The epidemic of suicides

MASERU – “I am the only one making mistakes and I will be better off if I am dead.”

This was not Libakiso, 19, speaking to a friend or relative.

Those words were instead on a suicide note Libakiso had scribbled before disappearing from her home in Mohale’s Hoek and drinking a bottle of pesticide.

That note, discovered by her younger sister Rose, triggered a frantic and desperate search for her. Rose posted Libakiso’s picture on social media platforms, appealing for help to find her. A neighbour found Libakiso unconscious at a local shop and rushed her to Ntšekhe Hospital where she stayed for two days.

For the first few days after the incident, Rose blamed Libakiso for trying to kill herself over what she thought was a “trivial reason”.

It was only a week after the incident that she reached out to Libakiso.

Yet even though she wanted answers she still had a nagging feeling what she wrote in the suicide note was “a cover-up story”.

That conversation, Rose says, helped her understand what Libakiso was going through.

“I almost lost her because I was unaware of what she was going through. I went for days without talking to her because I was angry and it affected me emotionally,” Rose says.

“I then started supporting her through it all.”

She is still worried that her sister might do the unthinkable.

“My sister has changed. She is no longer that bubbly, confident, talkative and sociable person…she even quit social media.”

“It is sad but I am hopeful she will be fine with time although she did not get any professional help.”

Rose says she learned “the hard way that even the smallest problems in life could trigger suicidal thoughts and many people act on them with disastrous consequences”.

Libakiso was fortunate to have been discovered before it was too late.

‘Makhotso, a 22-year-old tertiary student from Thaba-Tseka, committed suicide allegedly after her boyfriend rejected her when she told him that she was pregnant.

‘Makhotso had earlier posted about death on her Facebook page.

In one post she wished for her soul to rest in peace and asked how long it takes for poison to kill. Her fast attempt at taking her life however failed after she was discovered, on the verge of death by someone who took her to Queen ’Mamohato Memorial Hospital (QMMH).

Makhotso was discharged after two days. A few days later she killed herself.

Around March, a man from Leribe hung himself in a shop.

A suicide note in his pocket said he had taken his own life because his life was tough.

“I have not known the joy of life since I was a child”, the note said.

These three cases are neither isolated nor rare in Lesotho.

If anything, they illustrate an epidemic that has silently rocked Lesotho for years.

Although it rarely gets attention from the government or NGOs, suicide ranks number seven among the leading causes of death in Lesotho.

The latest data from the World Health Organisation (WHO) shows that suicide deaths in Lesotho reached 1 539 or 4.62 percent of total deaths per year in 2022. The age-adjusted suicide death rate is 87.48 per 100 000 of the population, ranking Lesotho number one in the world.

‘Mahlape Moremoholo, a therapist at Khanya Consultancy, says all suicides are linked to mental health.

Moremoholo describes suicide as “a behaviour motivated by a desire to escape from unbearable psychological pain”.

“People who attempt or kill themselves have mental illnesses or social problems which result in a feeling of hopelessness,” Moremoholo said.

“They don’t kill themselves because they do not want to live anymore but they believe they don’t have any other option therefore they are better off dead.”

She says suicide has become “a serious public health problem”.

Moremoholo’s link of suicide to mental health is supported by Psychcentral, a website that focuses on mental health.

The website says suicide is linked to borderline personality disorder (BPD), depression, bipolar disorder, post-traumatic stress disorder (PTSD), substance use disorders, psychosis, stress, anxiety disorders and eating disorders.

One-fifth of Lesotho’s 2.2 million people suffer from some form of mental illness, according to a 2016 study led by Dr Daniel Vigo of the Harvard School of Public Health which was supported by

Partners-In-Health, an NGO with operations in Lesotho.

It is said that this is the highest rate of mental illness in countries where PIH work.

Moremoholo however says many people with mental health problems don’t seek health for either lack of information or fear of being stigmatised.

This, she says, is why many suffer in silence and others resort to suicide.

There is a huge problem with the way society views those with mental problems.

“We need to educate people about this because mental illness exists.”

“We have to end the stigma surrounding it as it prevents people from seeking necessary treatment because people feel they should be able to solve their problems.”

Nthati Phakoe, an activist at Tunasafiri, an association of mental health activists, says “the biggest barrier in ending the stigma is lack of information”.

“Most people don’t understand what mental well-being is. One is either fine or crazy, there is no in-between before being diagnosed. If more people can come on board to raise awareness like

Tunasafiri is doing before the problem escalates, we would be able to deal with it,” says Phakoe, who is also a mental distress survivor (bipolar and brain epilepsy).

She says self-diagnosing through Google “is very harmful because it can misdiagnose a person”.

“Being diagnosed by a professional is very important to administer the right care.”

Phakoe says she spent “17 years of unnecessary pain and full of regrets because I did not understand myself.”

’Mantoa Maholi-Rampeta, a matron at Mohlomi Mental Hospital, has seen an increase in the number of people who are admitted after attempting suicide.

“They only get admitted for some time if they do not have a close person to monitor them 24 hours,” Maholi-Rampeta says.

She says they do raise awareness but the stigma associated with mental health is still a major challenge as people do not understand mental health and fear it.

“We need to strengthen our awareness campaigns until people understand that it is an illness like any other and that it can affect anyone,” she says.

She says mental health has to be integrated into all health services to deal with the crisis.

Despite this crisis, Lesotho is still using the outdated 1964 law on mental health.

The Ministry of Health tried to amend the law a decade ago but failed because authorities did not give it the priority it deserved.

The amendment had been funded by the WHO.

’Mapule Motsopa