Dixon Chibanda

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Dixon Chibanda is a psychiatrist , professor of psychiatry at the University of Zimbabwe , associate professor in global mental health at the London School of Hygiene and Tropical Medicine and director of the African Mental Health Research Initiative . He is known for his project Friendship Bench (English for friendship bench), a project for short psychological interventions by community health workers , which was developed and implemented in Zimbabwe .

Career

Chibanda claims to have developed an interest in mental health issues in his youth when he witnessed the separation of his parents at the age of twelve and, at fifteen, was the only black person in a school to experience exclusion until he switched schools a year later.

As part of his medical training, Chibanda attended a university in Czechoslovakia , where his situation as the only colored person appeared to him as a déjà-vu of racism. A fellow student committed suicide, which was completely unexpected for Chibanda and other fellow students; During this time, the acquaintance of a musician who became his mentor became important for Chibanda. When he got to know methods such as electrotherapy as part of his medical training after this experience , it was clear to him that a lot can be achieved for mental health just through discussions.

Chibanda graduated from Comenius University in Bratislava with a degree in medicine in 1993. He also holds Masters degrees in Psychiatry (2004) and Epidemiology (2007) from the University of Zimbabwe and a PhD in Psychiatry from the University of Cape Town (2015). After graduating from the University of Zimbabwe, he worked as a consultant for the World Health Organization (WHO). He is Professor of Psychiatry at the University of Zimbabwe, Associate Professor in global mental health at the London School of Hygiene and Tropical Medicine . Chibanda was one of the first to examine the psychological effects of Operation Murambatsvina in 2005 ; In surveys in twelve clinics, he found high rates of mental abnormalities, which indicated the presence of depression.

The idea for his project came up in the 2000s when it became clear that there were very few therapists in Zimbabwe, but at the same time there was a great need for psychological help. In 2004 there were only two psychiatrists in the whole of Zimbabwe, which at that time had a population of over 12.5 million, both of whom worked in the capital, Harare . Chibanda speaks of a four-generation collective trauma that has existed in Zimbabwe, often including rape and domestic violence . Poor people had little access to effective help, not only because of the small number of therapists, but also because of the difficulties of a long and costly journey. Chibanda experienced this immediately when a young patient committed suicide after being discharged from the clinic after she had not shown up for a consultation as previously discussed because her mother could not pay for the bus ticket.

The Friendship Bench project

concept

As part of the Friendship Bench project , grandmothers are trained to give interventions in psychosocial counseling . They use talk therapy methods that have been shown to be effective based on evidence in the treatment of people with mental or neurological disorders or substance abuse.

Chibanda relied on grandmothers for this project. The grandmothers are called "community grandmothers"; some of them have worked as community health workers at regional clinics in Zimbabwe since the 1980s . Known for their cultural knowledge and wisdom, they are closely associated with their home community. For these reasons, as well as a lack of financial and human resources, Chibanda used grandmothers as lay therapists, despite the skepticism of many colleagues and his own initial fear that effective treatment could possibly only be carried out by professional psychologists and psychiatrists. Together with Petra Mesu, he developed a therapy in the Shona language that was adapted to local cultural concepts . Their approach is focused on problem solving and integrates indigenous elements as well as elements of cognitive behavioral therapy . In Zimbabwe, emotional difficulties and disorders that resemble depression are sometimes grouped under the term kufenisisa , which can be roughly translated as If you think too much , as well as kusuwisisa (deep sadness as opposed to normal sadness, suwa ). Together with the grandmothers involved, Chibanda developed certain key concepts ( kuvhura pfungwa , kusimudzira and kusimbisa ) with which the central concepts of the method are expressed.

In 2011 the first scientific publication on the results of the project appeared. The authors Chibanda, Melanie A. Abas of King's College London and other colleagues found preliminary indications of a clinically relevant improvement of general mental disorders through their therapy. Further results were published in 2016 that showed a significant decrease in depressive symptoms after six months in patients who had received information, support and talk therapy as part of the project compared with patients who had also received information and support but no psychological intervention.

The therapy sessions are free for clients. Issues raised in the dialogues include domestic violence and AIDS . Those at risk of suicide are referred to professional supervisors. The data of those seeking advice is stored in the cloud and each patient receives text messages for assistance between sessions. If a client does not show up for an agreed meeting and does not respond to text messages, the grandmother concerned visits him at home together with a professional healthcare provider.

Some, but not all, of the community grandmothers receive payment from the local health authorities. According to Chibanda, the project is largely driven by her altruism . Chibanda now regards his original fear that grandmothers might become unhappy themselves in the face of the many bad testimonials from other people as outdated: on the contrary, lay therapists appreciate that society needs them.

distribution

Therapy sessions are offered in more than 70 Zimbabwean communities in Harare, Chitungwiza and Gweru. Since 2006, over 400 grandmothers have been trained in evidence-based talk therapy as part of the project (as of autumn 2018). In 2017 alone, more than 30,000 people were given help as part of the project. At the end of 2019, 240 lay therapists were working in Zimbabwe as part of the project. The outdoor therapy stations were initially called “Mental Health Bank”, but were soon renamed “Friendship Bench” because of the stigma attached to mental illness in Zimbabwe .

Modified forms of the project were also experimentally implemented: a Youth Friendship Bench for young people in Harare and another project specifically aimed at HIV-positive people.

In 2016, Chibanda reported on his project as part of TED Talks . Chibanda's work in Zimbabwe has also found application in New York under the name Friendship Benches . In some cases, the project met with resistance from representatives of the medical professions, especially as far as deinstitutionalization is concerned.

Chibanda sees the model as an example of peer-to-peer counseling for mental health that could be used worldwide.

Publications (selection)

Web links

Individual evidence

  1. ↑ a b c d e f g Visionary of the Month. Dixon Chibanda: The Friendship Bench. In: heartsonfire.org. IF Hummingbird Foundation, accessed January 3, 2020 .
  2. ↑ a b c d e f g h i j k Rachel Nuwer: Zimbabwe is pioneering a groundbreaking mental health program with stunning results - and the rest of the world is taking note. In: BBC. October 16, 2018, accessed January 3, 2020 .
  3. ↑ a b c d e f g h i j k Dixon Chibanda: grandmothers help to scale up mental health care . In: Bulletin of the World Health Organization . No. 96 , 2018, p. 376-377 , doi : 10.2471 / BLT.18.030618 ( who.int ).
  4. ↑ a b c d e f g h i j k l m Alex Riley: How a wooden bench in Zimbabwe is starting a revolution in mental health. In: mosaicscience.com. October 16, 2018, accessed January 3, 2020 .
  5. ↑ Speakers: Dixon Chibanda. In: eaglobal.org. The Center for Effective Altruism, accessed January 4, 2020 .
  6. ↑ a b c d e f Anne Backhaus: Psychotherapy in Zimbabwe: Grandmas who relieve mental anguish on park benches. In: Spiegel online. December 30, 2019, accessed January 3, 2020 .
  7. ↑ Dixon Chibanda: I have seen first-hand how the horrors of Mugabe's Zimbabwe people haunt our. In: The Guardian. January 11, 2018, accessed January 3, 2020 .
  8. ↑ Dixon Chibanda: Friendship Bench. Retrieved January 3, 2020 .
  9. ↑ Dixon Chibanda, Petra Mesu, Lazarus Kajawu, Frances Cowan, Ricardo Araya, Melanie A. Abas: Problem-solving therapy for depression and common mental disorders in Zimbabwe: piloting a task-shifting primary mental health care intervention in a population with a high prevalence of people living with HIV . In: BMC Public Health . tape 11 , 2011, Article 828 , doi : 10.1186 / 1471-2458-11-828 , PMID 22029430 ( biomedcentral.com [PDF]).
  10. ↑ D. Chibanda et al .: Effect of a Primary Care-Based Psychological Intervention on Symptoms of Common Mental Disorders in Zimbabwe: A Randomized Clinical Trial . In: JAMA . tape 316 , no. 24 , 2016, p. 2618-2626 , doi : 10.1001 / jama.2016.19102 , PMID 28027368 ( lshtm.ac.uk ).
  11. ↑ D. Chibanda, F. Cowan, R. Verhey, D. Machando, M. Abas, C. Lund: Lay Health Workers' Experience of Delivering a Problem Solving Therapy Intervention for Common Mental Disorders Among People Living with HIV: A Qualitative Study from Zimbabwe . In: Community Ment Health J . tape 53 , no. 2 , February 2017, p. 143-153 , doi : 10.1007 / s10597-016-0018-2 , PMID 27221123 .
personal data
SURNAME Chibanda, Dixon
BRIEF DESCRIPTION psychiatrist
DATE OF BIRTH 20th century