AS Zimbabwe’s Health and Child Care Ministry intends to adopt the Friendship Bench community mental health initiative, a research published on Lancet Psychiatry has shown that psychosocial therapy interventions is effective in bridging the mental health gap in low income and middle income countries.
By Kudakwashe Pembere
In Zimbabwe, there is a globally renowned intervention named the Friendship Bench where community health workers such as the Mbuya Utsanana and even the youth are used as psychotherapists.
The Health Ministry in its 2019-2023 Mental Health Strategic Plan in the adoption of the Friendship Bench as a Ministry of Health program, there will be, “Training of district mental health focal persons and primary care counsellors in friendship bench principles (screening for common mental health disorders, basic problem solving therapy, behavioural activation and referral guidelines) in pilot districts.”
The Ministry wants Friendship Benches set up at selected clinics in the pilot provinces and community awareness about the availability of the service done.
There will be a Roster for primary care counsellors to cover the bench and weekly supervision of primary care counsellors by local clinic nurses and the district mental health focal person,” says reads part of the strategic plan.
Psychosocial interventions, broadly defined as non-pharmacological interventions focused on psychological or social factors, can improve symptoms, functioning, quality of life, and social inclusion when used in the treatment of people with mental health conditions.
“Mounting evidence has shown the enormous impact of mental disorders on the global burden of disease. Considering the broad consequences of untreated mental illness on the individual and society, it is imperative that immediate efforts be made to expand mental health services and reduce the global treatment gap. At the same time, guidance of the implementation of specific mental health interventions by a strong evidence base is imperative to properly prioritise scarce resources in low-income and middle-income countries (LMICs), where 90% of the world’s population resides,” reads the paper.
The paper notes that psychosocial interventions are typically delivered by mental health professionals.
“In LMICs, however, very few mental health professionals might be available; therefore, for feasibility reasons, mental health interventions might be delivered by non-specialist professionals, including nurses without psychiatric training, lay health workers, or peer support workers,” notes the study. “Psychosocial interventions delivered by these workers might be less efficacious.”
In the study, psychosocial interventions included any non-pharmacological intervention focused on psychological or social factors, including, but not limited to, individual, family, or group psychological therapies, education, training, or guidance.
“Interventions with one or multiple components were included. Mental health conditions included any mental health problem along a continuum from mild, time-limited psychological distress to chronic, progressive, and severely disabling conditions,” states the study.
The study also recommends that to close the mental health treatment gap in LMICs, urgent dedication of policy, funding, and research to support the effective implementation of interventions with strong evidence is key, as is continued and more focused research on evidence-based interventions in contexts with less conclusive literature.
“Together, this work can support the development of solutions that promote equitable access to effective mental health services and advance wellbeing worldwide,” states the study.