Mohlomi battles overcrowding

MASERU – LESOTHO’S only referral psychiatric hospital, Mohlomi, is battling overcrowding.

The hospital’s forensic unit houses 80 instead of 35 patients as per its bedding capacity.

A room for two people is said to host more than five patients and some patients are forced to sleep on the mattresses, sharing everything.

The forensic ward houses patients who are judged unfit by the courts to stand trial and are sentenced to detention in the hospital until their mental illness has been treated.

Lesotho opened the ward in 2010 after a government decision to have a specialised ward for offending patients, closing a section at Mohale’s Hoek Prison that housed such patients.

Patients in the now-defunct Mohale’s Hoek prison were referred to as His Majesty’s Pleasure Inmates.

Initially, the Mohlomi Hospital did not have a ward for patients who committed crimes.

The hospital’s matron, ’Mantoa Maholi-Rampeta, said the main reason behind overcrowding is that patients have to be released by a committee which has a psychiatrist as one of its members.

She said the Mental Health Act 1964 said a psychiatrist has to be part of the committee “but we do not have a psychiatrist in the country”.

A psychiatrist from Partners-In-Health (PIH) visits the hospital once a week.

The PIH’s psychiatrist, Maholi-Rampeta said, was “instructed not to interfere with Lesotho’s law hence the psychiatrist does not go to the forensic ward”.

Maholi-Rampeta said the other reason for overcrowding is that the courts keep sending all people who are said to be unfit to stand trial even if their mental illnesses do not warrant them to be admitted.

“Those sent by the courts for assessment will never be released until they undergo psychiatrist assessment and the committee releases them,” Maholi-Rampeta said.

She said most of those sent by the courts have committed minor crimes and many of them can be treated as outpatients.

“We tried refusing to admit them at some point saying there is no space but judges asked for our names so that we could be charged with contempt,” she said.

“What is happening there is inhumane but we don’t have control over it until the amendments (to the Mental Health Act) are made.”

She said the overcrowding was also an indication that mental illness was rampant in Lesotho with a lot of patients roaming the streets unaware of their condition.

She further said this problem had put patients at risk of infecting each other with communicable diseases.

“Disease control is therefore compromised,” she said, recalling that during the Covid-19 crisis almost half of the patients got infected and isolation was a challenge.

Maholi-Rampeta further said a critical shortage of manpower is the country’s biggest challenge in providing clinical help to mentally ill people because most have retired.

Mohlomi Hospital has eight psychiatrist nurses, four psychologists and four doctors who are not psychiatrists.

“We are trying our best despite the lack of resources,” she said, adding that “we need specialists to ease our job.”

She said Lesotho has Mental Observation and Treatment Units (MOTU) popularly known as Mohlominyane within the government hospitals except Thaba-Tseka as it has outpatients only.

“MOTU is mandated to deal with patients at the district level and only refer them to Mohlomi if need be,” she said.

‘Mapule Motsopa