The power of grandmothers can boost communities | Opinion

Recently in this space, I discussed the fact that for almost two decades, the suicide rate among black children ages 5 to 12 was twice that of their white peers. The wider point was the lack of mental health resources available to children, especially minority children.

What I didn’t do in my earlier column was mention possible solutions.

In listening to the Oct. 11 episode of NPR’s TED Radio Hour, I heard what might qualify as a possible solution, even if it is outside the box. The program, titled “Erasing the Stigma,” focused on the stigma that attaches to mental health and how that stigma, along with a lack of resources, keeps millions of people from getting the help they need.

One segment featured Dr. Dixon Chibanda, who is one of only 15 psychiatrists in Zimbabwe, a country with about 16 million people. With numbers like that, you can imagine the waiting list and the volume of people who never get help.

Chibanda recounted the night he got a phone call about one of his patients from a hospital over 120 miles away from where he was. Apparently, the 26-year-old female patient had overdosed in an apparent suicide attempt. After the doctor and the emergency room physician discussed the patient’s medical history and treatment plan, it was decided that the she and her mother would travel to see Chibanda for follow-up care.

Weeks went by, and Chibanda hadn’t seen or heard from the patient or her mother. Then, one day, out of the blue he received a phone call from the mother saying that her daughter had committed suicide a couple of days earlier. Frustrated, Chibanda asked why they hadn’t come for the follow-up treatment. The mother said that she didn’t have the $15 for the 124-mile bus trip.

Knowing that there were few options for people in a poor country with a patient-to-psychiatrist ratio of a million to one, Chibanda began thinking about alternatives to treatment by a behavioral health professional. After talking with colleagues and friends, he realized that the most steady and reliable resource in every community was the grandmothers. They care, and unlike young medical students who come from a particular town, they don’t leave to pursue an education or to start their careers elsewhere.

With that insight, Chibanda began training grandmothers in evidence-based talk therapy. Grandmothers would meet people at a “Friendship Bench” placed in centrally located places in each community. According to the psychiatrist, this approach works in his part of the world because grandmothers are considered the custodians of local culture and wisdom. Now, they are also lay health workers who are known as "community grandmothers" in their respective cities.

The United States is not Zimbabwe, but I began to think about grandmothers in our own country. The reality is that many of them (and some grandfathers) are often the only stable presence in their families. How many grandmothers today are raising grandchildren because of drug addiction, incarceration or some other mess? Grandmothers have always played a critical role in the African American community, and I would argue that, today, grandmothers across all racial and ethnic lines are filling this child-care gap as never before.

Accordingly, Chibanda has introduced the Friendship Bench in New York City, and has found that the mental health issues there are similar to those in Zimbabwe. Depression is depression no matter where you live, even if the words we use to describe it differ from place to place.

As for results, six months after treatment from a trained grandmother, many clients remained symptom-free. Chibanda defines symptom-free as no signs of depression, with suicidal ideation completely reduced.

It may not come with a lab coat or be what we consider a Western medicine solution, but the Friendship Bench or its equivalent may be a way to help young people in need. Perhaps the Inspira Health Network, which has done a lot locally in terms of mental health and addiction treatment, might undertake a small pilot project modeled on the Friendship Bench.

In addition to augmenting the more traditional services that health care organizations provide, such a project would be a way to tap into the warmth, strength and wisdom of grandmothers — a formidable force and resource, not something to be dismissed or underestimated. Such is the quiet power of a generation.


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