The right to an environment that enables wellbeing and positive mental health is gaining momentum globally in the public health arena.

Loneliness has always been a pressing issue for human beings as we are social creatures who thrive in an environment of connectedness and mutual support. This connectedness and support allow us to experience less fear and feel safe and relaxed. From an overall health point of view, the absence of a sense of safety leads to a chronic experience of distress that worsens health outcomes and shortens our life spans. The brain will adapt to the situation by becoming better at recognizing and generalizing danger cues, leading to a higher rate of perceived threat alarms. 

Combined with a subjective (and often objective) impression of not being able to change one’s experience and feeling left alone with it, we develop maladaptive thought and behavior patterns such as lack of a sense of agency with the loss of interest and motivation, rumination, avoidance, and withdrawal. These are aspects that are commonly found in depression and anxiety, and while they can be understood as a short-term response, they can become pathological when present for a longer period of time. Because of the widespread stigma and unhelpful myths around mental health, people do not even know that they can access support. This increases the risk of loneliness and suffering even further.

In Zimbabwe, the Friendship Bench program offers an evidence-informed approach to support those at risk of having common mental disorders who would benefit from therapeutic support.

Friendship Bench supporters are community health workers who receive rigorous training and ongoing supervision in how to use basic counseling skills, recognize symptoms of common mental disorders, assess for suicidal thoughts, refer if needed, and how to guide a person through a solution-finding process based on a widely researched strategy called problem-solving therapy. This strategy aims to teach a person how to approach a presenting problem by utilizing a step-by-step exercise. Steps include a problem choice and definition, goal setting, creative brainstorming for solutions, evaluation, and choice of a solution as well as designing a very concrete action plan.

Furthermore, we encourage Friendship Bench users to establish peer support groups that also focus on income-generating projects. This aspect is extremely important in a low-income country where symptoms of common mental disorders are seen as being associated with chronic poverty, unemployment, food insecurity, drastically reduced chances for the younger generation as well as little access to well-resourced health care. Loneliness in low- and middle-income countries has not been the focus of research.  This has to change and we have to create ways that support people to feel safe with one another in a world that is very connected when it comes to sharing scary information and which needs to focus more on building a sense of resilience and connection.

We need a change in the way we approach each other. No person is always fine and unaffected by distress. Being open and honest in a way that allows vulnerability and authenticity would save a lot of energy that we could turn into connecting with each other which would increase our sense of community and decrease loneliness.