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Abstract We conducted a household survey among 6061 adults in Lesotho to (1) assess the prevalence of moderate/severe mental health (MH) and substance use (SU) problems (2) describe the MH and SU service cascades, and (3) assess predictors of MH and SU problem awareness (i.e., awareness of having a MH/SU problem that requires treatment). Moderate/severe MH or SU problems was reported between 0.7% for anxiety in the past 2 weeks to 36.4% for alcohol use in the past 3 months. The awareness and treatment gaps were high for both MH (62% awareness gap; 82% treatment gap) and SU (89% awareness gap; 95% treatment gap). Individuals with higher than the median household wealth had lower MH and SU problem awareness and those living in urban settings had greater SU problem awareness. Research should investigate how to increase population awareness of MH/SU problems to reduce the burden of these conditions in this setting.
Fernández et al. (2024) studied this question.