The mental health team travelling to Ha Ntsene in Nohana, Mohale’s Hoek
Photo by Justice Kalebe / PIH
For years, 47-year-old Malebohang Ntšene carried a burden few people could see. Each morning, she woke up thinking about her son. Each night, she went to sleep worrying about him.
As a mother, she had watched him grow into a bright young man with a promising future. She dreamed of seeing him complete high school, attend university, and build the life she knew he was capable of achieving. Instead, she found herself navigating a difficult journey after her son dropped out of school in 2022 and began struggling with substance use.
“He was very bright,” Ntšene recalls quietly. “I thought by now he would be at university.”
The change had not happened overnight. While still in school, her son began using marijuana. His behavior started changing. Teachers regularly called her to report incidents at school. At home, the once obedient young man became increasingly difficult to reach.
“When he is well, he listens and respects me,” she says. “But when he relapses, he becomes aggressive and refuses to take his medication.”
As the years passed, Ntšene devoted herself to caring for her son. She encouraged him to take treatment, supported him through periods of recovery, and stood by him during relapses. But somewhere along the way, the emotional toll of caregiving began to affect her own wellbeing.
“I also started having mental health challenges when my son dropped out of school,” she says. “I was always worried. I was always thinking about him.”
The stress accumulated slowly. She lost weight. Her thoughts became increasingly difficult to manage. At times, she experienced overwhelming confusion and felt as though her mind was filled with noise she could not explain.
“I would feel like someone was following me,” she says. “My head was never at peace.”
Like many caregivers, Nts’ene had spent so much time caring for someone else that she had little opportunity to care for herself. But her journey toward healing began when she was connected to mental health services.
Mpiti Nkuebe (left), during a mental health supervision with ‘Malebohang Ntšene (right) at Ha Ntšene in Nohana.
Photo by Justice Kalebe / PIH
A Screening That Opened the Door to Care
When Ntšene attended services at a PIH Lesotho-supported Nohana Health Centre, healthcare providers noticed signs that she might be experiencing emotional distress and referred her to mental health services for further assessment.
According to PIH Lay Counsellor Makhaola Kotsoane, the first step was screening.
“When Malebohang arrived, we screened her using the PHQ-9 and GAD-7 tools,” explains Kotsoane.
The Patient Health Questionnaire-9 (PHQ-9) is used to screen for symptoms of depression, while the Generalized Anxiety Disorder-7 (GAD-7) tool helps identify symptoms of anxiety. These evidence-based screening tools help healthcare providers better understand what a person may be experiencing and determine the most appropriate support.
“Her scores were very high on both assessments,” says Kotsoane. “It was clear that she was struggling with significant symptoms of anxiety and depression.”
The screening provided something Ntšene had not experienced in a long time: recognition that her own wellbeing mattered too.
Rather than allowing her struggles to remain unseen, the assessment connected her to the support she needed.
She was immediately enrolled in Problem Management Plus (PM+), a structured counseling intervention designed to help people manage stress, solve practical problems, strengthen social support, and regain control over their lives.
Small Steps Toward Healing
‘Malebohang Ntšene attending to her keyhole vegetable garden outside her home.
Photo by Justice Kalebe / PIH
When Kotsoane first met Ntšene, the effects of prolonged stress were evident.
“She was not in a good condition when we started working together,” he says. “She appeared very anxious and depressed.”
But after the first PM+ session, Kotsoana began noticing subtle changes.
“We could already see a small improvement. She was beginning to talk more openly and engage with the process.”
Over the following weeks, Nts’ene attended five PM+ sessions.
During counseling, she learned practical strategies to manage overwhelming thoughts, cope with stress, and focus on aspects of life she could control. The sessions also provided something equally important: a safe space to share her experiences as a caregiver.
“The counseling has helped me a lot,” she says. “I feel relieved.”
For the first time in years, she felt that someone was listening to her story and that someone understood the weight she had been carrying.
Supporting the Whole Person
PIH Mental Health Team with ‘Malebohang Ntšene at her home in Nohana, Mohale’s Hoek.
Photo by Justice Kalebe / PIH
Alongside counseling and psychosocial support, Ntšene also receives social assistance through PIH.
As an unemployed caregiver, meeting basic household needs can be a source of constant worry. Through the support package she receives, her family has access to staple foods that help ease some of that pressure.
“The social support helps me a lot,” she says. “It eases my mind.”
By helping meet essential needs, the support allows her to focus more fully on her health and her son’s recovery.
A Mother’s Hope
‘Malebohang Ntšene at her home during mental health supervision in Nohana, Mohale’s Hoek.
Photo by Justice Kalebe / PIH
Although her journey continues, Ntšene says she now feels better equipped to face the challenges ahead.
Her son still experiences periods of recovery and relapse, but she remains hopeful.
“I always encourage him to stop using marijuana,” she says. “Whenever he stops, he becomes better.”
As she speaks about her son, her voice carries so much hope and love that has sustained her through years of uncertainty.
Through mental health screening, counseling, home-based follow-up, psychosocial support, and even a small garden growing beside her home, Ntšene has discovered that caring for herself is not separate from caring for her son.
