The Power of Grandmothers
By Albert B. Kelly
Recently in this space, I discussed the fact that for the
better part of 2 decades, the suicide rate among black children between the
ages of 5 and 12 years old was twice that of their white peers. This was part
of a larger discussion about the lack of mental health resources, culturally
competent or otherwise, available to children especially minority children. What
I didn’t do was mention possible solutions.
But listening to an episode of the TED radio hour (www.npr.org/programs/ted-radio-hour/),
I heard what might qualify as a possible even if it is outside the box. This
program focused on the stigma that attaches to mental health and how that stigma,
along with a lack of resources, keeps millions of people from getting the help
they need.
The episode featured Dr. Dixon Chibanda, who is one of only
fifteen psychiatrists in the country of Zimbabwe with a population of
approximately 16 million people. According to the program, this translates into
a ratio of roughly one psychiatrist per million people. With numbers like that,
you can imagine the waiting list and the volume of people who never get help.
Dr. Chibanda recounted the night he got a phone call about
one of his patients from a hospital roughly 124 miles away from where he was.
Apparently his 26 year-old female patient had overdosed in an apparent suicide
attempt and after talking through the medical history and treatment plan with
the ER doctor, it was decided that the patient’s and her mother would travel to
Dr. Chibanda for follow-up care.
Weeks went by and Dr. Chibanda hadn’t seen or heard from the
patient or her mother. Then one day out of the blue he received a phone call
from the mother saying that her daughter had committed suicide a couple of days
prior. Frustrated, Dr. Chibanda asked why they hadn’t come for follow-up
treatment as had been discussed weeks earlier. The mother said that she didn’t
have the $15 for the 124 mile bus trip.
In his frustration, knowing that there were few options for
people in a poor country with a patient-to-psychiatrist ratio of a million to
one, Dr. Chibanda began thinking about out-of-the box solutions. After talking
with colleagues and friends, he realized that the most steady and reliable
resource in every community were the grandmothers. They care and they don’t
leave to pursue education or careers elsewhere.
With that insight, he began training grandmothers in
evidence-based talk therapy. Grandmothers would meet people at a “Friendship
Bench” placed in centrally located places in each community. According to Dr.
Chibanda, this approach works in that part of the world because grandmothers
are considered the custodians of local culture and wisdom and now they are lay-
health workers who are known as "community grandmothers" in their respective
cities.
We’re not Zimbabwe, yet I thought about grandmothers here and
the reality is that many grandmothers (and some grandfathers), are often the
only stable presence in families. How many grandmothers today are raising their
grandchildren because of drugs, incarceration, or some other mess? Grandmothers
have always played a critical role in the African American community and I
would argue that today, grandmothers of all stripes are standing in the gap as
never before and this cuts across all racial and ethnic lines.
Accordingly, Dr. Chibanda has introduced the Friendship
Bench (www.friendshipbenchzimbabwe.org/)
in New York City and he has found that the issues in NYC are no different than
in Zimbabwe. Depression is depression no matter where you live, even if the
words we use to describe it differ from place to place.
As for results, six months after treatment from a trained grandmother,
people were still symptom-free which Dr. Chibanda defines as no depression with
suicidal ideation completely reduced.
It may not come with a lab coat or be what we consider a
western medicine solution, but the Friendship Bench or its equivalent may be a
way to help young people in need. Perhaps Inspira, who has done a lot in terms
of mental health and addiction treatment in our area, might see fit to fund a small
pilot project modeled on the Friendship Bench.
In addition to augmenting the more traditional services they
provide, such a project would be a way to tap into the warmth, strength, and
wisdom of grandmothers - a formidable force and resource- not something to be
dismissed or underestimated. Such is the quiet power of a generation.