How communities provide mental health care support: 4 global examples

Around the world, increased requests for help and disparate resource networks are demanding innovative new approaches to ensure every individual has access to quality support.

A look at how communities are contributing to mental wellness demonstrates not only the breadth and complexity of mental health but also the universal needs for and benefits of listening and connecting, talk therapy and support groups.

Below are four approaches that merit further examination and perhaps replication, at the very least ongoing support, for their efforts and impact.

1.???? Zimbabwe: The Friendship Bench and Grandmother Project

In Zimbabwe, mental health services are costly and hard to come by, primarily because there are too few qualified professionals. A nonprofit organization called Friendship Bench is working to fill the need by training community members to provide talk therapy to people experiencing common mild- to moderate-level mental and behavioral disorders, such as anxiety and depression.

Initial training for the program focused on grandmothers, because they are widely respected and trusted. As of 2023, more than 1,700 people have been trained as community health workers, and more than 240,000 clients have received counseling or treatment from the friendship bench services.[1] Localities in Switzerland, the United States and several other countries have also planned or begun implementing similar Friendship Bench pilots. The project’s organizers plan to train 2,000 community-based workers over the next year.[2]

To learn more, about The Friendship Bench, visit https://www.friendshipbenchzimbabwe.org/. To learn more about Grandmother Project, visit https://grandmotherproject.org/.

2.???? Brazil: The National Strategy for Strengthening Anxiety and Depression Care

A national effort in Brazil aimed at children and adolescents is one of several initiatives launched in 2022 in response to a COVID-19-fueled increase in mental health problems.[3] The Ministry of Health also instituted a 24/7 live line to assist callers suffering from anxiety, depression or suicidal thoughts and a separate tele-consultation project to broadly expand access to mental health services.[4]

Nearly 80% of respondents to a 2021 survey in Brazil said that mental and physical health are equally important.[5] A similar proportion thought about their mental health very or fairly often, and 40% said mental health is Brazil’s top health-related problem.[6] In a separate 2022 study, more than one-third of Brazilians acknowledged they had talked to friends and family about mental health issues, and about one-quarter said they had discussed these issues with a mental health or primary healthcare professional.[7]

3.???? United States: The Confess Project Of America

This organization trains barbers in Black communities to become mental health advocates, whose objectives include heightening awareness and destigmatizing mental illness. Barbers are trusted members of their communities, and their shops are often considered safe spaces for sensitive conversations.

Barbers receive training around four pillars: active listening, validation, stigma reduction and communication. They are also taught to watch for signs of depression, anxiety and isolation, such as withdrawal, lack of affect or changes in grooming. With operations in 52 cities and 29 states, the Confess Project has trained nearly 3,000 barbers, reaching more than 2.4. million people per year.[8] Its goal is to raise that number to 5,000 by 2024.

The initiative also works with city governments, universities and other organizations to examine how mental health intersects with law enforcement involvement and LGBTQ or gender inequality issues.

4.???? Australia: The National Mental Health and Suicide Prevention Plan

A multibillion-dollar, government-directed effort was launched in 2021 to reform mental health support and treatment for all the country’s residents.[9] The budget investment for mental health and suicide prevention is the largest in Australia’s history. This includes mental health services in response to the COVID pandemic and a program to help teachers better understand and respond to mental health challenges.

The other areas targeted are suicide prevention, making mental health treatment services more accessible and effective, programs to support culturally and linguistically diverse communities and a 10-year strategy to deliver “a sustainable, skilled, supported and equitably distributed mental health workforce.”[10]?

The importance of mental health is being talked about and acknowledged. Public perception has changed. It is encouraging that many tactical, strategic and grassroots initiatives have been rolled out with the explicit goal of improving mental health services. Much more can and should be done to make the most of this potentially transformational moment. Next, in the blog series finale, we will explore additional pathways to progress through the three P’s: providers, proximity and process.

The views reflected in this article are the views of the author and do not necessarily reflect the views of Ernst & Young LLP or other members of the global EY organization.

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[1] “Friendship Bench One-pager,” Friendship Bench Medica Centre, website https://www.friendshipbenchzimbabwe.org/mediacentre, accessed July 19, 2023.

[2] Ibid.

[3] “With an investment of R$ 45 million, the Federal Government launches strategies to take care of the mental health of Brazilians,” Brazil Ministry of Health website, https://www.gov.br/saude/pt-br/assuntos/noticias/2022/junho/com-investimento-de-r-45-milhoes-governo-federal-lanca-estrategias-para-cuidar-da-saude-mental-dos-brasileiro.

[4] Ibid.

[5] “Public opinion on mental health in Brazil as of 2021,” Statista website, https://www.statista.com/statistics/1338303/public-opinion-mental-health-care-brazil/ ,” ?2023, Statista.

[6] Ibid.

[7] “Personal experience on means to tackle mental health issues in Brazil as of 2022,” Statista website, ?2023, Statista.

[8] The Confess Project Of America website, https://www.theconfessprojectofamerica.org/, accessed July 19, 2023.

[9] “Prevention Compassion Care National Mental Health and Suicide Prevention Plan, Australian Government,” ?2021, Commonwealth of Australia.

[10] “Prioritising Mental Health and Suicide Prevention – Workforce and Governance (Pillar 5)” Australian Government Department of Health and Aged Care website, https://www.health.gov.au/resources/publications/prioritising-mental-health-and-suicide-prevention-pillar-5-workforce-and-governance, accessed July 19, 2023.