At special “Friendship Benches” in Zimbabwe, people struggling with depression and anxiety can find support from respected older women in the community who have been trained in mental health counseling — a potentially life-saving initiative in a country with only 12 psychiatrists to serve a population of 16 million.

Dr. Dixon Chibanda, a psychiatrist at the University of Zimbabwe, first came up with the idea of training community counselors, who are also known as  “grandmother health providers.” A recent study published in the Journal of the American Medical Association shows that the Friendship Benches are making a big impact; while half of patients who received the standard treatment still showed symptoms of depression six months later, only 13% of those who participated in the Friendship Bench program still had symptoms. Dr. Melanie Abas, a psychiatrist at King’s College London and one of the study’s authors, praised the system: “This is really one of the few examples where treatments for common mental health problems have been delivered by people who actually live and work in the community.”

Mental illness is highly stigmatized in Zimbabwe; traditionally, people suffering from depression seek out a healer to perform an exorcism as mental illness is viewed as a curse. While many people are loathe to seek out treatment from a doctor, they are often open to the low-key alternative of talking to a community counselor on a park bench. The counselors avoid using Western terms like “depression”, instead referring to the mental health condition as kufungisisa or “thinking too much.” As Chibanda explains, “We use indigenous terms. These are words that people in the community can identify with.” Incorporating respected women from the community as counselors also helps create a sense of community support, says Brandon Kohrt, an assistant professor of psychiatry at Duke University. “It’s just a great model, and it’s impressive,” he observes. “The lessons from this can be applied globally, even in high income countries.”

One of the people who has benefited from the Friendship Bench program is 50-year-old Florence Manyande, whose husband had abandoned her in 2010, leaving her and their three children homeless and without family support; she even struggled with thoughts of suicide. An accident in the spring of 2016, however, turned out to be a stroke of luck; a health worker who stopped to help her after she was struck by a car introduced her to the Friendship Benches. The counseling she received not only helped quell her suicidal thoughts, Manyande was also able to build community connections that have helped her rebuild her life: “I made a friend who introduced me to a sister who had accommodation,” she explains. With housing she was able to start crocheting bags to sell to make money and she’s hoping to find full-time employment soon. “I realized at the Friendship Bench I have someone who is willing to listen to my problems,” she says. “I was so happy about that.”