Training lay health workers to deliver cognitive-behavioural therapy (CBT) could offer a ‘blueprint’ for tackling the mental health crisis in Africa, according to researchers from King’s College London.
The Friendship Bench, a brief psychological treatment delivered by lay health workers in Zimbabwe, was shown to dramatically improve the symptoms of patients with mental health problems in new research published by JAMA.
It found patients with depression or anxiety symptoms who received problem-solving therapy through the programme were more than three times less likely to have symptoms of depression after six months, compared to patients who received standard care (14 per cent of patients in Friendship Bench group compared to 50 per cent patients in control group).
Zimbabwe has a large treatment gap for mental, neurological and substance use disorders, with only 10 psychiatrists serving a population of 15 million. The Friendship Bench offers an opportunity to fill this void and make a real difference to the lives of those with mental health problems.
Dr Dixon Chibanda, from the University of Zimbabwe who co-founded the Friendship Bench Programme.
The Friendship Bench consists of six structured 45-minute one-to-one counselling sessions delivered on a wooden bench in a discreet area within the grounds of a clinic. They are given by supervised lay health workers, known as ‘grandmother health providers’, who have received training in problem solving therapy.
The trial was conducted by the University of Zimbabwe, the London School of Hygiene & Tropical Medicine and King’s College London, and supported by the Government of Canada through Grand Challenges Canada.
King’s College London is privileged to have been connected with research on depression in Zimbabwe for over twenty years. One of the most exciting aspects of the Friendship Bench is that it has emerged through empowering local health workers to use their own natural skills, bolstered by training in evidence-based problem-solving therapy.
The Friendship Bench is set to become the largest mental health programme for depression in any low-income African country, being feasible to scale-up, low cost and culturally acceptable.
Dr Melanie Abas, co-author and Associate Professor in Global Mental Health from King’s College London
Melanie Abas (right) pictured with a Friendship Bench supervisor.
Read the full story on the King’s website.