For many women in Togo, the first person they turn to when facing a personal difficulty is not a doctor, psychologist or other health professional. It is often someone they see regularly, someone who listens without judgment and someone with whom they feel comfortable sharing what they may not tell anyone else: their hairdresser.
A new study by the Bluemind Foundation sheds light on this often-overlooked relationship, revealing the important role trust can play in determining whether women feel able to speak about their mental health and, ultimately, seek professional support. Released ahead of World Mental Health Day on 10 October, the Trust Study examines the relationships and everyday interactions that often precede contact with formal healthcare services. The exploratory study involved 576 women, including 205 clients and 371 hairdressers, in Lomé, Kara, Sokodé and Dapaong between April and June 2026.
Its findings point to a striking reality: 30% of women surveyed said they would turn to their hairdresser first when facing a difficulty, compared with fewer than 1% who named a health professional. Only family members ranked higher, at 41%, while friends accounted for 11%.The findings raise an important question for mental health services: before someone reaches the healthcare system, who do they trust enough to speak to?
The Power of a Trusted Relationship
For many women, a visit to the hair salon is more than a routine appointment. It is an opportunity to talk, share experiences and find a listening ear in a familiar environment. The Trust Study suggests that these everyday relationships can provide a valuable space for women to express concerns they might otherwise keep to themselves. Among clients interviewed in depth, 89% said they shared things with their hairdresser that they did not tell anyone else. The findings also highlight how attentiveness can become part of these relationships. All the hairdressers interviewed said they had noticed when a client was struggling emotionally, sometimes before the woman herself had found the words to explain what she was experiencing.
Such observations underline the value of familiarity and regular contact. A hairdresser who sees a client over time may notice changes in her behaviour, mood or usual demeanour, creating an opportunity to offer support when it is needed. The relationship can be particularly meaningful because it occupies a distinctive place in a woman’s social life: close enough to foster confidence, yet sometimes sufficiently removed from family and close friends to make difficult conversations easier. These findings do not mean that hairdressers should take on the responsibilities of mental health professionals. Rather, they highlight the importance of recognizing the trusted relationships that already exist within communities and understanding how they might help women access appropriate support.
Turning Trust Into a Pathway to Care
For the Bluemind Foundation, the challenge is not simply to encourage women to speak about their difficulties. It is to ensure that, when professional assistance is needed, that first conversation can lead to meaningful and appropriate care. The study found that 99% of clients surveyed would either accept or consider a referral to professional support from their hairdresser. Of these, 69% said they would accept such a referral, while 30% said they might consider it.
The results suggest that hairdressers could serve as an important bridge between women experiencing distress and the professionals equipped to help them. “Women often already know who they trust enough to speak to first. The question for health systems is what happens next. Trust can make speaking possible, provide an initial form of support and, when more help is needed, open a path toward care. But a referral is only as useful as the care available at the other end.” Marie-Alix De Putter, Founder and President of BLUEMIND FOUNDATION ‘s remarks capture the central message of the study: trust can open the door to support, but it cannot replace the services, trained professionals and referral systems needed to provide effective mental healthcare.
Training Hairdressers to Support Mental Health
Since 2021, the Bluemind Foundation has been working through its Heal by Hair programme to equip hairdressers with the skills needed to respond safely and appropriately when clients share personal difficulties. The programme trains participants to listen without judgment, maintain confidentiality, recognize signs of emotional distress, respond to sensitive disclosures, including those involving violence, and understand when and how to refer someone to professional support.
The aim is not to turn hairdressers into therapists, but to help them recognize the limits of their role while making better use of the trust they already enjoy. Importantly, the Trust Study does not measure the impact of the Heal by Hair programme. Instead, it examines the relationships on which the initiative is built, documenting the trust that exists between women and their hairdressers. The distinction matters. The programme does not create these relationships; it seeks to strengthen the ability of hairdressers to respond responsibly when women choose to confide in them. By combining existing community relationships with practical training and links to professional services, the initiative offers one approach to making mental health support more accessible without medicalizing everyday interactions.
Addressing Africa’s Mental Health Care Gap
The study comes at a time when access to mental health services remains a significant challenge across Africa. According to the figures cited by the Bluemind Foundation, nearly 150 million people on the continent live with a mental health condition, yet fewer than one in ten receive any form of support. In Togo, the country has fewer than ten psychiatrists for a population of more than nine million, according to the World Health Organization. These shortages underscore the need to explore additional ways of helping people access support, particularly in communities where specialist services are limited. Community-based approaches can contribute to this effort, but they cannot substitute for investment in professional healthcare, an adequately trained mental health workforce and reliable referral pathways.
For the Bluemind Foundation, the wider question is how health systems can recognize and work with trusted relationships that already play a role in people’s lives. “The goal is not to medicalize everyday relationships. It is to understand the human infrastructure that already exists around people, and to connect it safely to stronger systems of care.” Marie- Alix De Putter further sends a clear message: improving access to mental health services requires more than expanding formal healthcare provision. It also means understanding the social environments in which people live, the relationships they rely on and the circumstances that make it easier or harder for them to ask for help.
Research From Togo With a Wider Message
Mental health research from Francophone Africa remains underrepresented in global discussions, making locally grounded studies particularly important.The Trust Study offers an exploratory account of how women in four Togolese cities navigate personal difficulties and identify people they feel comfortable approaching. Its findings are descriptive: they do not establish causality, demonstrate therapeutic impact or prove that the same patterns apply in other countries.
Nevertheless, the research raises questions relevant to mental health systems well beyond Togo. How can healthcare providers build stronger connections with the communities they serve? What makes people feel safe enough to disclose emotional distress? And how can trusted community relationships help people reach professional care when they need it? These are questions that warrant further investigation, particularly in settings where access to specialist services remains limited. The findings suggest that the path to mental health support may begin long before a person enters a clinic or speaks to a healthcare professional. Sometimes, it begins in a familiar place, during an ordinary conversation with someone who knows when something is wrong.
Recognizing that first point of contact could help health systems develop more accessible and responsive ways of supporting people, provided that appropriate safeguards, professional services and referral mechanisms are in place. For the Bluemind Foundation, the Trust Study is a starting point for understanding how trust can contribute to stronger mental health support systems without confusing a listening ear with clinical care. Ultimately, the message extends beyond hair salons and beyond Togo: mental health support must be accessible, trusted and connected to the professional care people need.
Mental health is health.
