A Bench for The Ailing Mind
Ratheesh Nair
Recently while going through several TED talks, I came across the interesting speech of Dr. Dixon Chibanda, Director of African Mental Health Research Initiative (AMARI). He was talking about his beautiful and effective initiative of the “Friendship Bench”. The concept took form when he got a call one night informing that a patient of his, a 26 year old young lady, had overdosed and his consultation was required to gauge her tendency for suicide and if it was safe to let her go post completion of treatment. Dr. Chibanda was 200 KMs away from the said patient and did the best he could to assess the situation. He gave a go ahead to discharge her from the medical facility only to find out a couple of weeks later that she had committed suicide. On asking her family why they didn’t come to meet him, the answer he received was simple yet a heart-wrenching one. The patient’s mother said, “We didn’t have money for the bus fare”.
This incident led to Dr. Chibanda searching for a solution to ensure he can reach out to maximum people and provide physical counseling. This search led to the creation of the Friendship Bench initiative in 2006. He identified grandmothers; older women of the community whom people knew very well and were integral to the community. They were loved, adored and respected by their communities. These women were trained to provide basic Cognitive Behavioral Therapy sessions to people who were in need. The initiative which started with a small group of grandmothers has since then grown to more than 600 grandmothers who have provided counseling services to close to 40,000 individuals. The initiative was such a grand success that it received $1 million funding from Grand Challenges Canada.
The interesting part of this initiative was the impact it created. The overall recurrence of symptoms pertaining to depression and anxiety in patients who received the Friendship Bench Therapy was considerably lower than standard clinical treatments. The overall mental health of patients who were treated through Friendship Bench improved substantially in comparison to trained practitioners who were taught the very same lessons that Dr. Chibanda imparted to these wonderful ladies.
I remember the time I visited a Psychiatrist when I had developed severe anxiety issues due to an ongoing conflict with my superior in the organization I once worked for. I remember looking at this middle aged lady who had a poker faced look when I used to narrate my problems and anxieties with her. After 2-3 sessions I realized one thing without doubt that she was in need of psychological treatment more than I did. I was even a little afraid that hearing my issues may lead her to depression and taking some drastic measures. So before I would be implicated in a case of abetment of suicide, I discontinued my sessions with her.
Until the advent of 21st century, people in India, were extremely skeptical about discussing issues pertaining to their mental health. The major cause was the social stigma caused by uneducated fools who believed mental illnesses to be a result of genetics and not individual issues. Families with known history of even a single mental patient resulted is ostracizing the entire family for generations. They would be greeted with prying eyes, waiting to witness the exact moment when any member of the family will descend into madness.
Things changed as the corporate culture grew significantly, encroaching the personal lives and even the most private areas of human life. This intrusion and the resultant imbalance between work and personal life resulted in several mental health problems in individuals. To add fuel to fire, these workaholic individuals scare their children into over-exerting in their studies and make them fiercely competitive by showing them a scary picture of how poor and unimportant they would become if they do not get a high paying corporate job. This pressure is the single largest cause of suicides in students whose mental framework is still very delicate to handle such emotionally and physically taxing pressures. A simple misconception of personal success and well-being has had a cascading effect on the very social fabric of our nation.
The only good thing, if thought from an extremely optimistic perspective, is that people have started getting more and more aware of mental problems and have started availing therapies to tackle the harmful effects of their stressful lives. However, the resultant impact of this self-aware approach towards mental issues is negligible. The overall number of suicides, recurring symptoms of acute mental disorders and stress related illness are on an all time rise. The concept of work-from-home, which was touted to be a lasting solution to tackling work stress, is currently the single greatest contributor of stress in corporate employees.
With this situation in our immediate surroundings, I was tempted for a second to think if the Friendship Bench project would help us in this situation.
It would be a lie to say that it will be an absolute success, as there are several hindrances. These hindrances are all attitudinal and have nothing to do with physical infrastructure or lack of sensible grandmothers in our midst. One of our greatest obstacles is that we are too engrossed in our personal pursuits to actually have the sense of community. We seldom, stop to help anyone in need as we are always in a hurry to reach somewhere no matter what we lose on the way. Our unwavering, single-minded focus on building a strong and stable career has taken us away from our families too.
The grandmothers of Dr. Chibanda were respected individuals whom the entire society recognized. However, the old and experienced around us are mostly found to be holed up alone in their houses, while their children are busy trying to earn as much money as possible. For a contemporary middle class house, parents and other elderly family members in the house are more of a physical support system to take care of the day-to-day household responsibilities, including raising the young ones, while their own offspring are slaving for their never ending quest for higher pay packages.
How can we have grandmothers helping the young people with mental problems when they themselves are in need of it to tackle their innumerable issues??
A final solution to this predicament is yet to be found however, we can start with taking smaller conscious steps in this direction. A handful of businesses and non government bodies have shown their genuine concern for mental well-being and have started taking necessary steps in this direction. Even educational institutions are focused on reducing undue pressure on the students from parents or even their peers. However, the impact of these initiatives is far from recognizable. Another by-product of this heightened awareness is the unhinged development of sympathy towards these unfortunate individuals. This sympathy further cripples the sufferer or it gives some of the manipulative types a reason to constantly seek attention and get things their way.
Such issues can only be rooted out of the system if we as a society stand together and shed out judgmental nature towards mental illnesses and the individuals who suffer with such problems. The solution is acceptance, not sympathy, definitely not isolation, but just a simple act of acceptance that such issues exist in our immediate environment and we need to keep ourselves open to it so as to assist the less fortunate victims wade out of it.