by Kopo Manamolela, Psychiatric Nurse, Berea Hospital
Depression is one of the challenging mental health conditions in Lesotho. In most cases it goes unreported until the late stages whereby measures to manage the condition are compromised and result in admission to hospital.
Contributing factors to depression, particularly in Lesotho include poor socioeconomic issues: such as high unemployment rate among young people, either academics or non-academics; poverty as some people find themselves trapped in a vicious circle of poverty despite measures they take to get out of it. This is due to traditional family structure of the Basotho, where one member of the family may be a breadwinner for the whole extended family and the effects of unpredictable climate changes which have made it almost impossible for farming. Most people are factory workers and domestic workers with minimum income either in the country or in neighbouring South Africa, thereby having to leave their families, resulting in a stressful situation.
Psychosocial issues also play a major role in depression. Divorce, loss of job, the current unstable political situation, chronic illnesses such as HIV/AIDS and bereavement are other contributing factors to individuals and their families. Adolescent depression and childhood depression are also being diagnosed in health settings. Health care workers are also high-risk groups because of having to work under stressful conditions with lack of staff and facilities and approaching retirement.
Measures to diagnose and manage depression early remain a challenge due to fear of stigma, understaffed hospitals, lack of mental health specialised workers and negative attitude of health workers towards mental health.
Mental health personnel are trying to integrate mental health into other health services but this is a slow process due to resistance and fear from other disciplines. Lack of resources such as transport, fuel, audio-visual materials etc. hinders awareness and training campaigns.
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