Most often, a grandmother is one of our greatest support systems: a mentor, teacher, parent, and best friend rolled into one. So, it’s no surprise that when Dr. Dixon Chibanda wanted to revolutionize the mental health care landscape in his country of Zimbabwe, he turned to grandmothers, a bedrock of empathy, validation, and care in his community.
In his 2017 TED Talk, Dr. Chibanda narrated how, in his country of 14 million people, he was one of just 12 psychiatrists. He talked about Erica, one of his patients, who he lost to suicide. Erica’s family was unable to bring her to the hospital where Dr. Chibanda worked because they could not afford the bus fare, which amounted to 15 USD. It was this tragedy that changed the course of his career as he realized the stakes of bringing urgent mental health care to people across the country.
As grandmothers were the cornerstone of almost every community in Zimbabwe, Dr. Chibanda integrated the indispensable role of grandmothers in communities with scientific principles of cognitive behavioral therapy (CBT). CBT has long been demonstrated as an effective psychotherapy method to change negative patterns of thinking and behavior to treat conditions such as depression, anxiety, and other mental health disorders. Dr. Chibanda began an initiative where patients needing mental health care could talk to someone on a bench in a park. He called this intervention the Friendship Bench; it utilized the wisdom, experience, and healing abilities of grandmothers in the community to offer them support and care, from guiding them on how to navigate life's challenges to simply listening to their worries and struggles.
Over the years, this community-driven initiative has expanded to over 3,000 older listeners who last year saw more than 300,000 people all over the country. Clinical trials have shown its effectiveness in potentially closing the mental health care gap in Zimbabwe, with patients receiving treatment from the Friendship Bench reporting significantly lower symptom scores compared to patients receiving enhanced care delivered by medical professionals (Chibanda et al., 2016). With such striking results, the Friendship Bench has not only become a sustainable community intervention that provides accessible care but has also offered a scalable model for many communities beyond Zimbabwe. Indeed, since its inception in 2006, the Friendship Bench has expanded to other countries, including Malawi, Tanzania, Kenya, Vietnam, Jordan, the UK, and the US.
Today, around the world, approximately 332 million people—a figure roughly equivalent to that of the entire United States population—suffer varying degrees of the hopelessness, emptiness, and feelings of dejection that come with depression. In cultivating intergenerational friendships, Dr. Chibanda’s innovative approach has helped the world break some of the barriers to mental health treatment, including social stigma and a lack of awareness, investment, and skilled professionals.
With only a third of individuals with depression currently receiving adequate mental health care, even in high-income countries (WHO, 2025), initiatives like the Friendship Bench are crucial to overcome these obstacles and ensure the UN Sustainable Development Goal of good health and well-being. Dr. Chibanda's program offers an effective yet feasible model that can be implemented worldwide to change the narrative for communities that have suffered from a lack of mental health care. Ultimately, the wealth of wisdom, knowledge, and lived experience that grandmothers or similar peer listeners can provide is a crucial first step in empowering individuals to overcome their struggles with mental health and navigate the challenges of life with resilience and purpose.