SINGAPORE – Zimbabwe, which has fewer than 20 psychiatrists serving a population of 15 million, started a mental health initiative with senior volunteers offering mental health help in the community. Not only did the initiative take off, but it has also been replicated in other African countries and elsewhere, including New York.

Sitting on a wooden Friendship Bench placed near primary healthcare clinics or safe community spaces, these community health workers known as “grandmothers” counsel people who need help for common mental disorders, such as anxiety and depression.

They have no medical background but have been trained to provide counselling, usually over six structured 45-minute sessions.

The Friendship Bench initiative was founded in 2006 by Dr Dixon Chibanda, a Zimbabwe-based psychiatrist, after he lost a patient to suicide. She was due for a review, but her family had no money for her to travel by bus to Harare, the capital city, to see him.

The Asian hub of the Mental Health Innovation Network (MHIN Asia) set up in Singapore earlier in 2024 highlighted this project to The Straits Times as one of the possible solutions that can be adapted for use here and in the region.

MHIN is a knowledge exchange hub for the global mental health community that was created 10 years ago by the London School of Hygiene and Tropical Medicine and the World Health Organisation.

Regional hubs were subsequently created in Africa, Latin America and the Caribbean, and Asia.

The Asian hub, hosted by the SingHealth Duke-NUS Global Health Institute (SDGHI), was established with funding from Singapore-based Indonesian palm oil giant Musim Mas Group, to facilitate cross-country exchange and learning about mental health.

Musim Mas donated $1 million to the Singapore General Hospital (SGH) for developing future healthcare leaders through a regional fellowship programme, as well as for the establishment of MHIN Asia.

This was part of its $5 million donation tranche given to six charities, including philanthropic organisation Majurity Trust, which received $1.1 million for supporting youth mental health, and the Community Chest, which will use $1 million for causes that support the underprivileged, at-risk children and youth, and other vulnerable groups.

Musim Mas said it wanted its donation to go towards a wide range of causes that can better the lives of everyday Singaporeans.

“But having said that, we are aware that mental health is a growing concern in the region and deserves more support,” said Mr Alvin Lim, Musim Mas’ chief financial officer and executive director.

“We believe SGH’s aim of establishing the first Asian hub for MHIN will play an important role in the development of the human resources and institutional support needed to advance mental healthcare in the region, including Singapore.”

As Singapore shifts the centre of gravity of healthcare from hospitals to the community, there is much that it can learn from less well-resourced countries, said Associate Professor Tan Hiang Khoon, director of SDGHI and deputy CEO (Future Health System) at SGH.

“This Friendship Bench is one of the many examples we call task shifting. We shift the task of what is typically the responsibility of trained healthcare professionals to a group of people that are trained especially for their particular class, but effective in many ways,” he said.

“They have the respect of the folks that they are talking to.” 

There are other mental health initiatives that MHIN Asia can share, including those in regional countries.

Mental health systems and solutions originating from Asia remain significantly underrepresented globally, and many countries in the region continue to grapple with challenges such as stigma and a lack of evidence-based implementation, Prof Tan said.

Platforms such as MHIN Asia are thus crucial in elevating Asia’s position in the global conversation on advancing mental health, he added.

Prof Tan said the hub will not just curate existing knowledge, but is willing to invest in research to create new knowledge, too.

It can also be used as a platform for leaders, mental health champions and practitioners to share best practices and learn from one another, and as a think-tank for the region.

Assistant Professor Anne-Claire Stona, the global mental health lead at SDGHI, said Singapore, with its national mental health and well-being strategy, still needs to come up with new innovations and new models of care, while others in the region can tap the hub to learn about its strategy.

She said MHIN Asia is now working on mapping the existing mental health innovations in South and South-east Asia, in order to understand the need for, barriers to and facilitators of such innovations, as well as collate and showcase evidence-based solutions and ideas.

MHIN Asia will be officially launched in Singapore during the Global Mental Health in Asia 2025 symposium from Feb 17 to 19, 2025.