How DC Grandparents Are Improving Community Mental Health
A volunteer-led group in Washington, D.C., is adapting a successful community-based therapy approach pioneered in Zimbabwe
Angela Jasper listened to a woman describe her relationship with her husband. He struggled with alcoholism, and the woman was distraught. "She had sort of thrown her hands up," Jasper says.
Through their conversation, Jasper helped the woman identify a couple goals she could work on in her relationship. When they met the next time, the woman was beginning to feel an improvement.
"After she worked on those goals, she felt much better," Jasper says.
Jasper isn't a therapist. She's one of about 15 so-called "grandparents" in the Washington, D.C., area who have learned skills to offer basic mental health supports. These trained older adults — they're not all required to be grandparents — have started offering free counseling sessions in hubs around the city to anyone who might need someone to talk to.
These trained older adults — they're not all required to be grandparents — have started offering free counseling sessions in hubs around the city to anyone who might need someone to talk to.
Jasper is part of DC Grandparents for Mental Health, a volunteer-led effort adapting a community-based approach to mental health first pioneered in Zimbabwe two decades ago. This model, called Friendship Bench, tremendously increased access to services across the southern African country by training lay people to help treat conditions like depression and anxiety. To date, more than 600,000 people have been treated on a Friendship Bench.
And most of Friendship Bench's providers are older adults — specifically grandmothers.
"They are pillars within society," says Dr. Thandiwe Mashunye, head of programs at Friendship Bench Zimbabwe. "They've got a lifetime of experiences, of stories, and they can draw from that experience and help others who are going through similar challenges to be able to cope within those stressful moments."
The Resilience of Older Adults Is Valued
The idea to recruit grandmothers to improve mental health within communities came from Dr. Dixon Chibanda, a psychiatrist and founder of Friendship Bench. After one of his patients took her own life, Chibanda felt a strong need to build out more mental health supports across Zimbabwe.
The country has a shortage of mental health professionals. As of 2024, for a population of 17 million people, there were just 18 psychiatrists and six clinical psychologists.
"It's just harnessing those skills and then just adding a little bit of technical support."
Chibanda figured that older women were already well-known and respected figures within communities. By training them to administer techniques like problem-solving and structured talk therapy, they could provide the mental health supports that were so badly needed. Mashunye says the life experiences and resilience of older adults make them natural fits for this role.
"It's just harnessing those skills and then just adding a little bit of technical support," Mashunye says.
Instead of working out of medical offices, grandmothers in Zimbabwe meet clients on benches set up around communities.
In fact, the bench is not a required ingredient, explains Mashunye. Grandmothers can speak with clients in any place that is calm and quiet — in homes, under a tree, even over WhatsApp.
Not only is this model relatively cheap, but it is also proving to have a huge impact. People who were treated for anxiety or depression through Friendship Bench were three times less likely to have symptoms of depression six months after beginning treatment than people who didn't get treatment through the model. People who went through the program also experienced reduced anxiety and suicidal thoughts.
"They love their work, and they are self-motivated, and seeing the difference that they are making within the community really drives them."
And the benefits aren't only for visitors. Research finds that the grandmothers themselves experience lower levels of common mental health conditions.
Grandmothers are not treating mental health on their own. They have their support. They regularly check in with supervisors, who help manage more complex cases. And Friendship Bench offers support groups to grandmothers to help them manage their own mental health.
"They love their work, and they are self-motivated, and seeing the difference that they are making within the community really drives them," says Mashunye.
So far, more than 2,000 community health workers, mostly grandmothers, have been trained to offer therapy in Zimbabwe.
The program is now offered in all 10 provinces of Zimbabwe, and the model has been adapted in countries around the world, including Zanzibar, Vietnam, Jordan and New York City. Chibanda has a vision that someday, a bench will be in walking distance for everyone.
Adapting the Model in D.C.
When a group of older adults in Washington, D.C., were looking for a way to support mental health among people of all ages in their communities, they came across the Friendship Bench model.
The group had first coalesced during the COVID-19 pandemic in an effort to encourage loved ones and neighbors to get vaccinated. Their outreach proved effective, and they decided to redirect their work towards another pervasive issue: mental health.
The volunteer group is supported by HelpAge USA, the national affiliate of an international NGO that works to promote rights and wellbeing of older people. Through this global network, it was easy to connect with Friendship Bench Zimbabwe, explains HelpAge USA president and CEO Cindy Cox-Roman.
Over the course of about two years, the group worked to adapt the model to the Washington, D.C., context. So-called "grandparents" went through a 10-week training course.
"Our grandparents, at the right time, could say, 'I understand what you're going through.'"
Then, in June, the first bench opened for visitors at a senior wellness center in southeastern D.C.
The model works a bit differently than in Zimbabwe. Visitors need to make an appointment in advance and go through a screening process — ensuring that if their needs are more acute, that they can be referred to higher levels of treatment.
Instead of setting up benches around public places, the group partnered with existing community hubs — a move that both provides some security and also connects grandparents with existing groups of potential clients.
Now benches — both outdoors and indoors — are offered at five locations around D.C., including a school, a neighborhood assistance organization and a church. In contrast to formal mental health treatment, the interactions are distinctly de-medicalized, says Cox-Roman — instead of using terms like "depression," they ask about difficult thoughts and feelings. That helps reduce barriers and stigma that may deter visitors from other forms of treatment.
For grandparents in the D.C. area, one of the biggest lessons through the training process was learning how to help visitors without giving advice, Jasper and Cox-Roman recall. But — like in Zimbabwe — part of what makes this initiative unique is the experience each grandparent brings to their interactions on the bench.
"Our grandparents, at the right time, could say, 'I understand what you're going through,'" Cox-Roman says. "There's a message that can come through that, 'you're not alone, because I've been there.'"
'A Boost for All Generations'
For Jasper, whose career in education took her from preschool special education to the college level, learning to deliver mental health supports has been rewarding.
"The Friendship Bench DC experience has helped me to grow," Jasper says.
In each session, Jasper listens to the visitor's story and helps them identify specific issues and then think through issues they want to work on.
"We are not fixers," she says. "You know, [we] simply want to give our visitors an opportunity to look at an issue in another way and to work out a plan of action."
She sees how this community-based approach to mental health can help people of all ages.
"It's a boost for all generations," Jasper says.
