the trust and open exchange necessary. Various organizations can also build and be responsible for one or more benches and community leaders and others can reach out to those in the Diaspora to sponsor benches. As well, local artists can decorate the benches with appropriate art work and flowering plants can also be planted or placed in the vicinity to create a soothing ambience and make the process a truly community one.
In his interview Chibanda noted that “grandmothers working on Friendship Bench were a lot more resilient and less likely to have PTSD [post-traumatic stress disorder] and other common mental disorders. When you go deeper in the research, the common thread or response from the grandmothers is that it gives them a sense of purpose.” And Caribbean people know very well the powerfully constructive roles that grandparents play in extended families.
While the Rotary Club of Garden City did not indicate how their designated mental health bench would operate, we hope that it would be along the lines outlined by Dr. Chibanda above.
Thus, there is need for nationwide training to man or woman the benches, (grandmothers, community volunteers, NGOs, Faith Based and Community Based Organizations, educators and possibly grandfathers also), for a structured system to ensure referrals and to monitor and support the process. Perhaps the lay counselor and community health worker training offered through the Ministry of Health and the community advocates training offered by the Ministry of Human Services and Social Security can also now embrace talk therapy.
Yours faithfully,
Annan Boodram