COULD STRONGMINDS STOP A DEPRESSION EPIDEMIC IN AFRICA? by Donny Levit
Maplewood's Sean Mayberry has a brave plan
Let’s begin with a series of astounding statistics: Approximately 66 million women in Africa suffer from depression. Depression affects nearly one in four women in Africa. And
85 percent of these women who suffer from depression do not have access to
“If the extent of human suffering were used to decide which diseases deserve the most medical attention,” writes Heidi Ledford of Nature, “then depression would be near the top of the list.”
While these figures may seem bleak and overwhelming, Sean Mayberry is working tirelessly to change these statistics to offer African women a way out from this disabling disease.
Mayberry, who moved to Maplewood in 2009 with his wife and four sons, is a former diplomat and social marketer who got his start in his early twenties by joining the foreign service, which brought him to the Netherlands and Kenya. He finished an assignment at the U.S. embassy in Nairobi just six months before it was bombed by al Qaeda in 1998. He has also lived in the Congo and India.
“I was in the Congo during the middle of the Congolese war doing HIV and malaria work,” says Mayberry. “We’d be in the middle of nowhere, distributing nets on the Congo River, and we knew people there were mentally ill...and there was nothing we could do to help. It was professionally frustrating to have to walk away from individuals who were mentally ill.”
In addition to the first-hand struggles that he witnessed in Africa, Mayberry explains that mental illness played a role in his upbringing. “I grew up in rural western Massachusetts with severely depressed parents – a super blue collar, almost low-income family,” he says. “I know what depression does to a child and what it’s like having a mom and dad who can’t really engage and focus on you.”
Fast forward to 2012, when Mayberry’s wife alerted him to a career-changing article in The New York Times. Written by Tina Rosenberg, the article discussed a randomized control trial that used psychotherapy to treat depression in Uganda back in 2002.
“I found the article and the researchers who did that trial in 2002 – many of them were at Columbia [University], he says. “I literally ran up to Columbia one day at lunch and asked the researchers if it was as good as it sounds – and if [the approach] would be scalable. They became my mental health mentors, great friends still to this day, and connected me to the originator of interpersonal psychotherapy, Myrna Weissman.”
And so came the idea to form StrongMinds, an organization that uses Group Interpersonal Psychotherapy (IPT-G) with the goal of ending depression in African women. Mayberry, both founder and executive director, started the organization in 2013 out of his attic. “We used our family savings,” he says. “StrongMinds is Maplewood grown, born, and raised.”
StrongMinds has developed a scalable model of talk therapy. Led by a group leader, the women meet once per week for 90 minutes a session over the course of 12 weeks. The women are then monitored and evaluated after the group therapy session is complete. One of the most promising statistics shows that about 75 percent of these groups continue to meet after the 12-week program has finished.
“It’s the social bonding in the group that’s really our secret sauce,” says Mayberry. “A lot of times, women with depression are, for example, just selling cucumbers and they don’t see how futile it is because of the fog of depression. Somebody in that group will have the business acumen to open their eyes. So it’s the group waking them up.”
Astoundingly, only 30 psychiatrists exist to treat the 35 million people in Uganda. And medical staff typically have little to no mental health training. Mayberry points out that Uganda is a post-conflict country, which leads to intense pressure on daily life.
“A lot of these families have been ripped apart. Some have 15 children because they’re looking after their brother’s kids because he was killed during conflict,” says Mayberry. “Poverty exacerbates depression and gives you more triggers of depression. For example, you can be arguing with your spouse about how to spend the $2 you earned today. You’re arguing because you can’t afford school for your kids, you can’t buy food, you can’t buy medicine, you’re moving houses all the time, and you’re trying to dodge bullets.” And gender-based violence is pervasive, which adds to all the triggers of depression.
Mayberry believes that the key to the success of StrongMinds is creating a treatment process that is scalable. The organization is working to empower women who have completed the therapy program to go on to run their own therapy group in their own communities. Mayberry has set out to create a low-cost program with the goal of reaching millions of women in the Ugandan population.
“A lot of people in the mental health world view us as contrarians,” says Mayberry. “We’re a threat to them in many ways. We’re training anybody to treat depression well. But with a psychiatrist or many psychologists, that’s their whole business.”
Since StrongMinds began its work in 2013, over 43,000 Ugandan women have been treated for depression. Findings demonstrate that 77 percent of the women are depression-free after the conclusion of treatment, and that there is a 67 percent decrease in unemployment.
In just five years, the StrongMinds team has grown to 65 in Uganda. With the exception of one American social worker who serves as the country director, the rest are Ugandans. In addition to their headquarters in Kampala, they have smaller offices in Mokono and Iganga. “Roughly 45 of them are our group leaders,” says Mayberry. “It’s all about running groups, conducting groups, and getting the treatment. Group leaders spend days in the slums finding women, screening them, diagnosing them, and getting them into groups.”
Mayberry, StrongMinds program director Kari Frame, and a handful of staff work out of an office in the Map Building on Valley Street in Maplewood. While Maplewood is 7,000 miles away, he speaks with vibrancy about the details on the ground in Uganda.
A photo of a therapy group hangs on his office wall. “Here is a group of women sitting in a public group sharing their biggest challenges and life’s fears,” explains Mayberry. “Half of those women are regular moms and half are prostitutes. That woman is ‘Sophia’ and the group convinced her to drop prostitution. She ran for election and is now a local council person.”
While StrongMinds has already accomplished a tremendous amount, Mayberry believes that a continuous focus on growth is the vital step. “We have the model set, but the big questions are how do we scale this up and who is going to do it,” he explains. “We can’t end the depression epidemic itself. We have to find partners to do it. It’s about finding large international NGOs [non-governmental organizations] who will see the value of our model and integrate our model into their work.” StrongMinds has pilot programs scheduled this year with both Mercy Corps and Save the Children, addressing the needs of both adult refugees and adolescents.
In January 2019, StrongMinds opened an office in Zambia. “We had to find another country who we could partner with,” says Mayberry. “The Zambian Ministry of Health is optimistic, forward-leaning, and proactive. President [Edgar] Lungu of Zambia visited the local national mental hospital and stood up in front of the press and said that mental health is a priority in this country. This is totally unheard of in Africa.”
StrongMinds also wants to use its model to address depression in adolescent girls as well as the over one million refugees that have come to Uganda from South Sudan and the Democratic Republic of Congo due to war and violence in those countries.
And here’s one more vital statistic: StrongMinds wants to treat two million women with depression by 2025. “We want to win the Nobel Peace Prize in 2030 for having ended depression in Africa and for coming up with an amazing solution,” says Mayberry. “We want to come up with the iPhone of depression.”
To learn more about StrongMinds, visit its website strongminds.org.
Donny Levit is a journalist, writer, and Maplewood resident. He is the author of Rock n’ Roll Lies, 10 Stories. Follow him on @donnyreports.