Tag Archive for: Mental Health

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Zimbabwe’s Friendship Bench

Zimbabwe’s Friendship Bench: Grandmothers, Therapy, and TechnologyIn Zimbabwe, an ongoing revolution is transforming mental health care, driven by an unlikely group: the country’s grandmothers. These women, with little formal training, sit on park benches, offering not just a shoulder to lean on but evidence-based counselling that’s changing lives. Currently, they are using digital tools to extend their reach beyond the benches, bringing support to even the most isolated communities.

Mental Health Landscape in Zimbabwe

Zimbabwe’s road to its current mental health crisis took shape from years of trauma, from colonial history to the long fight for independence. Over time, socio-economic challenges, including hyperinflation, rampant unemployment and a failing health system, have deepened the emotional toll. As of 2021, the country faces one of the highest suicide rates in the world (23.6 per 100,000), alongside widespread depression and post-traumatic stress. With just 18 psychiatrists serving a population of 17 million, mental health care in Zimbabwe has been inaccessible for most and barely recognized. 

The Birth of the Friendship Bench

 The Friendship Bench began with a simple idea. Dr. Dixon Chibanda, a psychiatrist working in Harare, realized that Zimbabwe’s mental health crisis needed something different from more doctors. So, he turned to a deeply rooted tradition in Zimbabwean culture: the matriarchs of the community.

In 2006, psychiatrist Dr. Dixon Chibanda partnered with local health authorities to train a group of elderly women, many of whom had no formal education in mental health, in a simple yet effective form of therapy called Problem-Solving Therapy (PST). These women, affectionately known as the “grandmothers,” were among the few people with the time and willingness to serve as lay health workers, especially given the country’s severe shortage of mental health professionals. By shifting the model to rely on available, community-rooted personnel, something positive began to take shape.

Sitting on brightly painted benches outside local clinics, these grandmothers became trusted figures in their neighborhoods. They offered more than advice, they listened. Through open, empathetic conversations rooted in cultural familiarity, they used behavioral therapy techniques to address kufungisisa—a Shona term that translates loosely to “thinking too much” and often describes depression or deep emotional distress. Their approach was grounded in traditional values like kusimudzira (to uplift), kuvhurika pfungwa (opening up the mind) and kusimbisa (to strengthen). These weren’t just abstract ideas; they were culturally resonant tools for healing. 

Clinical trials showed that after just a few sessions on the bench, 98% of people who had previously considered suicide were no longer suicidal six months later. People who arrived feeling hopeless left with a sense of dignity, strength and direction. 

Taking a Digital Leap

The pandemic could have halted the progress of the Friendship Bench, but instead, it propelled it into a new era. With Zimbabwe’s already impressive mobile phone penetration (90% of the country has access), the grandmothers began reaching out through WhatsApp and voice calls, extending their therapy services to people who could not make it to a physical bench.

The shift kept the spirit of Zimbabwe’s Friendship Bench intact. This digital pivot meant that counselling could reach those in remote villages, women unable to leave their homes and even young people navigating mental health challenges in crowded urban centers. Unexpectedly, it also helped improve communication between the grandmothers and their supervisors, strengthening the support system behind the scenes. What started as a grassroots intervention under a tree had quietly evolved into a scalable, hybrid model. 

A Model for Accessible Global Mental Health

As of 2025, more than 2,000 grandmothers in Zimbabwe are delivering therapy to at least 500,000 people across the 11 provinces. But the model has not stopped at the country’s borders. It is currently in more than nine countries, including Kenya, Malawi and even the United States (U.S.), with each country tailoring the approach to its own cultural and social contexts. Yet wherever it goes, the core stays the same: community-led care, empathy, accessibility and the belief that healing can begin with a simple conversation.

Scaling Zimbabwe’s Friendship Bench

According to experts, scaling the Friendship Bench model further will depend on strong collaboration between Zimbabwe’s government, local health authorities and international partners. Sustaining the program’s momentum could mean finding smart ways to integrate it into existing public health and technology infrastructures.

The mobile phone industry, for example, offers real potential, not just for reaching clients, but for training grandmothers, supervising their work, collecting data and enabling real-time support through virtual platforms. By continuing to build on what’s already available, the Friendship Bench could go even further, reaching more people, in more places, with the same message: healing doesn’t have to be out of reach. By adapting an age-old tradition of community care to the digital age, Zimbabwe has created a model for mental health that could potentially be replicated globally. 

– Sriya Regulapati

Sriya is based in Vancouver, Canada and focuses on Business and Global Health for The Borgen Project.

Photo: Friendship Bench

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Who Am I?: The Influence of Mahmoud Darwish on Palestine

Mahmoud DarwishWhat will I do? What will I do without exile and a long night that stares at the water? Mahmoud Darwish asks in his poem “Who Am I, Without Exile?” The poem, published in 2008 in The Butterfly’s Burden, is a sentiment explored by Darwish throughout much of his work.

The master lyrical poet constantly asks for answers to who he is; however, Mahmoud Darwish never stood alone and never failed to call out to the Palestinian people he wrote for. Though Darwish sadly passed away in 2008, his work remains just as influential for the people of Palestine, who have always been the heart of his work.

The Healing Power of Poetry

Reading and writing poetry offers incredible mental benefits, even going so far as to decrease pain in the sick. In a study conducted in 2016, researchers observed how listening to or reading music and poetry could affect pain, depression and hope within adult cancer patients.

The findings were remarkable; the study directly identified “both music and poetry produced a similar improvement in the pain intensity. The two therapies also affected depression scores and only poetry increased hope scores.” The “hope score” mentioned in the study refers to a measurement of a patient’s optimism, which was solely increased by listening to poetry.

Writing for Palestinians

Born in 1941, Mahmoud Darwish published his first poetry collection at 22, titled “Leaves of Olives.” At this point, he had been put on house arrest and imprisoned by the Israeli government; Darwish’s back-and-forth with the Israeli government began when he was 14. Darwish’s influence on Palestinian voices has been an incredibly valuable tool and continues to be so today.

Being Palestinian himself, Darwish wrote to the people of Palestine, sharing their anxieties, suffering and love for their home. Darwish witnessed the beginning of it when he was a young boy. Born in al-Birwa before it became a part of Israel, Darwish watched the expansion of the Israeli army firsthand. Al Jazeera, an independent news organization operating out of Qatar, explains the unique significance of Darwish’s writing to his Palestinian audience: “For Palestinians, words are often the only weapon available to fight back, finding the power to shape perception.” Poetry’s power is not only one of healing, but one of hope. Darwish’s influence on Palestine reveals that.

Exile, Famine and Tragedy in Gaza

Since Darwish’s sad passing in Houston, Texas, his beloved homeland has become more dangerous as conditions worsen. The Israel-Gaza ceasefire expired in March 2025 and it remains unclear if any new progress has been made in peace talks between Hamas, Israel and the U.S.

Right now, starvation has become an incredibly pressing issue, with the BBC reporting that “almost one in three people in Gaza are going days without eating.” Malnutrition and famine are adding to an already immense body count. However, active humanitarian efforts are taking place across the globe.

Gaza’s Poets Today

This past July, a young Palestinian named Mohammed Moussa had his work posted on the Instagram account gazapoets, in which he writes, “How do you capture starvation in words? Hollow bowls, hollow promises, bellies aching like silent bombs…” Moussa mentions Darwish in another piece of writing, an article, telling the story of Moussa’s literary beginnings. In the same article, the other emerging poets Moussa interviewed named Darwish as one of their favorite poets. Darwish’s influence remains impressive, even among younger Palestinians.

It cannot be downplayed how much of an inspiration Darwish was during his life, even now as conditions continue worsening in Gaza. His name still holds significant power and hope. Darwish’s words remain as pertinent in 2025, still speaking to those struggling beneath war, famine and displacement. Currently, the #mahmouddarwish tag on TikTok contains 20,000 videos. The videos range from celebrating the work and language of the late poet to using his art to bring attention to the humanitarian crisis in Gaza.

– Peyton Worsham

Peyton is based in Jacksonville, FL, USA and focuses on Politics for The Borgen Project.

Photo: Pixabay

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The Hidden Burden of Depression in Africa

Depression in AfricaDepression is a word that embodies profound pain, despair and societal stigma. Despite growing mental health awareness, mental illness remains misunderstood as a sign of personal weakness. The reality is that depression can lead to suicide, which claims more than 700,000 lives worldwide every year. Treatment-Resistant Depression (TRD), a subset of major depressive disorder unresponsive to at least two treatments, affects approximately one-third of depression sufferers, raising suicide risk and posing a global concern.

In Africa, the situation is particularly acute. The continent has the highest suicide rate in the world, at 11 per 100,000 people, compared to nine globally. It is estimated that more than 20 million individuals in Africa have depression, representing 9% of the global burden. North, West and Central Africa are particularly affected, grappling with fragile health care systems, conflicts, stigma and limited mental health services.

The Central African Republic (CAR) has one of the highest suicide rates worldwide, often linked to untreated depression. In contrast, Nigeria has more than seven million sufferers. Even in better-resourced countries like Egypt, Tunisia and Morocco, depression rates remain high.

Africa’s Mental Health Crisis

Mental health systems in Africa are underfunded. African governments allocate less than $0.50 per person annually to mental health. This is far below the recommended $2 per capita for low-income countries. In 2020, only 94 mental health outpatient visits were recorded per 100,000 people compared to 2,001 worldwide, indicating a lack of formal treatment access for most Africans with mental health issues.

In West and Central Africa, psychiatric hospitals are scarce and located in large cities. The situation is further complicated by conflicts in Mali, the Democratic Republic of Congo (DRC), CAR and Libya, where many health facilities have been destroyed or are difficult to access. On average, sub-Saharan Africa has just one psychiatrist per million people. Specialists are often concentrated in capitals or major cities, leaving rural populations underserved. Patients usually face long-distance travel costs to tertiary hospitals, which are cost-prohibitive for many and rely on general practitioners with limited psychiatric training.

Furthermore, antidepressants and psychotropic drugs are often out of stock or unaffordable for many patients. According to the WHO, more than 75% of people with mental disorders in low- and middle-income countries, including most of Africa, receive no treatment for depression. Second-line TRD treatments, such as atypical antipsychotics and dopaminergic drugs, are rarely stocked in public health facilities or private clinics in Sudan, South Sudan, Niger, Mali and CAR. Even in Nigeria, Uganda and Ghana, which have better health care infrastructures, access to these treatments remains limited to tertiary referral hospitals in major cities, with frequent shortages.

Initiatives Addressing Mental Health in Africa

Despite challenges, promising efforts are underway, from policy reforms to community-led interventions.

  • Policy Reforms. Several countries have begun updating policies to prioritize mental health. Nigeria, for example, passed its first national Mental Health Act in 2023, replacing the colonial-era lunacy law. The legislation aims to improve access to mental health services and protect patients’ rights. It includes the creation of a Mental Health Department within the Ministry of Health and integrating mental health services into primary care. The Act also prohibits discriminatory and outdated practices like chaining or arbitrarily detaining individuals with mental disorders.
  • Community-Led Initiatives. StrongMinds, an NGO operating in Uganda and Zambia, uses group interpersonal therapy led by trained lay counsellors to address depression, particularly among women in low-income communities. Since 2013, StrongMinds has treated more than one million people. Addressing untreated depression helps break cycles of poverty, food insecurity, trauma and disruption. Strongminds also works with governments and other NGOs to incorporate mental health services into food security, health care and education programs. It intends to expand across Africa over the next decade. The International Medical Corps (IMC) also plays a crucial role. In Mali, IMC supports more than 100 health facilities and mobile clinics across northern and central regions. The IMC provides primary and mental health care. It offers psychosocial support alongside services for gender-based violence and nutrition. In CAR, IMC provides mental health consultations through health centers and mobile clinics in underserved areas, trains local health workers and community leaders to support those in distress and publishes educational booklets on mental health. IMC also collaborates with National Ministries of Health and Community-Based Organizations, ensuring its integrated Mental Health and Psychosocial Support (MHPSS) efforts respond to crises and build long-term resilient communities.

Conclusion

Depression in Africa is not just a personal struggle but a public health emergency driven by limited funding, poor access to care and deep-rooted stigma. With suicide rates among the highest globally and millions untreated, the call for action is urgent. Expanding community care, improving mental health training and ensuring access to essential medications are critical.

– Juliette Delbarre

Juliette is based in London, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Addressing Mental Health in Guinea-Bissau

Mental Health in Guinea-BissauIn the small West African country of Guinea-Bissau, rich culture and strong tradition mask a growing crisis, mental health neglect. Among the most prevalent conditions are depression and anxiety, often left unaddressed due to systemic gaps and social stigma.

A System Without Specialists

As of 2017, Guinea-Bissau had zero practicing psychiatrists. The country’s ratio of just 0.13 doctors per 1,000 inhabitants falls far below global standards for basic health care. This shows that mental health support is almost absent from the primary care setting. Additionally, a screening of adults attending general health facilities in Guinea-Bissau revealed that at least 12% had a diagnosable mental disorder. This shows the urgent need for integrated mental health services in the nation’s fragile health system.

A baseline study found that general practitioners correctly diagnose only one in three patients, meaning that the people in Guinea-Bissau’s rural communities are unknowingly struggling with mental disorders. They carry a silent weight that forces them to push through each day with far greater effort than others, struggling in isolation just to survive.

Poverty and Psychological Strain

Things such as rising climate anxieties and pandemic poverty are worsening mental health in Guinea-Bissau. In 2021, the poverty rate was reported to have increased by 2.8 percentage points, adding an additional 80,000 poor. Research shows that mental illness reduces employment and therefore income.

Cultural Beliefs and Stigma

Mental health in Guinea-Bissau is often interpreted through a spiritual lens. Communities blame mental issues on things like curses and ancestral wrath. As a result, individuals often look down upon seeking help from medical professionals. Sixty-three percent of rural mothers go to the witchdoctor, and 65% believe that curses have the power to kill. While traditional healers play a vital role in this community, their methods can delay access to cures. Stigma remains a barrier to those suffering silently.

Lending a Helping Hand

This West African nation faces a mounting crisis that demands international attention. Every person deserves access to necessities like mental health care. Guinea-Bissau’s struggle is a global problem; poverty, trauma and neglect reflect broader challenges that low-income countries face worldwide.

Progression Efforts

Mental health in Guinea-Bissau is beginning to see a glimpse of hope in this landscape. International organizations such as the World Health Organization (WHO) have stepped in to support the country. Guinea-Bissau’s fragile health system has improved as groups are working to train general health workers in basic psychiatric care.

The NOVAFRICA Knowledge Center is working to strengthen health care in Guinea-Bissau through an inclusive and culturally sensitive approach. Its model brings together modern medical practitioners and traditional healers, including witchdoctors, to bridge trust gaps and improve access to care. By acknowledging and respecting spiritual traditions deeply embedded in the community, NOVAFRICA promotes the acceptance of modern medical practices and helps lay the groundwork for more effective health interventions, including in mental health.

The Path Forward

In collaboration with NGO VIDA, NOVAFRICA supported the launch of a community health insurance program that allows residents to pay affordable premiums in exchange for access to medical care, transportation and essential medicines. Though the country still lacks a national suicide prevention strategy, collaborative efforts between NGOs and local health authorities are laying groundworks for a future policy reform.

Guinea-Bissau’s challenges are steep, but the people are resilient. With continued international support and growing local engagement, the nation is taking its first steps toward a future where the silenced have a voice. Acknowledging, treating and respecting mental health is not just the goal, it is the path to a future defined by dignity and resilience.

– Marissa Schoth

Marissa is based in Benton, LA, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Unsplash

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Poverty and Mental Health in São Tomé and Príncipe

Mental Health in São Tomé and PríncipeSão Tomé and Príncipe is a small island located off Central Africa’s west coast, near the equator, with a population of roughly 230,000. Nearly 60% of the population lives below the national poverty line and there are numerous health inequities. Mental health is an ongoing crisis in São Tomé and Príncipe, negatively impacted by poverty, a lack of services and limited infrastructure.

Challenges Facing Mental Health Services

There is a lack of awareness and data surrounding mental health in São Tomé and Príncipe. However, many residents face common mental health issues such as anxiety, depression, substance use and, in some cases, trauma from poverty and isolation.

Barriers to care include a severe shortage of mental health professionals. There are only 4.6 doctors per 10,000 residents, with even fewer trained in mental health. Infrastructure is weak and there are no specified mental health facilities or consistent and constant access to medication. Stigma also plays a major role, leaving many affected individuals misunderstood and unsupported.

The public health care system offers limited mental health support through a few hospitals. Only one outpatient mental health facility is linked to a hospital and just one psychiatric unit exists within a general hospital. As of 2017, there were 706 treated cases of severe mental disorders nationwide, equivalent to 361 cases per 100,000 people.

How Poverty Fuels Mental Health Challenges

Poverty also takes a toll on the mental health of São Tomé and Príncipe’s residents. Around a quarter of the population lives on less than $1.90 daily, one of the highest poverty rates among comparable countries. This is due to unemployment and low labor force participation. In 2020, the unemployment rate jumped from 13% to 20%.

Living in poverty often means daily stress over essentials like food, water and housing, things that can trigger or worsen depression and anxiety. With a chronically underfunded health care system, there is limited access to mental health professionals and affordable support remains extremely limited for those in need.

Women and children in São Tomé and Príncipe are especially vulnerable to mental health challenges due to limited economic and educational opportunities. In 2018, the birth rate for girls aged 15–19 was 0.4 per 1,000, an indicator of deeper social and health disparities. Mental health struggles among these groups are often linked to substance abuse and domestic violence. Yet, access to mental health services remains limited, further compounding the crisis.

Support From International Organizations

The United Nations Children’s Fund (UNICEF) is one of the organizations working to combat the poverty and mental health crisis in São Tomé and Príncipe. One serious problem in the country is violence against children. This occurs frequently; about 70% of children are exposed to psychological aggression and one in seven experience severe physical punishment. To address this, UNICEF developed a protocol for care and follow-up for adolescent victims of violence, sexual abuse or mistreatment. Indeed, this is a major factor in the mental health struggles many residents of São Tomé and Príncipe face.

The World Health Organization (WHO) is also working to strengthen health systems in São Tomé and Príncipe by improving working conditions and boosting staff motivation. Its efforts have significantly impacted both the more than 9,000 island residents and the 97 professionals working at the hospital. While emphasizing preventive health, the organization focuses on reducing deaths from preventable diseases and promoting long-term care and sustainability.

Conclusion

Mental health in São Tomé and Príncipe is often overlooked, yet neglecting it undermines education, productivity and overall well-being. Breaking the cycle of poverty requires addressing mental health. Spreading awareness is essential to ensure local communities can access the necessary services.

– Madyn Lewis

Madyn is based in Chicago, IL, USA and focuses on Good News and Global Health, Celebs for The Borgen Project.

Photo: Wikimedia Commons

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3 Charities Operating in Hong Kong

Charities Operating in Hong KongHong Kong is located on the east bank of the Pearl River on the south coast of China. It is known for its dazzling city life, colorful traditions and financial centers. What might be less apparent, however, is the divide between the rich and the needy. In the first four months of 2024, the most impoverished earned 81.9 times less than the richest. Following the COVID-19 pandemic, poverty rates have risen significantly. Currently, 1.39 million people live in poverty in Hong Kong, most of whom are older adults.

These three charities operating in Hong Kong provide aid to the most vulnerable communities and aim to mobilize local society to offer them care and support.

Kadoorie Farm and Botanic Garden

Sir Horace and Lord Lawrence, two brothers, founded Kadoorie Farm and Botanic Garden (KFBG) in 1956. The idea sprouted after a surge of Chinese immigrants arrived in Hong Kong following the civil war at the end of 1946. Since many of these immigrants were farmers, the Kadoorie brothers provided them with training, guidance on how to plough their land and interest-free loans.

Its programs empower rural communities in Hong Kong and beyond to build income sources, improve food security and gain skills that promote long-term self-sufficiency and environmental resilience.

Hong Kong Family Link Mental Health Advocacy Association Limited

This organization was established in 2003 by Dr. Lee Cheng and Dr. Zhao Yulong to raise awareness about mental health in Hong Kong. In a society where stigma around mental illness remains widespread, the Hong Kong Family Link Mental Health Advocacy Association Limited works to combat discrimination and uphold the rights of people with mental health conditions.

The organization not only works to improve the lives of individuals with mental health conditions by providing access to education, employment and housing, but also offers medical care and vocational training to support their recovery from treatable illnesses.

In addition, it trains family members to actively participate in the care and recovery of their loved ones, empowering them to become part of the healing process. To further dismantle the stigma surrounding mental illness, the organization engages the broader community, partnering with volunteers, journalists, medical professionals and other organizations to raise awareness and foster collaboration.

Helping Hand

Helping Hand was founded after Bob Saunders, a former fishmonger, came across 120 elderly individuals who had been evicted from “caged homes” and abandoned on the streets with only their meager belongings. In response, he established Helping Hand in 1978 to support underprivileged older adults in Hong Kong, with a mission to ensure they live with dignity after years of hard work.

Since then, the organization has expanded its services across several locations, including Tai Wo Ping, Shun Lee Tsuen and Lai King. Helping Hand provides 1,000 beds across its care homes and serves more than 40,000 older adults in need each year. Its services include housing, rehabilitation, a holiday center, physical activities and training programs designed to enhance the well-being of elderly residents.

In 1984, the organization launched its signature Cookie Campaign. This highly successful fundraising initiative continues to support Helping Hand’s mission of caring for Hong Kong’s aging population.

Conclusion

Despite the efforts of these three charities operating in Hong Kong, there is much more to do to bridge the wealth gap, eliminate societal stigma and provide every HongKonger with a decent and dignified life. Funding, volunteer work and community mobilization are the key moving forward.

– Yasmine Belabed

Yasmine is based in Algeria and focuses on Technology and Global Health for The Borgen Project.

Photo: Flickr

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Recent Innovations in Mental Health Care in Africa

Mental Health Care in Africa According to the World Health Organization (WHO), Africa has the highest suicide rate in the world. The continent’s suicide rate stands at 11 people per every 100,000, which is higher than the global average of nine people per every 100,000. Approximately 29 million Africans suffer from depression.

Despite these staggering statistics, Africa spent less than $1 per capita on mental health. The continent also has an average of one mental health worker per 100,000 people compared to the global average of nine.

Within the last few years, the need for mental health services in Africa has risen. Luckily, organizations and platforms around the world have begun to recognize this demand. Here are three recent innovations to improve mental health care in Africa.

Supporting Mental Health Care in Africa

At its inaugural Digital Well-Being Summit, social media giant TikTok discussed plans for improving in-app support for users struggling with mental health, with a focus on sub-Saharan African users. The summit in Johannesburg brought together policymakers, industry leaders and mental health experts from South Africa, Nigeria, Kenya, Ghana, Zimbabwe and beyond. The event acted as a platform to discuss enhancing online safety tools, providing users with reliable information, and expanding user access to experts on the app.

TikTok announced that its $2.3 million global Mental Health Education fund will now be expanded to encompass sub-Saharan African organizations for the first time since its establishment. The selected organizations include the South African Depression and Anxiety Group, Mentally Aware Nigeria Initiative, and Kenya’s Mental360. They will be provided with funding and support from TikTok to create relevant, evidence-based content that discusses mental health in African communities.

TikTok has committed to expanding its in-app mental health helplines to the continent. African users will now be able to easily access helplines that will connect them with expert support and mental health resources such as counselling and psychological support. It will also be easier for African users to report harmful content related to bullying, hate, self-harm, and other topics that violate TikTok’s community guidelines.

The summit also introduced TikTok’s new Mental Health Ambassadors. In a partnership with the WHO, TikTok’s Mental Health Ambassadors will use their platforms to give guidance and advice to users. The inaugural group of verified healthcare professionals from the WHO Fides Network includes Sanam Naran and Dr. Siya from South Africa, Dr. Claire Kinuthia from Kenya, and Dr. Wales from Nigeria.

“Weaving Lives Together” Helps Communities Recover

The Weaving Lives Together project in Northern Nigeria aims to provide support to violence victims. It introduces creative interventions to fill the gaps left by other mental health resources. Its goal is to bring together mental well-being and economic opportunities to support both psychological recovery and socio-economic livelihoods.

Weaving Lives Together is the result of a partnership with the Neem Foundation, Creative Women in Lagos, and fashion house Ituen Basi. People, especially women, are given a creative outlet to turn their artistic expression in fashion and textile arts into opportunities for economic independence.

The initiative received funding through the One King’s Impact Fund at the School of Global Affairs at King’s College of London, a fund to support interdisciplinary solutions to global challenges. They are committed to fighting for whole-life health, peace and justice, and gender equality worldwide.

Digital Innovations in Mental Health Care in Africa

King’s College of London is also sponsoring and funding a new digital platform for depression intervention in African countries. This initiative expands upon the success of Zimbabwe’s Friendship Bench project, a model that has provided Zimbabweans with therapy for common disorders such as anxiety and depression by trained health workers.

Led by Dr. Gabrielle Samuel of the Department of Global Health and Social Medicine, the new platform will make mental health support more accessible, especially to those in underserved communities. People will be able to access self-guided therapy via their mobile phones, which will expand the reach of health workers and reduce wait times for those seeking help.

Mental health care in Africa has long needed improvement, with suicide and depression rates higher than global averages, especially in males. These three new innovations are only part of the efforts to bring better mental health counselling, resources, and education to the continent.

– Hannah Fruehstorfer

Hannah is based in Pittsburgh, PA, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Street Children in the Comoros

Street Children in Comoros

When one thinks about the issue of street children, the Comoros rarely, if ever, come to mind. Yet, the visibility of children working and living on the streets is a growing reality across the country’s three islands: Anjouan, Mohéli and Grand Comore. For many Comorians, encountering groups of children selling goods or soliciting money and cigarettes on the streets has become increasingly common.

Despite this, institutional policies, government data and international reporting on these vulnerable children remain absent. Although a few governmental programs were implemented in 2021 targeting child labor and education, they remain insufficient and fail to address the increasing phenomenon of street children. Similarly, international organizations are predominantly directing their efforts toward combating child labor and addressing de-schooling, leaving street children, especially those without family support, largely overlooked.

Street Children and Poverty

The causes behind the issue of street children in the Comoros are multifaceted. However, extreme poverty stands out as the main factor. In a country where more than 40% of the population experiences poverty, many children resort to street work to secure basic subsistence or help feed their families. Most of them have left the school system, which, although compulsory until age 15, lacks strong enforcement mechanisms to check and enforce school attendance. In 2023, more than 20% of primary school-aged children were out of school in the Comoros, excluding the high absenteeism rates.

Street Children and Parental Migration       

Another major cause contributing to this problem, closely linked to extreme poverty, is the migration of many Comorian parents to the French-administered island of Mayotte. This mass migration leaves many children homeless as their parents seek better economic opportunities.

Street Children and Mental Health

Children with disabilities and mental health conditions face higher risks of living and working on the streets. This is due to a lack of proper psychiatric care, exacerbated by the presence of only one psychiatrist in the country and the high cost of medications, alongside educational exclusion. According to the most up-to-date UNICEF report from 2015, 73% of these children did not attend secondary school and only 2.9% progressed beyond secondary education, illustrating the exclusion children with disabilities encounter.

Gender-Based Vulnerabilities

Girls and young women are disproportionately affected by educational exclusion and societal norms that promote submission to male authority. This often leads to mistreatment, sexual abuse, early sexual activity starting as young as 12 and unwanted pregnancies. These factors contribute significantly to the increasing number of young women living on the streets, as some parents repudiate their daughters who have terminated unwanted pregnancies.

Life on the Streets Equates Survival

Once children are on the streets, whether they return home after working or both work and live there, survival becomes the primary goal. The lack of reliable housing exposes youth to physical, sexual and emotional abuse. Health issues such as parasitic diseases, pneumonia, sexually transmissible diseases and HIV are common, compounded by past and present trauma. Without adequate support, children become the perfect targets for drug dealers, both as consumers and sellers.

The absence of comprehensive systems and official data exacerbates their plight. The Comoros lacks social structures to shelter street children, with few competent host families. Children’s judges rarely place them under those families and there are not enough inspectors to follow up. The lack of official and international data on the number of children living and working on the street in the Comoros also worsens the situation, as their abuses remain undocumented and unacknowledged, leaving children vulnerable to aggressors who can commit crimes with impunity and many disappearing without anyone noticing.

Efforts Toward Empowerment

Despite the alarming situation, some organizations like Ticket to Life and MAEECHA are working to address these challenges, offering hope for street children in the Comoros. Ticket to Life provides vocational training and education to street children, children with disabilities, refugees and all of those who suffer from poverty. Since its creation in 2022, it has helped 400 children through scouting and sewing training. It enabled some students to open their sewing shops and become an integral part of their local communities, transforming their future. By 2026, Ticket to Life intends to assist another 2,000 children.

MAEECHA operates in Anjouans and focuses on education equality and support for isolated children through its Education, Care, Support and Inclusion (ECMA) program. Its center of professional insertion helps out-of-school children, including those at risk of street involvement due to family breakdown or abandonment. It provides professional vocational training in several fields, such as agriculture, sewing, electronics, carpentry and culinary arts, targeting about 60 children annually. It is supported by partnerships with French and European organizations promoting apprenticeships and certifications.

Conclusion

The phenomenon of street children in the Comoros is a multifaceted issue rooted in systemic poverty, inadequate social structures and violence. Working and/or living on the streets exposes children to sexual, physical and emotional abuse. While Ticket to Life and MAEECHA are making strides in providing support and comprehensive governmental action, the involvement of international organizations focused on this issue and American aid would help address the root causes of street children. It would also help protect the rights and futures of the Comorian children, especially as an increasing number of them attempt to join the French-administered island of Mayotte, often at the peril of their lives.

– Juliette Delbarre

Juliette is based in London, UK and focuses on Global Health for The Borgen Project.

Photo: Pexels

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The Positive Situation for Mental Health in San Marino

Mental Health in San MarinoRecent statistics show that the country of San Marino has a suicide rate of 7.59. In comparison, the worldwide average suicide rate as of 2021 is 8.9. Additionally, suicide rates have also dropped in the country, with an 8.01 rate in 2020 and a 7.59 rate in 2021, showing that mental health in San Marino receiving attention on a considerable level.

After the COVID-19 pandemic, San Marino experienced a concerning decrease in the mental health of its citizens and faced hard decisions on how to reintegrate citizens into a post-pandemic lifestyle. Over the last five years, San Marino has found that deteriorating mental health has links to stress, economic pressure and social isolation.

Community-centered environments are a strong deterrent against declining mental health and offer relief from stress, pressure and isolation. Because mental health decreased at the same time social isolation increased during the pandemic, the country focused on creating suitable community-based programs for citizens young enough to be in middle school, and old enough to be in retirement homes.

Mental Health for Old and Young Citizens

To specifically address mental health concerns in younger citizens, San Marino employs many awareness programs that work directly with public education in the country. These awareness programs started in 2021, prompted by COVID-19. The awareness programs involve partnering with police and substance abuse facilities for events to educate students and create environments where they can easily talk about depression and mental strain. Negative mental health for young citizens has almost always had links to academic pressure; citizens who could not perform well in school often felt frustrated and stuck. Interestingly, to San Marino, this meant that if public education could be improved upon and more accommodating for different students, then overall mental health in young citizens would generally increase.

Similar to young citizens, the country found that most of its older citizens over the age of 60 suffer from low mental health, largely due to social isolation. After partnering with the regional office of the Parliamentary Assembly of the Mediterranean (PAM), San Marino addressed many concerns with the mental health of older citizens. The country was able to employ more social services for older citizens, and further partnered with the World Health Organization (WHO) to allow community-based help. The country originally partnered with the WHO in 2013, but after the COVID-19 pandemic in late 2020, the country and the WHO made additional projects and plans to facilitate positive mental health.

Since 2020, San Marino’s citizens over 60 years old have had stable and improving mental health. Instead of the majority of elderly people living in retirement homes, the WHO has made it so that systems of care are in place where the majority of elderly citizens can grow old without leaving their original homes. Lowering feelings of depression among the elderly and promoting community-based involvement in neighborhoods due to the system of care in place.

Efforts To Address Mental Health in San Marino

Organizations like the WHO and PAM go to great lengths to ensure that countries like San Marino are well equipped to give citizens an environment that promotes mental well-being. The country also adopted the philosophy of “Parlare Aiuta” or Talking Helps, a national campaign promoting the openness of receiving care for poor mental health and quality conversations around the subject with the correct tones and vocabulary.

San Marino found that in many ways, at least for a small country, the best way to encourage positive mental health is to have productive conversations around the topic. Raising awareness with statistics is not enough; poor mental health has a connection to social isolation, so one of the best ways to help is to encourage citizens to educate themselves on the issue so they can have meaningful conversations when necessary.

Poverty is a contributing factor to poor mental health, but it has remained stable in San Marino over the last several years. The overall poverty rate in San Marino has stayed below 8%. In contrast, the average poverty rate worldwide is about 8.5%.

– Russell Bivins

Russell is based in Phoenix, AZ, USA and focuses on Good News for The Borgen Project.

Photo: Wikipedia Commons

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TikTok Is Addressing Stigma Around Mental Health in the Arab Gulf

Mental Health in the Arab GulfMental health awareness has become increasingly prevalent in the modern day. A study made by the World Health Organization (WHO) in 2019 found that worldwide, 970 million people suffer from mental health issues, predominantly anxiety and depression. Mental health has become a well-discussed issue for much of the Western world. The existence of schemes such as mental health days and mental health first-aiders in the workplace demonstrates many businesses’ commitment to improving their workers’ mental health.

In the Arab Gulf, mental health is often considered a taboo subject. Issues such as depression or trauma can be perceived as shameful and shouldn’t be discussed with others. However, TikTok is now being used as a medium to address this stigma around mental health in the Arab Gulf states.

Perception of Digital Mental Health Campaigns in the Arab Gulf

A 2024 study analyzing responses to a digital mental health awareness campaign in the Gulf Cooperation Council (GCC) demonstrated that mental health remains an incredibly stigmatized topic. The study highlighted prevalently-held beliefs that mental illness does not exist and that such personal issues result from a lack of willpower, laziness or that it is a personal choice to be depressed or anxious.

Many in the survey also asserted beliefs that mental illness holds ties with religious and spiritual deficiencies, proclaiming that issues result from the influences of “Jinn” (evil spirits) or the “evil eye.” They often quoted practices of religious devotion, reciting the Qur’an or regularly praying as the solutions to these problems.

The widespread denial of mental illness throughout the GCC leads to a domino effect of issues, both socially and economically:

  1. Awareness and education around mental health is poor.
  2. Those suffering from issues of anxiety, depression or untreated trauma are unlikely to seek help from either professional services or to confer with others in their communities about their problems.
  3. Without seeking help or as a result of being criticized by others, these issues will likely exacerbate, potentially leading to emotional burnout, job loss, social exclusion or suicide.

Using TikTok To Breach the Stigma Around Mental Health

A few TikTok-based initiatives are currently being used to address the stigma around mental health in the Arab Gulf. As a free and popular digital platform, TikTok is a powerful tool for reaching those without access to formal mental health services. It uses approachable, entertaining ways to promote understanding and communication. Saudi Arabia and the United Arab Emirates (UAE) are the top two countries where TikTok has the most reach, with virtually 138.2% of Saudi Arabia’s population using the platform.

In 2024, TikTok began the “Change-Makers Program.” This initiative promoted creators’ and NGOs’ endeavors using the platform to prompt beneficial community changes. At the program’s launch, TikTok announced a list of 50 of these “Change-Makers,” including the first Change-Maker of UAE, Dr. Jana Bou Reslan. A Lebanese educational psychologist and professor, Bou Reslan has been posting TikTok content since 2022 and has garnered more than 220k followers.

Bou Reslan’s content offers Arabic-language education on how to tackle mental health issues such as high-functioning anxiety and low self-esteem. She also encourages well-being practices and open discussion of mental health. “Good mental health is of utmost importance for thriving communities, influencing everything from education to workplace productivity. Social media has been playing a vital role in reaching out to different audiences and promoting positive and relatable topics within our community,” she said.

Furthermore, in February 2024, TikTok MENAT hosted a Youth Mental Health Awareness Summit in Dubai. The event featured discussions by mental health professionals and TikTok’s safety experts. It focused on how social media can better equip young people in GCC with critical-thinking skills, promote media literacy and strive to build supportive digital communities. These strategies aim to improve the mental well-being of young people while also encouraging the building of digital skills that will improve future job prospects.

Improving Mental Health Awareness Can Help Alleviate Poverty

On the face of it, addressing the stigma around mental health in the Arab Gulf might not appear impactful when it comes to fighting poverty. However, the WHO notes that improving mental health care is inherently linked to reducing inequality and poverty across nations. One of the clearest ways this link manifests is through employment and income potential. Improving employment and income potential. Mental health can have a direct impact on individual employability and the economy as a whole.

According to the 2022 WHO World Mental Health Report, approximately 12 billion workdays a year are lost due to issues associated with anxiety and depression. By promoting open discussions about mental health, introducing workers to stress-reducing techniques and better equipping people for emotional regulation, people are less likely to burn out and hence not lose pay and/or their jobs. Unemployment can also be seen as shameful or indicative of personal failure in the Arab Gulf, especially for men and poor mental health also impacts the ability to find new work.

Another way mental health awareness can contribute to poverty alleviation is by supporting young people. It is estimated that worldwide, one out of seven adolescents exhibit symptoms of mental disorders. In the UAE, 17% to 22% of young people exhibit signs of depression and 28% show symptoms of anxiety. Better mental health awareness and support reduce school dropout rates. Also, by encouraging the diversification of skills in young people into digital literacy, generational poverty can be reduced through new fields of employment. Finally, improving skills in stress management can help with school and work pressures and improve coping skills in economically unstable households.

Final Remarks

In low-income countries, there is roughly one mental health professional per 100,000 persons. With such critically low access to services, free digital-based platforms such as TikTok provide easily accessible education on mental health and culturally appropriate content made in local languages.

They are a good entry point for NGOs looking to help communities. TikTok creators are busy addressing the stigma around mental health in the Arab Gulf to help people learn skills for personal empowerment, provide the means to form digital support networks and give access to advice where formal psychological services are unavailable.

– Reuben Avis-Anciano

Reuben is based in Oxfordshire, UK and focuses on Technology and Global Health for The Borgen Project.

Photo: Unsplash