Reflections: Healing on the friendship bench
Thresholds, July 2025

When Dr Dixon Chibanda lost a patient to suicide, he began a soul-searching journey that eventually led to a mental healthcare revolution. As one of only six psychiatrists in all of Zimbabwe, a country traumatised by decades of conflict, Chibanda quickly realised that millions there were suffering from mental illness with no hope of receiving care. He saw that the only way to narrow this care gap was to leverage existing resources in the community, and one such resource was the compassion and understanding of grandmothers.

With 14 of these wise elders as partners, Chibanda pioneered the Friendship Bench programme, a community-driven initiative addressing loneliness, depression, substance abuse and suicide by fostering intergenerational connectedness.ÌýSince then, more than 500,000 people worldwide have sat on a park bench to share their personal stories with an empathetic grandmother.

Chibanda’s new book The Friendship Bench is a case study of how interventions supported by robust scientific evidence can be made accessible for all. Ultimately, it is a celebration of the collective wisdom and knowledge of those rooted in their communities, and their profound ability to foster belonging, purpose and healing. We hope you’ll enjoy this excerpt overleaf. More than two very full years had passed since I’d met the wonderfully wise, extremely opinionated, and generously dedicated grandmothers of the Friendship Bench. They had become more than just my friends, colleagues and mentees – in many ways, they were my true teachers.  

My life as a psychiatrist had not allowed me to be so deeply rooted in the larger community of Harare, as I often spent long hours at the hospital attending to patients and the relentless administrative work that is a large part of being one of a small handful of medical professionals in my specific field. But as I spent time with the grandmothers, learning about their lives and going on site visits to the community in Mbare, I was touched by the depth of their care for the people around them, which I was able to see firsthand.Ìý

Often, when I was at the clinic in Mbare, I would watch from a distance as the grandmothers offered sessions to community members. Sometimes, with a client’s permission, we would also randomly record audio of the sessions on the Friendship Bench, so that we could evaluate programmatic fidelity by measuring the extent to which our intervention was following the model we’d set forth. Such evaluations are always extremely important when it comes to developing an effective model and implementing an evidence-based programme, and indeed they would prove to be so in the near future.

I was touched by the willingness of the grandmothers to reveal their own vulnerability. I could see how this melted their clients’ reservations, how the clients’ tightness and even embarrassment often gave way to laughter, to tears, to the joy of recognising that they were understood and cared for. The grandmothers had a way of establishing a rapport, a therapeutic alliance, that was like nothing I’d ever seen before – except, perhaps, in the single voodoo ceremony I had been fortunate to witness.Ìý

It was not merely their sense of responsibility to their community that propelled their work; for them, it was the only way they’d ever lived and breathed: in connection to everyone around them. This was as true for their pain and sorrow as for their joy and laughter. While I had adopted a more Western way of thinking about people in relation to life – as atomised parts of an always fragmented whole – the grandmothers recognised something that the world at large is now beginning to see and honour: we are all connected, and if we don’t realise this soon enough, our persistent sense of isolation might tear us apart. I began to apply this lesson in my daily psychiatric work and also in my regular interactions with people, trying to be present in the moment. This made me a lot more open to culturally rooted perceptions of wellbeing and mental health that were an alternative to Western approaches. During my travels, whether I was in Brazil or China, or any of the other places where I was increasingly journeying to share the Friendship Bench model, I observed how people actually interacted with one another in the favelas or the villages and among the Indigenous peoples, who often had their own sophisticated approaches to connection and social cohesion. Although I had favoured Western models of care for so long, working with the grandmothers helped me to see where these models were limited – and where my own blind spots were keeping me from being the force of change I badly wanted to be.  

More and more, I found myself loosening up around my clinical approach. At this time, I also shared the progress I was making with Dr Sekai Nhiwatiwa, who was a senior psychiatrist and my mentor. She enthusiastically suggested that I stay focused on this important work, as everything we were doing with the Friendship Bench presented possible solutions to the mental healthcare gap that Zimbabweans had faced for too many decades.Ìý

Of course, I had selfish reasons for continuing with the work, despite the fact that we had no institutional support to speak of. I enjoyed talking with the grandmothers and learning about their distinctive approach, and the work gave me a sense of purpose that helped assuage the vulnerability and remorse I continued to feel around my patient’s death.Ìý

Aside from the fact that the Friendship Bench was serving an indirectly therapeutic purpose for me, the message was clear: the community itself could address many of the challenges that mental health professionals had assumed for so many years. Not every problem that the people faced required a specialist or professional who would poke and prod at their ‘pathologies’ through an ‘objective’ lens. People could talk to an empathetic layperson – a loving grandmother – and receive the care they’d probably been in search of all along.Ìý

 My eyes were wide open, and they stayed that way. All of this experience transformed how I provided care to my own patients. I began to emphasise community resources even more than before. And when I interacted with a client at the hospital, I found out who at home or in their community might be able to provide consistent support. If possible, when I connected with someone who lived in Mbare or close by, I thought to link them up with one of the grandmothers or to an existing peer support group. I could imagine that the grandmothers’ bedside manner would help to ease the nerves of many a traumatised or disturbed person who walked through the doors of the hospital.

Perhaps most notably, I became much more cautious about prescribing medication. It isn’t that I believed it wasn’t essential; there were certainly situations in which it clearly was. At the same time, context was important. I realised it was premature to put someone on a regimen of medication without knowing more about their story, their struggles, how they’d come to sit before me in the first place. I certainly didn’t think it was necessary to put people on antipsychotic medication for lengthy periods of time. Little by little, just as I was transforming, so was my practice.Ìý

Excerpted from The Friendship Bench: how fourteen grandmothers inspired a mental health revolution. Copyright © 2025 by Dixon Chibanda, MD. Reprinted with permission from .Ìý