_{By Tatenda Chimbwanda}

Harare, Zimbabwe - Like most Sub-Saharan African countries, Zimbabwe faces significant challenges in meeting the Mental Health (MH) care needs of its population. With only two psychiatric hospitals and one psychiatrist for every one million people, the vast majority of Zimbabwe's 14 million population, including the 67.8% living in rural areas, have limited access to MH care. In addition, MH resources are concentrated in major cities and hospitals, making the integration of MH care at the Primary Health Care (PHC) level of paramount importance.

To address the urgent need for expanded MH services at the PHC level, the Ministry of Health, and Child Care (MoHCC) in Zimbabwe, with support from the World Health Organization (WHO) Zimbabwe, officially launched the FRIENDZ project on 12 July 2023. The project aims to scale up the assessment and management of priority mental, neurological, and substance abuse disorders, extending from community to primary and tertiary health care levels in Zimbabwe. The ambitious goal is to reach a total of over one million people by 2025 with quality MH services. The initiative took off during a breakfast meeting at Newlands Country Club in Harare and will be implemented in four provinces, namely, Mashonaland East, Mashonaland Central, Harare, and Matabeleland North, over a three-year period. The FRIENDZ project is part of the Zimbabwe Special Initiative for Mental Health and implemented in partnership with WHO and Friendship Bench.

Dr. Patience Maunganidze, MoHCC Deputy Director of the Mental Health Department, officiated the official launch of FRIENDZ. She conveyed the government's enthusiasm about this revolutionary project that promises to increase the quality and accessibility of MH services, especially in rural areas. "Through this program, we will train health workers at the PHC level to provide quality mental health services, ensuring no one is left behind," she added.

The FRIENDZ project will enhance access to quality MH services through improved referral pathways. This guides individuals through their journey from the community level to PHC, secondary and tertiary levels, and back, creating a seamless MH network.

"Today marks a significant day for mental health services in Zimbabwe. The FRIENDZ project will allow us to increase access to community-based MH services, reaching deep into marginalized communities to serve those who often do not get access to such services," said Friendship Bench Director Professor, Dixon Chibanda.

The FRIENDZ project, which will run for three years, is financially supported by Grand Challenges Canada, which has committed USD $820,000. These funds are allocated under the WHO Special Initiative for Mental Health, supported by NORAD and USAID, with a total budget of USD 2.1 million.

WHO Zimbabwe Country Representative a.i Professor Jean-Marie Dangou, speaking during the launch, expressed his excitement about the integration of the WHO Mental Health Gap Action Programme (mhGAP) and Friendship Bench  Problem Solving Therapy (PST) within the FRIENDZ project framework. "Universal Health Coverage cannot be achieved without MH. Therefore, we are steadfast in our commitment to assist Zimbabwe in fortifying its MH services," he emphasized.

After the successful launch, the focus will now shift to capacity building for health workers in the four identified provinces.

Looking forward, the WHO mhGAP  ambitiously aims to scale up services for mental, neurological, and substance use disorders. This program is particularly targeted towards low- and middle-income countries. It propounds that with the right care, psychosocial assistance, and medication, tens of millions of individuals could be treated for conditions such as depression, schizophrenia, and epilepsy.

The PST, a feature of the Friendship Bench approach, is an evidence-based, cognitive-behavioral intervention. It has been designed to aid individuals in coping with stressful life experiences with an aim to enhance resilience and improve functioning in various areas of their lives, including personal, professional, social, or self-directed development.

The amalgamation of these two impactful approaches is poised to significantly increase access to MH services in Zimbabwe. The evidence gathered from the four provinces will be instrumental in nationwide rollout, using the lessons learnt from these provinces for resource mapping and generating the required resources.