Tag Archives: family involvement

Grandmas and Friendship Benches Help Treat Depression in Africa

Image from CNN.com.

Grandmothers, take note: in Africa, mental health professionals pioneered a method where they used grandmothers and friendship benches to screen people for basic psychiatric services.

In 2004, a man named Dixon Chibanda was one of only two psychiatrists in all of Zimbabwe (a country of about 12.5 million people). He had a patient named Erica who traveled to Harare, the capital city, from a rural village more than 160 miles away to meet with him. Erica had passed her exams at school but was unable to find work. She had hoped to marry a man who chose another woman. She felt worthless.

Chibanda and Erica met monthly for about a year. He prescribed a mild antidepressant, hoping it would help her cope with her difficulties. Then Erica committed suicide in 2005.

Chibanda changed his career path after Erica’s death, focusing instead on helping get mental help for under-served populations like Erica’s village. And he started with the grandmothers.

Grandmothers had been working in public health clinics in Zimbabwe since the 1980s. In 2006, the clinics asked grandmothers to provide basic psychological therapies to people.

Chibanda and the grandmothers decided to put a Friendship Bench under a shade tree. This is where they would ask patients 14 questions to determine if they needed further treatment, such as “In the last week, have you been thinking too much?” or “Have you thought of killing yourself?”

Then the grandmothers would help them through problem-solving therapy to identify the stresses and social issues in their lives and guide patients to find their own solutions. If the patient needed more intensive therapy, the grandmothers would refer them to Chibanda.

In 2016, Chibanda and his colleagues found that Friendship Bench treatment showed “a significant decrease in depressive symptoms.”

I think this is wonderful. There are so many benefits when younger people to connect with the elderly. Elderly people can feel a sense of purpose that is sometimes lacking with age. Young people can benefit from the perspective that comes with their years.

Older people tend to be less stressed themselves (I wrote about a study that stress levels drop off for women when they reach their 50s and 60s) and they can mirror this behavior for younger people through turbulent periods of their lives.

Grandmothers, remember that you are important. Take some time to reach out to your loved ones or figure out ways to mentor vulnerable youth and young adults in your area. It can truly save lives.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958 or email her at satu214@gmail.com. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.


Family involvement and the treatment of Depression

There was an interesting study that came out this month in Psychiatr Serv. 2013 Feb 1. It was a study of Veterans who were being treated for Depression. It confirms what I have believed all along, that is to get the families involved in the treatment of those suffering with Depression.

In this study after questioning patients, it was found that 64% of Veterans did not have family involvement and the rest did. Among those that did it was found that the patients had better social support and medication adherence. This group had much better outcomes than the those that did not have family involvement.

In my practice I have always believed that a patient needs involvement of his family. Not only can family provide support and make sure that a patient takes their medications, a family can provide valuable feedback to the mental health practitioner about how the patient is doing. The family may notice side effects like irritability or anger or lack of social activity of which the patient may not be cognizant. It is common in mental illness for a patient to not have good insight regarding her illness. I often tell my patient with poor insight to ask his/her family how they think he is doing

Another reason I like to involve the family is that I like to educate them about the nature of mental illness and how to best help. Family may have wrong information about mental illness. Sometimes family may believe the patient has a character flaw that would be cured if “he would only try harder”. Proper psychoeducation can help the family be of the best help to the patient.
Depression is one of the top causes of disability benefits in this country. It a serious problem for all of us. I would like to see mental health practitioners include in the care of their patients the participation of families.