This country has only 10 psychiatrists. That's where 'professional grandmothers' come in.
Getting mental health care in America can be difficult. In Zimbabwe, it's near impossible.
The country is home to 15 million people and only about 10 psychiatrists. For comparison, the United States has at least 24,000 psychiatrists. But depression and anxiety are not just a first world problem.
"Common mental disorders impose a huge burden on all countries of sub-Saharan Africa," said health researcher Dr. Dixon Chibanda in a press release.
Zimbabwe has a secret weapon though: the Friendship Bench.
Image from The Friendship Bench Project, used with permission.
Developed from over 20 years of community research, The Friendship Bench Project is a different and smart way to tackle mental health care.
You can find one of the inviting benches outside some of Zimbabwe's many health clinics. Sitting down, you might get a visit from an older woman. These women are known as golden ladies or grandmothers. You can talk to them. They listen. Then, they might help you identify problems in your life or give you advice to help you feel positive and in control.
Its might seem simple, but these grandmothers are health workers — and very effective.
Photo from Grand Challenges Canada/Flickr, used with permission.
They're not just dispensing random advice. The grandmothers are health care workers who've have been trained in what's called problem-solving therapy. And it turns out it could be a pretty effective strategy.
A recent study published in the Journal of the American Medical Association compared the grandmothers against the usual care options, including a nurse assessment or optional medications. The study found that after six visits to the Friendship Bench, visitors were three times less likely to have the symptoms of depression six months later (50% versus 14%). The results were even more striking for anxiety or suicidal thoughts.
There were, of course, a few limitations to the study. Not a lot of men signed up, for example. And there's some more nuance, like exactly how the comparison was done. If you're interested, the full text is here. But the bottom line is that it seems to have worked.
Better mental health care is important for everyone, but low- and middle-income countries may need it especially badly.
"In many parts of Africa, if you are poor and mentally ill, your chances of getting adequate treatment are close to zero," said Karlee Silver in a press release about the Friendship Bench Project. Worse still, in many places in Africa, there's still a stigma — sometimes very serious stigma — around mental disorders and mental health care.
And all this adds up. In addition to adding to human suffering, the cost of treating mental health problems and lost productivity are estimated to cost low- and middle-income countries $870 billion a year. The number may grow to more than $2 trillion by 2030.
That's why it's so heartening to see clever programs like The Friendship Bench Project at work.
Photo from Grand Challenges Canada / ZAPP.
So far, over 27,500 people have used The Friendship Bench Project.
The program's been working with a number of other organizations too, such as the Zimbabwe Ministry and Health and Grand Challenges Canada. They are currently located in a few of Zimbabwe's cities, including Harare, the capital, but are planning to expand to even more clinics.
They also plan to reach out to more vulnerable populations, such as youth or refugees, in the future.
There's a reason why some people can perfectly copy accents, and others can't
Turns out, there's a neurodivergent link.
A woman in black long sleeve shirt stands in front of mirror.
Have you ever had that friend who goes on vacation for four days to London and comes back with a full-on Queen's English posh accent? "Oooh I left my brolly in the loo," they say, and you respond, "But you're from Colorado!" Well, there are reasons they (and many of us) do that, and usually it's on a pretty subconscious level.
It's called "accent mirroring," and it's actually quite common with people who are neurodivergent, particularly those with ADHD (Attention Deficit Hyperactivity Disorder). According Neurolaunch, the self-described "Free Mental Health Library," "Accent mirroring, also known as accent adaptation or phonetic convergence, is the tendency to unconsciously adopt the accent or speech patterns of those around us. This linguistic chameleon effect is not unique to individuals with ADHD, but it appears to be more pronounced and frequent in this population."
Essentially, when people have conversations, we're constantly "scanning" for information—not just the words we're absorbing, but the inflection and tone. "When we hear an accent, our brains automatically analyze and categorize the phonetic features, prosody, and intonation patterns," writes Neurolaunch. For most, this does result in copying the accent of the person with whom we're speaking. But those with ADHD might be more sensitive to auditory cues. This, "coupled with a reduced ability to filter out or inhibit the impulse to mimic…could potentially explain the increased tendency for accent mirroring."
While the article explains further research is needed, they distinctly state that, "Accent mirroring in individuals with ADHD often manifests as an unconscious mimicry of accents in social situations. This can range from subtle shifts in pronunciation to more noticeable changes in intonation and speech rhythm. For example, a person with ADHD might find themselves unconsciously adopting a Southern drawl when conversing with someone from Texas, even if they’ve never lived in the South themselves."
People are having their say online. On the subreddit r/ADHDWomen, a thread began: "Taking on accents is an ADHD thing?" The OP shares, "My whole life, I've picked up accents. I, myself, never noticed, but everyone around me would be like, 'Why are you talking like that??' It could be after I watched a show or movie with an accent or after I've traveled somewhere with a different accent than my 'normal.'
They continue, "Apparently, I pick it up fast, but it fades out slowly. Today... I'm scrolling Instagram, I watch a reel from a comedian couple (Darcy and Jeremy. IYKYK) about how Darcy (ADHD) picks up accents everywhere they go. It's called ADHD Mirroring??? And it's another way of masking."
(The OP is referring to Darcy Michaels and his husband Jeremy Baer, who are both touring comedians based in Canada.)
Hundreds of people on the Reddit thread alone seem to relate. One comments, "Omfg I've done this my whole life; I'll even pick up on the pauses/spaces when I'm talking to someone who is ESL—but English is my first language lol."
Sometimes, it can be a real issue for those around the chameleon. "I accidentally mimicked a waitress's weird laugh one time. As soon as she was out of earshot, my family started to reprimand me, but I was already like 'oh my god I don’t know why I did that, I feel so bad.'"
Many commenters on TikTok were shocked to find out this can be a sign of ADHD. One jokes, "Omg, yes, at a store the cashier was talking to me and she was French. She's like 'Oh are you French too? No, I'm not lol. I'm very east coast Canada."
And some people just embrace it and make it work for them. "I mirror their words or phrase! I’m 30. I realized I start calling everyone sweetie cause my manager does & I work at coffee shop."