Friendship Bench: by offering a listening ear, grandmothers bring hope to people with depression

On 7 May 2026, King Philippe and Queen Mathilde presented the KBF Africa Prize to Friendship Bench. This initiative from Zimbabwe deploys grandmothers to lift the spirits of depressed patients. Its success lies in the power of a selfless listening ear. Esther Tumbare, CEO of Friendship Bench, told us all about it.

Linda from Zimbabwe had already been carrying a heavy burden in silence for some time. After her husband accused her of infidelity, she suffered regular physical abuse. Her husband even stopped paying the children's school fees and neglected his responsibilities.

Listening without judging

The situation upset her completely. She felt isolated and downhearted. Until she met Jokera, one of the grandmothers from Friendship Bench, at the local clinic. The organisation trains non-specialists – especially grandmothers – to provide people with mental health problems with a listening ear.

Grandmothers in Zimbabwe are known for their warmth, and they also carry so much wisdom within them. Grandmother Jokera, too, gave Linda the attention she so desperately needed. “Just tell me your story.” Grandmothers are people with whom patients immediately feel at ease, just like you do with peers who have also been through a lot. They don't look at your problems like a psychiatrist would through the lens of scholarship. Instead, they listen without judging.

While actually sitting next to Jokera on a wooden ‘friendship bench’, Linda slowly began to open up. She was able to tell her story, and the tears were allowed to flow. Gradually, during the course of six sessions, Linda regained a feeling of hope and her emotional strength. She overcame her stress and depression and that miraculously improved her situation! The physical violence ceased and her husband started caring for her family again. Linda also felt happier and more stable.

Only 18 psychiatrists for a population of 17 million

In Zimbabwe, there are tens of thousands of people like Linda, who are suffering from depression or even contemplating suicide. Sometimes, this is due to relationship problems, but it can also be a result of conflict, poverty or unemployment. In Africa, some 150 million people are said to be struggling with mental health problems. But what can you do to support them? Zimbabwe has 18 psychiatrists for a population of 17 million!

Twenty years ago, the powerlessness to do anything about the overwhelming needs that existed affected the Zimbabwean professor and psychiatrist Dixon Chibanda very deeply. We spoke with Esther Tumbare, CEO of Friendship Bench, at the offices of the King Baudouin Foundation in Brussels. She was in Belgium at the time in order to receive the KBF Africa Prize two days later from the King and Queen of the Belgians.

Involving lay people

“Prof. Chibanda was working in the Zimbabwean capital Harare and had discussed the treatment of a depressed patient over the phone," Tumbare began. “The patient lived in the countryside, about 200 km from Harare. He had invited the patient and her mother to come and see him a week later, but they didn't come. Later on, the mother let him know that she had no money to pay for the bus. Meanwhile, her daughter had hanged herself from a mango tree in the garden.”

Prof. Chibanda suffered greatly as a result of this case and talked about it with his grandmother. “She and one of her friends prayed for the patient,” said Tumbare. “And she encouraged her grandson and gave him comfort. So this was how Prof. Chibanda came up with the idea of getting grandmothers involved in the provision of mental healthcare.”

He realised that the small number of psychiatrists in the country would never be enough. Bringing in lay people had become a necessity. And who better to do that than the grandmothers who possess so much wisdom and life experience? After a short training session, an initial team of 14 grandmothers was able to start work in 2006. Friendship Bench was born.

The old taking care of the young

The approach has been found to work surprisingly well. “I think that the key to its success lies in its simplicity,” said Tumbare. “We are tapping into a resource that's available in every community – grandmothers. Actually, the idea of the old taking care of the young is something that was already part of our culture. It's just that, as a result of urbanisation and westernisation, we've lost some of that.”

Because what people struggling with mental health problems need, first and foremost, is a safe place, someone who listens and does not judge, with whom the patient can form a connection.

Tumbare: “Grandmothers only use simple phrases such as ‘Can I help you?’ or ‘Tell me.’ And if the patient finds it slightly difficult to start talking, the grandmother tells her own stories. ‘You know, I also used to do this, like you,’ and they start laughing about it. It all happens very naturally, like in an ordinary conversation, so that the patient feels at ease.”

Evidence-based

It is also crucial for the therapy to be ‘evidence based’. “Prof. Chibanda immediately made it the subject of a clinical trial. He was therefore able to demonstrate that the approach was not only effective, but that it was even better than treatment from a psychiatrist. Eighty percent of patients were found to have been cured and to have remained symptom-free six months after treatment. We also published more than 100 papers in peer-reviewed journals!”

Furthermore, an important element of the approach is that the initial one-to-one sessions are followed by group work. “Just as soon as they feel better as a result of the conversations with one of the grandmothers, the patients are included in a circle of peers called the Circle Kubatana Tose, with people who have gone through similar issues. They literally reach out to each other and find support from each other.”

Growing vegetables

Surprisingly, they often find a solution to their problems within that circle, even when the underlying cause was poverty and unemployment. Tumbare continued: “You know, many patients initially think they have nothing, but then it turns out someone in the circle has a patch of land. Another has a wheelbarrow, and someone else can provide seeds. So if they put all of those things together, they can start something that will change everyone's life.”

Solutions of this type are even more sustainable than situations where an outside project were to provide guidance and a small amount of start-up capital. “That is because these solutions come from within society and from within the group itself. They may involve growing vegetables, raising pigs or chickens for eggs, starting a car wash, you name it.”

Cost-effective

One of the factors that certainly also contributed towards the success of this approach is the fact that the Friendship Bench team involved the government right from the start. The Ministry of Health has recognised the approach and has included it within its operation. This helped the initiative spread throughout the country. More than 2,300 grandmothers – and also some grandfathers – have already received training.

The approach is also hugely cost-effective. “The cost per patient is only $13 compared to over $100 if you worked with a psychiatrist. In fact, the grandmothers are doing this entirely for free, except for a small expense allowance. Still, they are highly motivated. Helping patients gives them a purpose in life and they are happy to be able to give something back to the community.”

Germany, the UK and the US

The approach is so convincing that other African countries and countries located further away, such as Germany, the UK and the US, have already adopted it. “We have also received interest from Namibia, Australia, Israel and India. Friendship Bench really can be effective anywhere. In essence, it means that (1) lay people rather than specialists follow up with patients and that (2) the care is provided in the community, not in a clinic. That makes it easier to access.”

Something that does need to be adapted to the context is who is acting as a lay helper. “In Zimbabwe, we have our grandmothers, but elsewhere, it may be better for men to be helped by men, because it is so difficult for them to talk about their feelings. Or for students to be helped by students...”

250,000 euros in prize money

Even though the approach is dirt-cheap, there are still costs. “We need to organise training, and supervision, follow-up and research are still needed. We also need to collect data that we pass on to the government. To obtain the money, we could mainly have recourse to philanthropic organisations in Europe and the US and to the World Health Organization."

But now, there is the KBF Africa Prize from the King Baudouin Foundation that will provide Friendship Bench with 250,000 euros. “This award really has come at an ideal time,” Tumbare said with satisfaction. “We will use it primarily for three things. (1) To scale up our approach even more and integrate it into national health systems in order to access the hardest-to-reach groups. (2) To radically digitalise our approach. After all, some young people simply prefer to receive support online nowadays. And (3) to breathe new life into our partnership with UNESCO for cooperation with higher education. Young people often struggle due to a lack of prospects, cyberbullying and competition. They are also easily led astray into alcohol and drug abuse.”

When asked if Friendship Bench would catch on in Belgium, Tumbare was very convincing. “Of course! It's a fantastic place here. The parks here in Belgium all have benches. In the end, all of us are struggling with the same problems and in many cases, speaking with lay people is better than speaking with specialists. I will tell that to King Philippe and Queen Mathilde,” she concluded with a broad smile.