The World Health Organization reports that in Lesotho, 87.5 people per 100,000 die by suicide each year. This rate is more than double that of Guyana, the second-highest, and nearly ten times the global average of nine suicides per 100,000 people.
The path from the main road to the home of 79-year-old Matlohang Moloi is a challenging ascent through the mountains that contribute to Lesotho’s status as one of the highest countries globally. Matlohang, a mother of ten, welcomes me into her tidy home and shares photos of her large family. I am here to discuss her eldest son, Tlohang.
At 38, Tlohang became part of a troubling statistic: Lesotho, known as the kingdom in the sky, has the highest suicide rate in the world. “Tlohang was a good son,” Matlohang recounts. “He had confided in me about his mental health struggles. Even on the day he took his own life, he told me, ‘Mother, one day you’ll hear that I have ended my life.’ His death deeply affected me. I wish he had explained more about what troubled him. He was afraid that opening up would make him seem weak.”
Organizations like HelpLesotho are working to change this by helping young people develop mental health management skills. In Hlotse, about two hours from the capital, Maseru, I attend a group therapy session for young women led by social worker Lineo Raphoka.
“People think discussing mental health conflicts with our African principles and spirituality,” says 24-year-old Patience. “But avoiding the issue doesn’t help. I’ve lost three friends to suicide and have attempted it myself.”
Everyone in the group has faced suicidal thoughts or knows someone who has died by suicide. Thirty-five-year-old Ntsoaki shares a traumatic experience of being raped in a hospital, which has influenced her thoughts on suicide. “The only thing that kept me going was my brothers’ belief in my strength,” she says.
The group provides emotional support, and as the session concludes, the women express relief from sharing their stories. Ms. Raphoka identifies common factors contributing to Lesotho’s high suicide rate, such as rape, unemployment, and substance abuse. According to a 2022 World Population Review report, 86% of women in Lesotho have experienced gender-based violence, and the World Bank reports that two in five young people are neither employed nor in education.
Many people in Lesotho are hesitant to discuss mental health due to fear of judgment. Khosi Mpiti, speaking in a bar in Hlotse, mentions that while there is a growing openness, some still worry about gossip. “As a group of friends, we support each other,” he says.
However, seeking help can be challenging due to the struggling public health system. Last year, the ombudsman criticized the country’s only psychiatric unit for lacking a psychiatrist since 2017 and for having poor conditions. The government is currently drafting a national mental health policy.
“Mental health has become a pandemic,” acknowledges Mokhothu Makhalanyane, an MP. He emphasizes the importance of advocacy and education, drawing on lessons from Lesotho’s successful HIV/AIDS response.
Back in the mountains, Ms. Moloi visits Tlohang’s grave, which offers a serene view. She has a message for those struggling like her son did: “Taking your own life is never the answer. It’s important to talk to those around you for support.”
