Online Reporter
Manley Nemakonde
Correspondent
ZIMBABWE has a National Mental Health Policy that commits to “accessible, affordable, and quality mental health services for all”, yet there is one psychiatrist for every 1,5 million people.
These two facts cannot both be true.
One of them has to be critiqued.
This is not to dismiss the policy’s genuine strengths. As a community psychologist reviewing Zimbabwe’s Mental Health Policy, I find much to critically review in what it stands to advance.
Vision without implementation is not policy. It is theatre.
Community psychology is not merely an academic perspective. It is a practice and Zimbabwe has one of the world’s most celebrated examples.
The Friendship Bench did not begin in a ministry boardroom. It began when Professor Dixon Chibanda listened to grandmothers in Mbare, Harare who told him that clinical training alone would not heal a community in distress. Those elderly women renamed his intervention, redesigned its delivery, and became its primary practitioners. They were not “stakeholders consulted” or “beneficiaries targeted.” They were co-creators of knowledge and co-owners of the programme.
This is community psychology. It is not about adapting medical services to community settings. It is about recognising that communities already possess therapeutic resources and that the psychologist’s role is to resource, support, and follow their leadership.
When I apply a community psychology lens to Zimbabwe’s Mental Health Policy, I am probing: does this policy create conditions for more interventions like the Friendship Bench? Or does it inadvertently reproduce the very hierarchies expert over layperson, institution over community, English over Shona that community psychology seeks to dismantle?
To its credit, Zimbabwe’s Mental Health Policy does not merely gesture towards community care. It explicitly names task-sharing as a central implementation strategy.
Section 4.3 commits to “training and supporting primary health care workers, community health workers, and peer counsellors in the delivery of evidence-based psychological interventions.” This reflects Zimbabwe’s pioneering role in the World Health Organisation (WHO) Special Initiative for Mental Health (FRIENDZ project) and acknowledges that the Friendship Bench is not a Non-Governmental Organisation (NGO) pilot project to be admired from a distance, but a national resource to be scaled.
Similarly, the policy’s recognition of “traditional leaders, faith-based organisations, and community groups” as mental health partners (Section 5.1) is not boilerplate. It represents a hard-won acknowledgment that in a country with one psychiatrist per 1,5 million people, mental health systems must be built with not just located in communities.
These commitments distinguish Zimbabwe’s policy from those that still position communities merely as settings for service delivery rather than as sources of authority and knowledge.
But a policy is only as good as its implementation.
In this regard, Zimbabwe is falling short.
The financing constraints:
The Ministry of Health and Child Care allocates less than one percent of its budget to mental health. The WHO recommends five percent. This is not a resource constraint; it is an administrative choice. Meanwhile, the policy’s own implementation plan remains unfunded.
Donor dependency: What little mental health funding exists comes from donors with narrow mandates. PEPFAR funds HIV-integrated mental health services but not general mental health care. Grand Challenges Canada funded Friendship Bench scale-up but not recurrent costs. The Global Fund’s C19RM mental health window is time-limited. A policy that cannot be financed through domestic resources is bound to have serious shortcomings. It is a wish list.
The human resource crisis: Zimbabwe has fewer than 20 psychiatrists and fewer than 50 psychologists serving a population of 15 million. But the crisis is not only about numbers. It is about distribution. Rural postings remain unfilled. Qualified personnel refuse to work outside the country’s two major cities – Harare and Bulawayo – because working conditions, housing, supervision and resources are untenable. The policy commits to decentralisation but does not address why professionals will not go where they are most needed.
The silence on traditional healing: The majority of Zimbabweans consult traditional healers and prophetic churches for mental distress. The policy says almost nothing about how to engage these systems ethically and collaboratively.
The Dandemutande (spiderweb) framework developed by Zimbabwean scholars precisely to address this gap is absent from the policy. This is not merely an omission. It is a failure of epistemic justice.
Stigma and weak community systems:
While the policy acknowledges stigma, there has been no sustained national anti-stigma campaign since 2016. Community psychosocial support centres remain rare. Peer support groups operate without funding. Family interventions are not systematically available. The policy speaks of community care, but in practice services remain institutional and urban-centred.
Invisible data:
The Ministry of Health and Child Care has not published disaggregated mental health data since 2021. Without community-level data on who is accessing services, who is being left behind, and what outcomes are being achieved, the policy is being implemented blind.
The Ministry of Health and Child Care cannot continue to claim commitment to mental health while allocating less than one percent of its budget to implementation. Treasury cannot continue to defer mental health financing to development partners whose mandates are time-bound and disease-specific.
First, finance the policy. Government must seriously consider allocating at least five percent of the health budget to mental health – the WHO minimum. This is not unaffordable. It is a question of priority.
Second, resource what already works. The Friendship Bench has training and supervision infrastructure that could be expanded. Zvandiri’s CATS (Community Adolescent Treatment Supporters) model proves that peer support works. Chipinge’s school mental health programme demonstrates what is possible. These are not pilot projects. They are existing national assets. They need to be funded.
Third, build community oversight. Ward and district-level mental health committees involving health workers, community leaders, service users, and civil society should be established. These committees should have real authority over resource allocation, programme design, and accountability. The Health Centre Committee structure already exists. It only needs to be utilised.
Fourth, engage traditional and faith-based healers. The Dandemutande framework provides an ethical, collaborative model for integrating indigenous healing practices into mental health care. The policy must articulate a framework for partnership – not silence.
Fifth, publish the data. The Ministry must release disaggregated mental health data annually. Without data, there is no accountability. Without accountability, there will be no implementation.
Zimbabwe’s Mental Health Policy is not a failed policy. It is an unimplemented one. The framework exists. The evidence exists. The community practitioners – that is grandmothers, peer counsellors and village health workers – exist. What is missing is the sustainable will, domestic financing, and accountable governance.
The policy advocates that mental health services should be “accessible, affordable, and of good quality.” For the grandmothers in Mbare who work unpaid and for the CATS in Epworth who carry vicarious trauma without support, the policy is a promise that has not been kept or fulfilled yet.
It is time to ask not what the policy says, but who will be held accountable for what it has not done.
Manley Nemakonde is a community psychology intern currently placed with an empowerment programme in Mutare. He works with communities navigating the gap between policy promises and lived reality. This review emerges from that daily practice
