1 00:00:14,956 --> 00:00:24,116 Speaker 1: Pushkin hay Slight Changed listeners. It's Maya. Since May is 2 00:00:24,196 --> 00:00:27,716 Speaker 1: mental health Awareness month, we're revisiting some of our favorite 3 00:00:27,716 --> 00:00:31,996 Speaker 1: conversations with scientists about how we can live healthier, happier lives. 4 00:00:32,996 --> 00:00:37,116 Speaker 1: This episode features the undeniable power of grandmothers to heal 5 00:00:37,156 --> 00:00:41,036 Speaker 1: our communities. Since we're a few days away from Mother's Day, 6 00:00:41,316 --> 00:00:43,356 Speaker 1: you might want to share this with a grandmother or 7 00:00:43,356 --> 00:00:46,276 Speaker 1: two that you know in your life. We'll be back 8 00:00:46,276 --> 00:00:48,956 Speaker 1: with our new season soon, but in the meantime, I 9 00:00:48,996 --> 00:00:52,796 Speaker 1: really hope you enjoyed this conversation. And a quick note. 10 00:00:53,236 --> 00:00:55,876 Speaker 1: In this episode, Dixon and I talk about a patient 11 00:00:55,916 --> 00:00:58,996 Speaker 1: who struggles with depression, and there is a brief mention 12 00:00:59,156 --> 00:01:03,196 Speaker 1: of suicide. It's not graphic or detailed, but in the 13 00:01:03,236 --> 00:01:06,316 Speaker 1: spirit of taking care of our mental health, I wanted 14 00:01:06,316 --> 00:01:08,956 Speaker 1: to make sure you knew that upfront, so you can 15 00:01:08,996 --> 00:01:10,596 Speaker 1: do what you need to do to take care of 16 00:01:10,676 --> 00:01:14,196 Speaker 1: yourself while listening. If you or someone else you know 17 00:01:14,316 --> 00:01:17,836 Speaker 1: is struggling, We've included some resources in our show notes. 18 00:01:28,556 --> 00:01:31,956 Speaker 2: In Zimbabwe, let alone the whole of Africa, you're looking 19 00:01:32,036 --> 00:01:35,356 Speaker 2: at a ratio of one psychiatrist to about one and 20 00:01:35,396 --> 00:01:37,036 Speaker 2: a half million people. 21 00:01:37,636 --> 00:01:42,116 Speaker 1: That's doctor Dixon Chabanda, a psychiatrist in Zimbabwe. He knew 22 00:01:42,156 --> 00:01:45,236 Speaker 1: people in his country desperately needed access to mental health 23 00:01:45,236 --> 00:01:48,436 Speaker 1: care but weren't getting it, and even though Dixon felt 24 00:01:48,476 --> 00:01:51,436 Speaker 1: daunted by the magnitude of the problem, he was determined 25 00:01:51,436 --> 00:01:52,716 Speaker 1: to try and find a solution. 26 00:01:53,916 --> 00:01:57,796 Speaker 2: My initial thoughts were to work with trained nurses and 27 00:01:57,876 --> 00:02:00,596 Speaker 2: doctors at the hospital, but I was immediately told know 28 00:02:00,676 --> 00:02:04,076 Speaker 2: the nurses and the doctors are are extremely busy. They 29 00:02:04,116 --> 00:02:06,516 Speaker 2: have to deal with people who are living with HIV, 30 00:02:06,756 --> 00:02:08,716 Speaker 2: they have to deal with people who are coming in 31 00:02:08,756 --> 00:02:11,036 Speaker 2: with my hilarry and all sort of other things. They 32 00:02:11,156 --> 00:02:13,636 Speaker 2: just don't have the time to do this mental health stuff. 33 00:02:14,676 --> 00:02:17,356 Speaker 1: Since health professionals were fully tied up with other work, 34 00:02:17,716 --> 00:02:20,756 Speaker 1: Dixon was forced to look elsewhere, and so in two 35 00:02:20,796 --> 00:02:23,636 Speaker 1: thousand and five, he turned to a rather unorthodox group 36 00:02:23,676 --> 00:02:29,156 Speaker 1: for help. On today's episode, how you can vastly improve 37 00:02:29,276 --> 00:02:32,076 Speaker 1: access to mental health care when you put grandmothers on 38 00:02:32,156 --> 00:02:38,076 Speaker 1: the case. I'm Maya Shunker and this is a slight 39 00:02:38,156 --> 00:02:40,676 Speaker 1: change of plans, a show about who we are and 40 00:02:40,716 --> 00:02:43,116 Speaker 1: who we become in the face of a big change. 41 00:02:57,516 --> 00:03:00,316 Speaker 1: Dixon and I started our conversation by talking about what 42 00:03:00,436 --> 00:03:03,436 Speaker 1: drew him to the field of psychiatry. He had initially 43 00:03:03,436 --> 00:03:07,036 Speaker 1: wanted to become a pediatrician, but then something happened in 44 00:03:07,076 --> 00:03:10,916 Speaker 1: medical school that deeply affected him. A classmate of his, 45 00:03:11,116 --> 00:03:15,116 Speaker 1: who outwardly seemed stable and cheerful, took his own life. 46 00:03:15,236 --> 00:03:18,036 Speaker 1: This came as a total shock to Dixon, and it 47 00:03:18,076 --> 00:03:20,636 Speaker 1: motivated him to reassess how he wanted to spend his 48 00:03:20,716 --> 00:03:21,756 Speaker 1: time as a doctor. 49 00:03:22,516 --> 00:03:24,436 Speaker 2: And then there were a couple of other things. You know, 50 00:03:24,556 --> 00:03:31,116 Speaker 2: I grew up in a family where my parents they 51 00:03:31,116 --> 00:03:34,916 Speaker 2: didn't really have a wonderful marriage, you know, if I 52 00:03:34,916 --> 00:03:38,796 Speaker 2: could put it that way, And when my parents divorced, 53 00:03:38,836 --> 00:03:42,436 Speaker 2: that really affected me psychologically emotionally. I think I must 54 00:03:42,476 --> 00:03:45,756 Speaker 2: have had childhood depression for a very long time, and 55 00:03:45,836 --> 00:03:49,716 Speaker 2: no one really knew and I didn't know either, you know, 56 00:03:49,916 --> 00:03:52,396 Speaker 2: So that all of these kind of things, and then 57 00:03:52,996 --> 00:03:58,836 Speaker 2: going to high school and being bullied, and then you know, 58 00:03:58,996 --> 00:04:03,476 Speaker 2: feeling completely out of place. So quite a number of 59 00:04:03,636 --> 00:04:09,676 Speaker 2: events which had an emotional or traumatic effect on me, 60 00:04:10,756 --> 00:04:14,796 Speaker 2: I believe contributed to that final decision for me to 61 00:04:14,876 --> 00:04:18,756 Speaker 2: get into mental health and psychiatry. The thinking was, you know, 62 00:04:18,796 --> 00:04:22,556 Speaker 2: if I can understand more about mental health and mental illness. 63 00:04:22,916 --> 00:04:28,196 Speaker 2: I'll be able to heal myself, you know, And that's 64 00:04:28,276 --> 00:04:31,116 Speaker 2: actually what it's all about, you know, It's really about 65 00:04:31,156 --> 00:04:35,236 Speaker 2: finding a way of making myself a better person. 66 00:04:37,196 --> 00:04:40,756 Speaker 1: So you end up deciding to become a psychiatrist, and 67 00:04:41,916 --> 00:04:45,236 Speaker 1: you end up having a patient named Erica whose experience 68 00:04:45,916 --> 00:04:49,596 Speaker 1: inspires you to specifically work in the area of increasing 69 00:04:49,676 --> 00:04:51,236 Speaker 1: access to mental health care. 70 00:04:51,676 --> 00:04:53,196 Speaker 3: Do you mind sharing her story? 71 00:04:54,916 --> 00:05:02,516 Speaker 2: Yeah, Erica. Erica was a twenty six year old patient 72 00:05:02,556 --> 00:05:05,956 Speaker 2: of mine who I had been seeing for a good 73 00:05:06,716 --> 00:05:12,236 Speaker 2: close to three years. Was initially brought to the hospital 74 00:05:12,276 --> 00:05:16,156 Speaker 2: where I worked as a psychiatrist with a history of 75 00:05:16,476 --> 00:05:21,436 Speaker 2: major depression. And I spent quite a lot of time 76 00:05:21,516 --> 00:05:23,676 Speaker 2: with Erica and I really got to know her. And 77 00:05:23,716 --> 00:05:26,236 Speaker 2: I think that's one of the things with psychiatry, when 78 00:05:26,276 --> 00:05:31,196 Speaker 2: you really connect with your clients, you get to know 79 00:05:31,316 --> 00:05:35,116 Speaker 2: them on a very personal level, and you know everything 80 00:05:35,196 --> 00:05:37,396 Speaker 2: about their lives, because I mean, that's what mental health 81 00:05:37,436 --> 00:05:39,156 Speaker 2: is all about, you know, you talk to people, you 82 00:05:39,276 --> 00:05:43,876 Speaker 2: listen to people's stories, and so, you know, over the years, 83 00:05:44,396 --> 00:05:48,196 Speaker 2: Erica and I had built this very strong rapport. But 84 00:05:48,476 --> 00:05:53,076 Speaker 2: Erica actually lived some three hundred kilometers from where I am, 85 00:05:53,556 --> 00:05:57,716 Speaker 2: and she would come and see me once every month 86 00:05:57,796 --> 00:06:01,196 Speaker 2: together with her mom, you know, for review. And she'd 87 00:06:01,276 --> 00:06:05,876 Speaker 2: made a lot of progress over the years. And you know, 88 00:06:06,276 --> 00:06:09,876 Speaker 2: one evening, I get a call in the middle of 89 00:06:09,916 --> 00:06:13,196 Speaker 2: the night from the hospital where I worked, and the 90 00:06:13,516 --> 00:06:17,756 Speaker 2: er doctor you know, informs me that Erica, you know, 91 00:06:17,836 --> 00:06:21,756 Speaker 2: my patient, Erica, has taken an overdose, but she will 92 00:06:21,796 --> 00:06:24,916 Speaker 2: be fine. But you know, they kind of think that 93 00:06:24,996 --> 00:06:28,836 Speaker 2: after that she should really come over and probably get 94 00:06:29,596 --> 00:06:33,756 Speaker 2: more psychiatric evaluation and attention. And you know, we agreed 95 00:06:33,836 --> 00:06:36,316 Speaker 2: that that was what was going to happen, you know, 96 00:06:36,436 --> 00:06:40,276 Speaker 2: as soon as she's released. But you know, Erica didn't come. 97 00:06:40,716 --> 00:06:43,436 Speaker 2: When she was released from the er, they went back 98 00:06:43,676 --> 00:06:46,676 Speaker 2: to the village where she lived with her mother and father. 99 00:06:47,436 --> 00:06:49,956 Speaker 2: And I only got a call three weeks later from 100 00:06:50,076 --> 00:06:54,316 Speaker 2: Erica's mother to tell me that Erica had had hang herself. 101 00:06:57,556 --> 00:07:00,556 Speaker 2: You know, when Erica's mother phoned me to tell me 102 00:07:00,636 --> 00:07:04,436 Speaker 2: what had happened, my you know, my sort of instinctive 103 00:07:04,716 --> 00:07:09,796 Speaker 2: knee jerk response was to say, to Erica's mother, why 104 00:07:09,836 --> 00:07:14,076 Speaker 2: didn't you bring Erica to the hospital for the review 105 00:07:14,236 --> 00:07:17,796 Speaker 2: that we had talked about, you know, after she had 106 00:07:17,836 --> 00:07:22,116 Speaker 2: taken that initial overdose, and it was her response really 107 00:07:22,156 --> 00:07:25,356 Speaker 2: that struck me, you know, because she said, you know, 108 00:07:25,436 --> 00:07:28,836 Speaker 2: we wanted to come, but we couldn't because we didn't 109 00:07:28,876 --> 00:07:32,396 Speaker 2: have a bus there to come to your hospital, and 110 00:07:32,476 --> 00:07:36,756 Speaker 2: that was like ten dollars, and as a result, Erica 111 00:07:36,916 --> 00:07:38,916 Speaker 2: couldn't really get the help that she needed. 112 00:07:41,676 --> 00:07:44,716 Speaker 1: Yeah, and from what I understand, I mean, the fact 113 00:07:44,916 --> 00:07:48,476 Speaker 1: Erica even had access to you already put her in 114 00:07:48,796 --> 00:07:53,316 Speaker 1: a minority of people, right, just given the sheer number 115 00:07:53,356 --> 00:07:54,836 Speaker 1: of psychiatrists in the area. 116 00:07:55,276 --> 00:08:00,476 Speaker 2: Yeah, the ratio is actually quite appalling. When you think 117 00:08:00,516 --> 00:08:05,756 Speaker 2: about the statistics in terms of psychiatrists in Zimbabwe, let 118 00:08:05,796 --> 00:08:08,716 Speaker 2: alone the whole of Africa. You're looking at a ratio 119 00:08:08,796 --> 00:08:12,676 Speaker 2: of one psychiatrists to about one and a half million people. 120 00:08:13,556 --> 00:08:18,316 Speaker 2: And I think, you know, that whole story about Erica 121 00:08:18,756 --> 00:08:23,676 Speaker 2: got me really thinking about my role as a psychiatrist. 122 00:08:24,556 --> 00:08:28,716 Speaker 2: You know, when you're trained as a psychiatrist, you kind 123 00:08:28,756 --> 00:08:31,756 Speaker 2: of see yourself working in a hospital. I mean, that's 124 00:08:31,796 --> 00:08:35,396 Speaker 2: what psychiatrists do. You know, they work in hospitals. You know, 125 00:08:35,516 --> 00:08:38,716 Speaker 2: we work in clinics, We deal with people, people come 126 00:08:38,756 --> 00:08:41,956 Speaker 2: to us. And I started asking myself if this was 127 00:08:42,036 --> 00:08:45,716 Speaker 2: really the right way of looking at my role as 128 00:08:45,756 --> 00:08:49,956 Speaker 2: a psychiatrist in Africa, expecting people to come to me, 129 00:08:50,436 --> 00:08:52,916 Speaker 2: and you know, I just realized that that just wasn't 130 00:08:52,956 --> 00:08:53,476 Speaker 2: going to work. 131 00:08:54,596 --> 00:08:57,596 Speaker 1: Erica's inability to access help when it mattered most had 132 00:08:57,596 --> 00:09:01,436 Speaker 1: a profound impact on Dixon. He felt inspired to bridge 133 00:09:01,436 --> 00:09:04,316 Speaker 1: this gap and access to mental health care, but wasn't 134 00:09:04,356 --> 00:09:07,676 Speaker 1: sure how to do it. Then a moment of insight. 135 00:09:08,396 --> 00:09:11,676 Speaker 1: Dixon was in Africa at an academic conference being run 136 00:09:11,716 --> 00:09:14,596 Speaker 1: by the World Health Organization when he caught wind of 137 00:09:14,596 --> 00:09:18,356 Speaker 1: a local ceremony nearby. It was a spiritual gathering where 138 00:09:18,356 --> 00:09:20,596 Speaker 1: a number of people had come together to try and 139 00:09:20,676 --> 00:09:23,956 Speaker 1: heal those in the community who were suffering, and Dixon 140 00:09:23,996 --> 00:09:27,356 Speaker 1: immediately took note of one particular aspect of this ceremony, 141 00:09:27,756 --> 00:09:30,796 Speaker 1: the prominent role elderly women played in leading it. 142 00:09:31,836 --> 00:09:36,756 Speaker 2: They were really powerful, but above all, they had this 143 00:09:37,156 --> 00:09:44,036 Speaker 2: amazingly profound way of conveying empathy and connecting with their subjects. 144 00:09:44,996 --> 00:09:48,036 Speaker 2: That was really what struck me, and that was when 145 00:09:48,076 --> 00:09:52,556 Speaker 2: I kind of realized that there was something in having 146 00:09:53,876 --> 00:10:00,196 Speaker 2: an older woman who has wisdom and experience, you know, 147 00:10:00,396 --> 00:10:05,316 Speaker 2: reaching out to help a young mother who is struggling 148 00:10:05,636 --> 00:10:09,556 Speaker 2: with postnatal depression. You know, a young mother who is 149 00:10:09,956 --> 00:10:15,396 Speaker 2: struggling with anxiety disorder, and just reaching out and establishing 150 00:10:15,436 --> 00:10:19,956 Speaker 2: that connection that makes that person feel comfortable to share 151 00:10:20,356 --> 00:10:24,556 Speaker 2: their story, to make them feel that sense of belonging 152 00:10:24,636 --> 00:10:26,996 Speaker 2: that I am in a place where I'm being taken 153 00:10:27,036 --> 00:10:28,756 Speaker 2: care of. That was really powerful. 154 00:10:29,756 --> 00:10:32,916 Speaker 1: Dixon drew a lot of inspiration from observing the elderly 155 00:10:32,956 --> 00:10:35,956 Speaker 1: women in that ceremony. The influence they had in the 156 00:10:35,956 --> 00:10:39,156 Speaker 1: community because of their age, their wisdom, and their empathetic 157 00:10:39,276 --> 00:10:42,836 Speaker 1: nature gave him an idea. Since there weren't enough mental 158 00:10:42,876 --> 00:10:45,956 Speaker 1: health professionals in Zimbabwe to meet the needs of his community, 159 00:10:46,476 --> 00:10:48,436 Speaker 1: Dixon thought one way to help could be to bring 160 00:10:48,476 --> 00:10:52,036 Speaker 1: elderly women or grandmothers into the fold. If they could 161 00:10:52,076 --> 00:10:55,156 Speaker 1: lend a compassionate ear to people who were struggling, that 162 00:10:55,236 --> 00:10:58,796 Speaker 1: could give more people the support they needed. But when 163 00:10:58,796 --> 00:11:01,756 Speaker 1: Dixon told his friends in the medical community about his idea, 164 00:11:02,116 --> 00:11:04,116 Speaker 1: they did not share his enthusiasm. 165 00:11:04,916 --> 00:11:10,276 Speaker 2: Well, the initial reaction was obviously negative. Everyone thought it 166 00:11:10,436 --> 00:11:17,396 Speaker 2: just wouldn't work. Because therapy is designed to be delivered 167 00:11:17,476 --> 00:11:23,076 Speaker 2: by trained therapists such as psychiatrists or clinical psychologists, and 168 00:11:23,196 --> 00:11:27,836 Speaker 2: grandmothers with minimal education, just did not have the capacity 169 00:11:28,076 --> 00:11:32,556 Speaker 2: to do this kind of work. So friends in the field, 170 00:11:32,716 --> 00:11:37,196 Speaker 2: colleagues and other senior colleagues as well, who I looked 171 00:11:37,276 --> 00:11:41,156 Speaker 2: up to, all kind of thought this wouldn't work, you know. 172 00:11:41,196 --> 00:11:43,116 Speaker 2: But I guess at the back of my mind, I 173 00:11:43,156 --> 00:11:48,036 Speaker 2: always had that vision of these elderly women, and also 174 00:11:48,236 --> 00:11:51,076 Speaker 2: just looking at my own childhood as well. You know, 175 00:11:51,156 --> 00:11:55,156 Speaker 2: I grew up in a family where the women were 176 00:11:55,276 --> 00:12:00,516 Speaker 2: very strong, very powerful, but my grandmothers, you know, were literate, 177 00:12:00,996 --> 00:12:06,956 Speaker 2: were educated and had a very strong contribution to the 178 00:12:06,996 --> 00:12:10,996 Speaker 2: family and making this vision. So I guess that's another 179 00:12:11,076 --> 00:12:15,836 Speaker 2: part of my history or my childhood that has influenced 180 00:12:15,876 --> 00:12:16,476 Speaker 2: this work. 181 00:12:17,236 --> 00:12:19,516 Speaker 1: Dixon did not have to wait long to test out 182 00:12:19,516 --> 00:12:23,476 Speaker 1: his theory. Zimbabwe was reeling from a recent government crackdown 183 00:12:23,676 --> 00:12:27,596 Speaker 1: which traumatized millions and left hundreds of thousands of people homeless. 184 00:12:28,356 --> 00:12:32,476 Speaker 1: Against this backdrop, Dixon's medical supervisor implored him to double 185 00:12:32,516 --> 00:12:35,236 Speaker 1: down on his existing efforts and try to find a 186 00:12:35,236 --> 00:12:37,636 Speaker 1: solution to the growing mental health crisis. 187 00:12:38,236 --> 00:12:41,356 Speaker 2: And at the time, I was the only psychiatrist actually 188 00:12:41,796 --> 00:12:46,356 Speaker 2: working within the public health sector, you know, So my 189 00:12:46,516 --> 00:12:50,476 Speaker 2: supervisor said, you need to go out there and you 190 00:12:50,596 --> 00:12:55,436 Speaker 2: need to come up with something, you know, but there's 191 00:12:55,476 --> 00:12:58,916 Speaker 2: no money. You know, you have to try and think 192 00:12:58,956 --> 00:13:03,956 Speaker 2: of some innovative way of addressing the psychological trauma that 193 00:13:04,036 --> 00:13:07,956 Speaker 2: this community is going through. And my initial thoughts were, 194 00:13:08,276 --> 00:13:13,156 Speaker 2: you know, to work work with the trained nurses and 195 00:13:13,276 --> 00:13:15,956 Speaker 2: doctors at the hospital. But I was immediately told no, 196 00:13:16,076 --> 00:13:19,476 Speaker 2: the nurses and the doctors are are extremely busy. They 197 00:13:19,516 --> 00:13:21,876 Speaker 2: have to deal with people who are living with HIV, 198 00:13:22,156 --> 00:13:24,156 Speaker 2: they have to deal with people who are coming in 199 00:13:24,196 --> 00:13:26,636 Speaker 2: with malaria and all sorts of other things. They just 200 00:13:26,676 --> 00:13:29,036 Speaker 2: don't have the time to do this mental health stuff. 201 00:13:29,716 --> 00:13:33,756 Speaker 2: But you could consider working with other, you know, non professionals, 202 00:13:33,796 --> 00:13:36,076 Speaker 2: you know, and I thought, my goodness, this can't be 203 00:13:36,156 --> 00:13:39,356 Speaker 2: done by non professionals, but just the thought then, you know, 204 00:13:39,916 --> 00:13:44,116 Speaker 2: there are lots of community grandmothers here who have been 205 00:13:44,196 --> 00:13:48,836 Speaker 2: involved in sort of outreach programs. How about I start 206 00:13:48,876 --> 00:13:53,796 Speaker 2: with just fourteen grandmothers from this community and see what 207 00:13:53,876 --> 00:13:57,956 Speaker 2: we can do. A part of me was also quite skeptical, 208 00:13:58,196 --> 00:14:01,756 Speaker 2: but you know, when you think you're onto something, you 209 00:14:01,876 --> 00:14:04,276 Speaker 2: kind of keep going, you know. 210 00:14:04,556 --> 00:14:07,276 Speaker 1: Yeah, I mean I can also imagine therapists and doctors 211 00:14:07,316 --> 00:14:11,516 Speaker 1: reacting negatively because they're thinking, I have a real degree 212 00:14:11,516 --> 00:14:13,716 Speaker 1: in this. You know, I'm actually trained, and now you're 213 00:14:13,716 --> 00:14:17,276 Speaker 1: telling me that grandma's can do my job for me. Like, 214 00:14:17,396 --> 00:14:19,516 Speaker 1: did you hear any of that kind of response? 215 00:14:19,876 --> 00:14:22,556 Speaker 2: Yes, I heard a lot of that kind of response. 216 00:14:22,956 --> 00:14:26,316 Speaker 2: But you see, that's where I think, you know the 217 00:14:26,436 --> 00:14:32,516 Speaker 2: problem we have with today's education, where we see everything 218 00:14:32,716 --> 00:14:37,716 Speaker 2: through the lens of academia and academics, you know, particularly 219 00:14:37,836 --> 00:14:44,076 Speaker 2: from the northern hemisphere, and we don't take time to 220 00:14:44,276 --> 00:14:51,756 Speaker 2: look at the local indigenous knowledge and the wisdom that 221 00:14:51,956 --> 00:14:55,156 Speaker 2: is inherent in every culture. I mean, one of the 222 00:14:55,196 --> 00:14:59,596 Speaker 2: things that I really learned from the grandmothers is that 223 00:15:00,996 --> 00:15:08,516 Speaker 2: every culture has their amazing ability to teach you a 224 00:15:08,716 --> 00:15:13,876 Speaker 2: piece of profound wisdom. And this is something that I 225 00:15:14,036 --> 00:15:19,756 Speaker 2: have really taken to heart from my interactions with a grandmother's, 226 00:15:19,876 --> 00:15:24,276 Speaker 2: just appreciating more the local culture and the role that 227 00:15:24,356 --> 00:15:28,516 Speaker 2: it can play in addressing not only mental health issues, 228 00:15:28,556 --> 00:15:32,596 Speaker 2: but a wide range of issues that people are struggling 229 00:15:32,596 --> 00:15:34,716 Speaker 2: with in communities or in society. 230 00:15:39,196 --> 00:15:45,356 Speaker 1: We'll be right back with a slight change of plans. 231 00:15:53,076 --> 00:15:57,156 Speaker 1: Doctor Dixon Chibanda, a psychiatrist in Zimbabwe, had an idea 232 00:15:57,316 --> 00:15:59,676 Speaker 1: for how to help more people in this country access 233 00:15:59,676 --> 00:16:02,556 Speaker 1: mental health services, and it would come to be known 234 00:16:02,676 --> 00:16:06,596 Speaker 1: as the Friendship bench. Here's how it would work. Members 235 00:16:06,596 --> 00:16:08,916 Speaker 1: of the community with mental health needs would be paired 236 00:16:08,956 --> 00:16:11,916 Speaker 1: with local grandmother. They then plan to meet up at 237 00:16:11,956 --> 00:16:15,196 Speaker 1: a bench outdoors and work through problems the person was facing. 238 00:16:16,116 --> 00:16:18,956 Speaker 1: Dixon took his idea to some grandmothers in his community 239 00:16:19,276 --> 00:16:20,756 Speaker 1: in order to get their feedback. 240 00:16:21,436 --> 00:16:26,596 Speaker 2: I was given fourteen grandmothers who were not very excited 241 00:16:26,796 --> 00:16:29,076 Speaker 2: about working with me initially. 242 00:16:29,316 --> 00:16:30,916 Speaker 3: Because can you tell me more about that? 243 00:16:31,716 --> 00:16:33,796 Speaker 2: Well, you know, when I approached them, I had my 244 00:16:33,916 --> 00:16:37,916 Speaker 2: psychiatrist's hat, and over time, over the years, I've realized 245 00:16:37,956 --> 00:16:40,996 Speaker 2: that when you really want to engage with communities, you 246 00:16:41,076 --> 00:16:43,836 Speaker 2: need to take off your professional hat. If you really 247 00:16:43,876 --> 00:16:48,436 Speaker 2: want to heal people who are traumatized in this part 248 00:16:48,476 --> 00:16:52,996 Speaker 2: of the world, you need to rely on the local language, 249 00:16:53,396 --> 00:16:58,476 Speaker 2: the local idioms of distress, and just use the language 250 00:16:58,476 --> 00:17:02,516 Speaker 2: that resonates with communities. Because when you use their own language, 251 00:17:02,836 --> 00:17:06,476 Speaker 2: you instantly remove stigma. Because stigma is one of the 252 00:17:06,516 --> 00:17:09,756 Speaker 2: biggest problems that we face in mental health and in 253 00:17:09,796 --> 00:17:13,716 Speaker 2: this part of the world. Stigma is brought about because 254 00:17:13,956 --> 00:17:16,956 Speaker 2: we're trying to adopt terms that I used in the 255 00:17:16,956 --> 00:17:19,796 Speaker 2: western world. You know, if you talk about depression in 256 00:17:19,836 --> 00:17:23,156 Speaker 2: my country, people think you've lost it yourself. That people 257 00:17:23,156 --> 00:17:28,156 Speaker 2: don't believe there's depression. People think that depression is something 258 00:17:28,316 --> 00:17:30,756 Speaker 2: that just doesn't happen to people in this part of 259 00:17:30,796 --> 00:17:35,436 Speaker 2: the world. But if you use the terms which resonates 260 00:17:35,556 --> 00:17:38,756 Speaker 2: with the local folks, like in our culture, for instance, 261 00:17:38,756 --> 00:17:43,636 Speaker 2: the equivalent for depression is a word called kofungi sisa, 262 00:17:43,716 --> 00:17:49,116 Speaker 2: which literally means thinking too much. When you break down 263 00:17:49,596 --> 00:17:53,556 Speaker 2: the symptoms of thinking too much in the local language, 264 00:17:53,676 --> 00:17:57,876 Speaker 2: it's exactly the same as depression. So you know, I 265 00:17:58,196 --> 00:18:03,116 Speaker 2: learned from the grandmothers that the words that we use 266 00:18:03,636 --> 00:18:07,916 Speaker 2: and the terms that we use to describe people's emotional 267 00:18:08,036 --> 00:18:11,516 Speaker 2: experiences can make or break people. 268 00:18:12,396 --> 00:18:17,916 Speaker 1: Fascinating, So you said, the grandmothers were not excited initially 269 00:18:18,156 --> 00:18:20,636 Speaker 1: about the prospect of working with you, but you learned 270 00:18:20,636 --> 00:18:25,196 Speaker 1: to adopt the language of the locals right and to 271 00:18:25,276 --> 00:18:29,036 Speaker 1: make sure that you were speaking in their terms. Was 272 00:18:29,036 --> 00:18:32,836 Speaker 1: that effective in getting them onto your side and motivating 273 00:18:32,836 --> 00:18:35,756 Speaker 1: those fourteen initial grandmothers to want to partner with you. 274 00:18:37,116 --> 00:18:41,596 Speaker 2: I remember grandmother Jack, the very first grandmother who I 275 00:18:41,796 --> 00:18:45,236 Speaker 2: interacted with and spoke to about the friendship bench and 276 00:18:45,276 --> 00:18:51,476 Speaker 2: the idea that I had. She was very apprehensive initially 277 00:18:52,396 --> 00:18:59,316 Speaker 2: and dismissive when I first approached her, because I was 278 00:19:00,396 --> 00:19:05,596 Speaker 2: I was using lingo from the DSM five, you know, 279 00:19:05,636 --> 00:19:10,436 Speaker 2: the Diagnostic Statistical Manual, which is kind of the psychiatrist 280 00:19:10,596 --> 00:19:14,516 Speaker 2: handbook or bible, you know, and I was using terms 281 00:19:14,556 --> 00:19:17,556 Speaker 2: from that book. And she's looking at me, like, and 282 00:19:17,596 --> 00:19:19,756 Speaker 2: you think that kind of stuff is going to fly 283 00:19:19,916 --> 00:19:20,836 Speaker 2: in this community. 284 00:19:21,036 --> 00:19:24,476 Speaker 3: You know, it's totally interesting. 285 00:19:24,116 --> 00:19:28,076 Speaker 2: You know, And I remember distinctly, you know, she said, 286 00:19:29,236 --> 00:19:31,756 Speaker 2: if you really want to make a difference in this community, 287 00:19:31,916 --> 00:19:36,516 Speaker 2: you have to put down your book and don't come 288 00:19:36,556 --> 00:19:42,276 Speaker 2: here acting like a doctor. She knows the community inside out. 289 00:19:43,036 --> 00:19:46,676 Speaker 2: And I persisted, you know, every week, you know, I'd 290 00:19:46,716 --> 00:19:49,636 Speaker 2: go to the clinic, you know, meet the grandmother's and 291 00:19:49,796 --> 00:19:52,356 Speaker 2: you know, grandmother Jack would be looking at me, you know, 292 00:19:52,556 --> 00:19:57,156 Speaker 2: very skeptical and and and gradually, you know, she warmed 293 00:19:57,236 --> 00:19:59,756 Speaker 2: up to me, you know, and gradually you know, they're 294 00:19:59,796 --> 00:20:02,596 Speaker 2: bought into the whole idea of therapy on a bench. 295 00:20:04,476 --> 00:20:06,676 Speaker 1: Yeah, you know you said that the grandmother is eventually 296 00:20:06,716 --> 00:20:08,596 Speaker 1: warmed up to you. But it seems like a key 297 00:20:08,636 --> 00:20:12,636 Speaker 1: feature of that is the fact that you maintained an 298 00:20:12,636 --> 00:20:16,036 Speaker 1: open mind throughout right you were you were viewing this 299 00:20:16,196 --> 00:20:19,236 Speaker 1: as a dialogue between you and grandmothers, right, a two 300 00:20:19,276 --> 00:20:23,796 Speaker 1: way street in which both sides were contributing to the conversation. 301 00:20:23,916 --> 00:20:27,476 Speaker 1: And I think that's such an important lesson for people 302 00:20:27,476 --> 00:20:31,676 Speaker 1: who are trying to bring new and innovative approaches to 303 00:20:31,716 --> 00:20:34,436 Speaker 1: their communities. You know. An example of this is that 304 00:20:34,596 --> 00:20:37,796 Speaker 1: initially you had planned to call the bench the mental 305 00:20:37,796 --> 00:20:41,156 Speaker 1: health bench, right yeah, and no one was coming what 306 00:20:41,276 --> 00:20:43,356 Speaker 1: it was called the mental health bench, and then the 307 00:20:43,396 --> 00:20:45,836 Speaker 1: grandma's you know, came to you, I imagine Grandma Jack 308 00:20:45,956 --> 00:20:48,836 Speaker 1: was among them and said, look, Dixon, you need to 309 00:20:48,876 --> 00:20:50,916 Speaker 1: change the name to Friendship Bench. No one is going 310 00:20:50,996 --> 00:20:52,156 Speaker 1: to come to the mental health bench. 311 00:20:52,236 --> 00:20:54,876 Speaker 2: Yeah. Yeah. And that's a good example of me having 312 00:20:54,916 --> 00:20:58,876 Speaker 2: my psychiatrist's hat on, you know, like, hey, this is 313 00:20:59,156 --> 00:21:02,236 Speaker 2: we're providing mental health services. Yes, so this is the 314 00:21:02,276 --> 00:21:04,956 Speaker 2: mental health bench. And it just didn't occur to me 315 00:21:05,076 --> 00:21:08,836 Speaker 2: that a name could make or break a program, But 316 00:21:09,276 --> 00:21:11,596 Speaker 2: learned now. You know, the language is very important, the 317 00:21:11,676 --> 00:21:14,516 Speaker 2: language that you use to navigate through the therapy, through 318 00:21:14,556 --> 00:21:18,036 Speaker 2: the session, that's critical because that's what people identify with. 319 00:21:18,636 --> 00:21:21,316 Speaker 2: So yeah, indeed, everything is in a name. 320 00:21:21,356 --> 00:21:25,036 Speaker 1: I guess I'd love to dive a bit deeper into 321 00:21:25,276 --> 00:21:28,396 Speaker 1: the features of Friendship Bench, and there's this very strong 322 00:21:28,476 --> 00:21:32,236 Speaker 1: storytelling component involved. But what's truck me about the program 323 00:21:32,356 --> 00:21:36,316 Speaker 1: is that both sides are encouraged to share their stories. 324 00:21:36,516 --> 00:21:40,436 Speaker 1: And I find this fascinating because in the clinical world, 325 00:21:41,236 --> 00:21:46,916 Speaker 1: providers are often discouraged from sharing personal stories, right, but 326 00:21:46,956 --> 00:21:51,036 Speaker 1: you've identified that there are huge therapeutic benefits to having 327 00:21:51,076 --> 00:21:55,076 Speaker 1: people bond in this way. So can you share a 328 00:21:55,076 --> 00:21:55,836 Speaker 1: bit more about that? 329 00:21:56,356 --> 00:21:59,276 Speaker 2: Sure? I think before I share one of the things, 330 00:21:59,356 --> 00:22:02,796 Speaker 2: I'd like to also just mention that through my interaction 331 00:22:03,796 --> 00:22:07,756 Speaker 2: with the grandmothers, over the years, my own approach as 332 00:22:07,796 --> 00:22:12,756 Speaker 2: a psychiatrist has changed significantly. I am more comfortable sharing 333 00:22:12,796 --> 00:22:17,316 Speaker 2: my own story with clients who come to me, you know, 334 00:22:17,436 --> 00:22:21,476 Speaker 2: for help, and I find that extremely powerful because you 335 00:22:21,596 --> 00:22:25,676 Speaker 2: really connect at a human level. You know. When we're 336 00:22:25,716 --> 00:22:29,476 Speaker 2: trained as psychiatrists, we're trained to keep this distance, don't 337 00:22:29,596 --> 00:22:33,196 Speaker 2: really open up, don't show your vulnerabilities because as a 338 00:22:33,276 --> 00:22:37,036 Speaker 2: therapist you're supposed to be strong, but actually there's a 339 00:22:37,076 --> 00:22:41,156 Speaker 2: lot more strength in showing your vulnerabilities. There's a lot 340 00:22:41,196 --> 00:22:45,836 Speaker 2: more strength that comes from telling your own story, including 341 00:22:45,876 --> 00:22:49,276 Speaker 2: the negative things, because then you really connect. Because one 342 00:22:49,356 --> 00:22:51,676 Speaker 2: of the things I've learned from Friendship Bench is the 343 00:22:51,676 --> 00:22:56,956 Speaker 2: therapy actually starts when you connect with a person. The 344 00:22:57,076 --> 00:23:00,996 Speaker 2: different steps that you take in the process of reaching 345 00:23:01,036 --> 00:23:04,596 Speaker 2: out to people are important, but if you do not 346 00:23:04,836 --> 00:23:10,036 Speaker 2: have that connection that from poor you may lose everything else. 347 00:23:10,996 --> 00:23:13,916 Speaker 2: So if you ask me what I consider to be 348 00:23:13,956 --> 00:23:17,236 Speaker 2: the most critical feature of the work we do, it's 349 00:23:17,276 --> 00:23:21,756 Speaker 2: that connection. Being able to get two people to connect 350 00:23:22,316 --> 00:23:26,796 Speaker 2: in a way that is empathic. And that's the first part, 351 00:23:26,956 --> 00:23:30,836 Speaker 2: you know, which the grandmother's call or opening up the mind, 352 00:23:31,676 --> 00:23:34,596 Speaker 2: because without opening up the mind, you don't get to 353 00:23:34,676 --> 00:23:39,356 Speaker 2: the root of the problem. The other key component that 354 00:23:39,436 --> 00:23:47,596 Speaker 2: we emphasize is the grandmother's ability to summarize. So if 355 00:23:47,636 --> 00:23:50,636 Speaker 2: you're listening to a story, you know, this is what 356 00:23:50,756 --> 00:23:53,716 Speaker 2: I normally would say to the grandmothers. If you're listening 357 00:23:53,716 --> 00:23:58,796 Speaker 2: to a story, how does the person that is telling 358 00:23:58,836 --> 00:24:03,396 Speaker 2: the story know that you really were listening? And the 359 00:24:03,476 --> 00:24:08,436 Speaker 2: simplest way is a summary. You know, a good summary 360 00:24:08,556 --> 00:24:13,436 Speaker 2: of what you've heard shows how well you were immersed 361 00:24:13,516 --> 00:24:17,156 Speaker 2: in the story, and you can see from the grandmothers 362 00:24:17,276 --> 00:24:21,676 Speaker 2: who are brilliant at summarizing, they are also the best 363 00:24:21,716 --> 00:24:25,716 Speaker 2: grandmothers when it comes to immersing themselves into a story 364 00:24:25,756 --> 00:24:30,756 Speaker 2: and also showing that empathy and that ability to make 365 00:24:30,796 --> 00:24:36,636 Speaker 2: people feel respected and understood. So those are the two 366 00:24:36,716 --> 00:24:37,756 Speaker 2: key components. 367 00:24:38,476 --> 00:24:42,476 Speaker 1: Another component of the friendship bench is a diagnostic screening tool. 368 00:24:42,796 --> 00:24:45,396 Speaker 1: The grandmothers have everyone who comes to the bench fill 369 00:24:45,396 --> 00:24:47,916 Speaker 1: out a questionnaire so they can get a better sense 370 00:24:47,956 --> 00:24:50,756 Speaker 1: of what kinds of symptoms the person is experiencing and 371 00:24:50,796 --> 00:24:54,956 Speaker 1: their degree of severity. If someone presents with severe symptoms, 372 00:24:55,036 --> 00:24:58,476 Speaker 1: the grandmother refers them right away to a trained medical professional, 373 00:24:59,196 --> 00:25:02,076 Speaker 1: but if someone presents with more mild to moderate symptoms, 374 00:25:02,236 --> 00:25:05,596 Speaker 1: the friendship bench is for them. Grandmothers are trained in 375 00:25:05,636 --> 00:25:09,276 Speaker 1: a form of cognitive behavioral therapy called problem solving therapy, 376 00:25:09,716 --> 00:25:14,596 Speaker 1: which focuses on identifying concrete problems like unemployment, rather than 377 00:25:14,676 --> 00:25:18,556 Speaker 1: the symptoms of that problem like anxiety. Grandmothers then work 378 00:25:18,596 --> 00:25:21,396 Speaker 1: with a person to brainstorm specific steps they can take 379 00:25:21,476 --> 00:25:25,156 Speaker 1: to solve the problem, and according to research, this focus 380 00:25:25,196 --> 00:25:28,836 Speaker 1: on resolving specific problems can give people a greater sense 381 00:25:28,876 --> 00:25:30,436 Speaker 1: of agency over their lives. 382 00:25:31,436 --> 00:25:38,196 Speaker 2: A classical sort of presentation on the bench is, you know, 383 00:25:39,876 --> 00:25:48,916 Speaker 2: a young client presenting with numerous problems. I'm HIV positive, 384 00:25:49,516 --> 00:25:54,116 Speaker 2: I'm unemployed, I'm in an abusive relationship, I have a 385 00:25:54,236 --> 00:25:57,516 Speaker 2: child who is not able to go to school because 386 00:25:57,556 --> 00:26:00,236 Speaker 2: I don't have money to pay for school fees. I'm 387 00:26:00,276 --> 00:26:04,596 Speaker 2: struggling to feed my family. So they present with numerous problems, 388 00:26:05,596 --> 00:26:09,116 Speaker 2: you know. And one of the things that has really 389 00:26:09,396 --> 00:26:16,996 Speaker 2: characterized the therapy component is the ability to help these 390 00:26:17,476 --> 00:26:20,916 Speaker 2: clients who come to the bench after sharing these stories, 391 00:26:21,356 --> 00:26:25,436 Speaker 2: the ability of the grandmothers to help them select one 392 00:26:25,556 --> 00:26:29,836 Speaker 2: problem to focus on. And that sounds very simple, but actually, 393 00:26:29,876 --> 00:26:33,516 Speaker 2: when you're immersed in all these problems, every single one 394 00:26:33,556 --> 00:26:36,756 Speaker 2: of those problems is a big problem for you. So 395 00:26:36,956 --> 00:26:40,676 Speaker 2: because the grandmothers live in these communities, the actual treatment 396 00:26:40,836 --> 00:26:44,636 Speaker 2: is often not only on the bench, but it also 397 00:26:44,716 --> 00:26:47,316 Speaker 2: occurs in the community. So you can get a grandmother 398 00:26:47,556 --> 00:26:51,156 Speaker 2: meeting a client, for instance, at church, So I'll see 399 00:26:51,156 --> 00:26:53,836 Speaker 2: you this Sunday at church and you and I can 400 00:26:53,876 --> 00:26:57,556 Speaker 2: pray together. I will see you at the market and 401 00:26:57,596 --> 00:27:00,396 Speaker 2: we can do this together. So you're slowly introducing a 402 00:27:00,556 --> 00:27:05,516 Speaker 2: very practical kind of behavior activation to help someone who 403 00:27:05,636 --> 00:27:12,476 Speaker 2: is depressed and unmotivated and isolating themselves at home because 404 00:27:12,796 --> 00:27:16,476 Speaker 2: they feel they're in this miserable situation. But because the 405 00:27:16,556 --> 00:27:19,476 Speaker 2: grandmother has come up with the set of activities that 406 00:27:19,516 --> 00:27:23,436 Speaker 2: they then carry out together, you slowly begin to see 407 00:27:23,436 --> 00:27:27,876 Speaker 2: this person transforming. So that's one sort of example of 408 00:27:27,916 --> 00:27:31,396 Speaker 2: how the grandmothers will deal with situations of depression. Often 409 00:27:31,436 --> 00:27:34,836 Speaker 2: people think the work we do is just on the bench. 410 00:27:35,996 --> 00:27:39,276 Speaker 2: The bench, the friendship bench, or the bench. The physical 411 00:27:39,316 --> 00:27:43,276 Speaker 2: bench is just an entry point. There's a lot more 412 00:27:43,316 --> 00:27:47,516 Speaker 2: that happens outside of the bench. We encourage everyone who 413 00:27:47,676 --> 00:27:50,476 Speaker 2: sat on the bench with the grandmother is to join 414 00:27:50,556 --> 00:27:53,876 Speaker 2: a support group in the community. And through the support 415 00:27:53,956 --> 00:28:00,556 Speaker 2: groups that you get peer support with individuals who've all 416 00:28:00,596 --> 00:28:05,836 Speaker 2: gone through the Friendship Bench, share their own experiences and 417 00:28:05,916 --> 00:28:09,756 Speaker 2: collectively problems solve around challenges that they have racing within 418 00:28:09,796 --> 00:28:10,556 Speaker 2: the community. 419 00:28:11,596 --> 00:28:13,476 Speaker 1: I'd love if you could talk about the efficacy of 420 00:28:13,476 --> 00:28:17,676 Speaker 1: the program, because you actually ran a randomized control trial, 421 00:28:17,756 --> 00:28:22,516 Speaker 1: which is considered the gold standard of evaluation, and found 422 00:28:22,516 --> 00:28:25,596 Speaker 1: some extremely exciting results. 423 00:28:26,716 --> 00:28:33,076 Speaker 2: Yeah. So we have over fifty peer reviewed publications, you know, 424 00:28:33,116 --> 00:28:36,116 Speaker 2: scientific publications about the Friendship Bench. But I guess the 425 00:28:36,116 --> 00:28:41,636 Speaker 2: most seminal publication would be our cluster randomized controlled trial 426 00:28:41,756 --> 00:28:45,596 Speaker 2: which is published in the Journal of the American Medical Association, 427 00:28:46,236 --> 00:28:51,116 Speaker 2: which in a nutshell shows that six months after receiving 428 00:28:51,236 --> 00:28:57,556 Speaker 2: therapy from a trained community grandmother on a bench in Zimbabwe, 429 00:28:58,156 --> 00:29:03,516 Speaker 2: people were still symptom free. The grandmothers were in essentially 430 00:29:03,676 --> 00:29:09,076 Speaker 2: much better than enhanced usual care, and enhanced usual care 431 00:29:09,396 --> 00:29:14,276 Speaker 2: was a trained mental health nurse, clinical psychologists or psychiatrists, 432 00:29:14,556 --> 00:29:16,956 Speaker 2: you know. And I think the reason why the grandmothers 433 00:29:16,996 --> 00:29:19,636 Speaker 2: tend to be better is because they are rooted in 434 00:29:19,676 --> 00:29:23,916 Speaker 2: their communities. The grandmothers are the custodians of local culture 435 00:29:23,996 --> 00:29:25,236 Speaker 2: and wisdom, you know. 436 00:29:26,636 --> 00:29:29,636 Speaker 1: And it's positively changing the lives of grandmothers as well. 437 00:29:30,316 --> 00:29:34,196 Speaker 2: Yeah. One of our most recent publication actually took a 438 00:29:34,316 --> 00:29:38,676 Speaker 2: random sample of grandmothers who are working on friendship bench 439 00:29:39,436 --> 00:29:44,516 Speaker 2: and compared them with a similar random sample of grandmothers 440 00:29:44,556 --> 00:29:49,596 Speaker 2: with similar social demographic characteristics, and we found that the 441 00:29:49,636 --> 00:29:52,916 Speaker 2: grandmothers who work on friendship bench were a lot more resilient, 442 00:29:52,996 --> 00:29:57,516 Speaker 2: They had lower rates of common mental disorders and postraumatic 443 00:29:57,596 --> 00:30:02,356 Speaker 2: stress disorder. And when we dug deeper, we actually found 444 00:30:02,436 --> 00:30:06,636 Speaker 2: that this work gave the grandmothers, a profound sense of 445 00:30:06,716 --> 00:30:10,596 Speaker 2: purpose and a sense of belonging, and this is why 446 00:30:10,636 --> 00:30:13,796 Speaker 2: they do this work. It's a win win. Actually, they 447 00:30:13,796 --> 00:30:17,556 Speaker 2: are not only reaching out and helping people, but it's 448 00:30:17,676 --> 00:30:18,596 Speaker 2: helping them too. 449 00:30:19,516 --> 00:30:22,036 Speaker 1: So one thing that's been so exciting about the program 450 00:30:22,116 --> 00:30:25,396 Speaker 1: is that the Friendship Bench is scaling to places all 451 00:30:25,396 --> 00:30:28,916 Speaker 1: over the world. What are your future dreams for this program, 452 00:30:28,956 --> 00:30:31,196 Speaker 1: like if you could wave a magic wand what is 453 00:30:31,196 --> 00:30:34,076 Speaker 1: the presence of the Friendship bench like in communities all 454 00:30:34,116 --> 00:30:34,756 Speaker 1: over the world. 455 00:30:36,356 --> 00:30:40,676 Speaker 2: The vision of Friendship Bench is to actually have a 456 00:30:40,716 --> 00:30:47,316 Speaker 2: friendship bench within walking distance everywhere. It sounds grandeous, very ambitious, 457 00:30:47,316 --> 00:30:52,916 Speaker 2: but it's something that I am working towards because in 458 00:30:52,956 --> 00:30:59,196 Speaker 2: every culture, people thrive when they connect with each other. 459 00:30:59,876 --> 00:31:04,076 Speaker 2: And the Friendship Bench is not just an intervention that 460 00:31:04,236 --> 00:31:09,996 Speaker 2: addresses mental health issues. It's really an intervention that connects people. 461 00:31:10,436 --> 00:31:12,876 Speaker 2: And I think that's where the real power of this 462 00:31:13,036 --> 00:31:18,636 Speaker 2: comes from. And when you connect people, particularly using grandmothers 463 00:31:18,756 --> 00:31:23,876 Speaker 2: or the elderly, you have this profound sense of belonging 464 00:31:24,436 --> 00:31:28,036 Speaker 2: and it creates a sense of purpose, particularly for the 465 00:31:28,116 --> 00:31:31,316 Speaker 2: grandmothers and the you know so, So I think that's 466 00:31:31,956 --> 00:31:33,876 Speaker 2: that's what I would like to see you know in 467 00:31:33,956 --> 00:31:37,036 Speaker 2: the next coming years, and unfortunately we are you know, 468 00:31:37,076 --> 00:31:40,956 Speaker 2: we are gaining traction. Uh. And I just want to 469 00:31:41,356 --> 00:31:44,636 Speaker 2: make it possible for every person out there who needs 470 00:31:44,676 --> 00:31:47,916 Speaker 2: to connect, who feels they need to talk to be 471 00:31:48,036 --> 00:31:51,356 Speaker 2: able to talk to someone who is empathic, someone who's 472 00:31:51,436 --> 00:32:13,436 Speaker 2: able to respect them and to understand them. 473 00:32:13,516 --> 00:32:16,356 Speaker 1: A Slight Change of Plans is created, written, and executive 474 00:32:16,396 --> 00:32:20,156 Speaker 1: produced by me Maya Schunker. The Slight Change family includes 475 00:32:20,236 --> 00:32:24,036 Speaker 1: Tyler Green our senior producer, Jen Guera our senior editor, 476 00:32:24,396 --> 00:32:28,516 Speaker 1: Ben Holliday, our sound engineer, Emily Rosstek our producer, and 477 00:32:28,596 --> 00:32:32,636 Speaker 1: Meia LaBelle our executive producer. Louis Scara wrote our theme 478 00:32:32,756 --> 00:32:36,316 Speaker 1: song and Ginger Smith helped arrange the vocals. A Slight 479 00:32:36,436 --> 00:32:39,196 Speaker 1: Change of Plans is a production of Pushkin Industries, So 480 00:32:39,316 --> 00:32:43,316 Speaker 1: big thanks to everyone there, including Malcolm Gladwell, Jacob Weisberg, 481 00:32:43,676 --> 00:32:47,556 Speaker 1: Lee tal Mallatt and Heather Fame, and of course a 482 00:32:47,716 --> 00:32:51,156 Speaker 1: very special thanks to Jimmy Lee. You can follow A 483 00:32:51,156 --> 00:32:54,476 Speaker 1: Slight Change of Plans on Instagram at doctor Maya Shunker 484 00:32:55,036 --> 00:32:55,876 Speaker 1: See you next week. 485 00:33:02,676 --> 00:33:04,196 Speaker 3: Is there any chance for grandfathers? 486 00:33:04,756 --> 00:33:09,676 Speaker 2: When we first started, we did involve some grandfathers. The 487 00:33:09,916 --> 00:33:13,636 Speaker 2: challenge with grandfathers is they just don't have the same 488 00:33:13,716 --> 00:33:17,036 Speaker 2: ability as grandmothers when it comes to creating space and 489 00:33:17,116 --> 00:33:21,916 Speaker 2: letting people tell their stories. Grandfathers tend to be prescriptive. 490 00:33:22,476 --> 00:33:24,556 Speaker 2: They tend to tell you what you need to do. 491 00:33:24,676 --> 00:33:26,716 Speaker 2: You go and talk to this person, and go and 492 00:33:26,796 --> 00:33:27,196 Speaker 2: do this. 493 00:33:27,796 --> 00:33:29,716 Speaker 3: You know, so there's some man explaining going on. 494 00:33:30,316 --> 00:33:31,316 Speaker 2: Yes, quite a lot of it.