Just before suicide: when the mind reaches its darkest place

Multiple, overlapping life crises can contribute to suicidal distress.[Courtesy]

For years, Loice Mwende felt as though one crisis followed another.

Her husband was sick. Her young son was battling a serious medical condition and faced the possibility of losing his eyesight without urgent treatment. Money was scarce, support was limited and past trauma had already taken a toll on her mental health.

Then came another devastating loss a miscarriage.

The weight of illness, financial hardship, grief and emotional exhaustion eventually became overwhelming. Mwende reached a point of profound psychological distress, convinced that she had run out of options.

Today, she speaks about that period not as someone who believes everything has been erased, but as a survivor slowly rebuilding her life.

“I never recovered. I wouldn't say that I recovered, but at least I'm progressing so well,” says Mwende, a mother of one.

Her story illustrates how suicidal distress can develop when several pressures converge. It is not always one event that pushes someone into crisis, but the accumulation of problems that gradually erodes a person's sense of hope and control.

Illness, financial insecurity, grief, relationship difficulties, trauma and loneliness can each be difficult to navigate. When they occur together, they can leave a person feeling trapped.

As Kenya marks  Suicide Prevention Month in September, mental-health professionals and humanitarian organisations are urging families and communities to recognize distress early and help people access care before a crisis escalates.

The Kenya Red Cross Society's Mental Health and Psychosocial Support service offers a glimpse into the scale of the challenge.

Between September 2025 and September 2026, its toll-free 1199 hotline handled between 50 and 80 mental-health-related cases a day, with 40 to 60 clients receiving counselling daily.

During the same period, the service recorded more than 600 cases involving suicidal thoughts, ideation or crises. On some peak days, as many as 10 callers presented with suicide-related concerns.

The figures, however, represent only people who reached one particular support service. Many others may never call a hotline, visit a health facility or tell anyone what they are experiencing.

For Mercy Githara, Mental Health and Psychosocial Support Manager at Kenya Red Cross, the reasons people seek help are varied.

Suicidal thoughts are among the concerns raised by callers, alongside unemployment, gambling addiction, financial difficulties, relationship problems, bereavement and grief.

Young people and women account for a significant proportion of callers, although men also seek support.

Financial distress is increasingly visible in conversations with counsellors. Some callers have lost money through gambling, including money meant for rent, school fees and other basic needs. Others have spent months looking for work without success.

But, Githara says, financial hardship is not only about lacking money. Prolonged uncertainty can also affect a person's sense of hope.

“Someone has been looking for a job for so long. Someone has been hoping that the situation will change for so long,” she says.

When financial pressure is combined with isolation, substance use, relationship breakdown or an existing mental-health condition such as depression or anxiety, the emotional burden can become harder to manage.

Some callers seek help while intoxicated, making alcohol and other substance use another concern in crisis intervention.

The timing of distress can also matter. Githara says calls to the 1199 service can increase during the early hours of the morning, when people are awake and alone with their thoughts, as well as later in the day.

For some callers, the crisis is so severe that they are struggling with basic needs such as food.

“It’s like a situation of desperation,” Githara says.

When several crises collide

For Mwende, illness was at the center of her crisis.

Her husband's health problems and her son's medical condition created emotional and financial pressure at a time when she was already dealing with earlier trauma.

She needed medical care for her family and psychological support for herself.

Accessing continued care, however, was difficult.

Mwende was eventually admitted to a mental-health facility, where she spent months receiving treatment. But the cost of continued care became another challenge.

Then came the miscarriage.

She says she also experienced bullying and judgment from people around her, making it even harder to speak openly about what she was going through.

That silence is one of the major challenges in suicide prevention.

People experiencing severe emotional distress may already feel frightened, ashamed or isolated. When attempts to seek support are met with ridicule, condemnation or dismissal, they may retreat further.

“Most of the time when I am suicidal or when we are suicidal, we don't talk to people,” she says. “We just keep it to ourselves.”

Counselling psychologist Joseph Kimani Wahothi says people in distress often first turn to friends, relatives or other trusted people before seeking professional help.

The response they receive can influence whether they continue looking for support.

Instead of judgment, he says, people need emotional safety, an environment where they can speak honestly without being mocked or condemned.

Mental-health crises do not always look dramatic. Sometimes they appear through changes in everyday behavior.

Wahothi says warning signs can include social withdrawal, losing interest in activities previously enjoyed, persistent changes in sleep or appetite, increased irritability, difficulty concentrating or making decisions, and expressions of hopelessness about the future.

Such changes do not automatically mean that someone is suicidal. But when they are significant or persistent, they can provide an opportunity to check in and encourage professional support.

“Should not confuse illnesses with weakness,” Wahothi says.

Mental-health conditions require care just as physical illnesses do.

The connection between physical and mental health is also evident among people living with serious illnesses.

For cancer survivor Kitiki, the disease brought more than the physical challenge of treatment.

It brought stigma, isolation, financial pressure, lost clients and strained relationships.

Rumors about his condition affected his family and social life, including misconceptions that he had HIV.

“When I was in that situation, with people spreading rumors about me and even my family believing I had HIV, I felt like I had come to the end,” he says.

The emotional burden eventually affected his mental health and he required treatment for depression.

“I had to be put on antidepressants,” he says.

His experience demonstrates why cancer care cannot focus solely on the physical disease.

A serious diagnosis can affect employment, finances, relationships and a person's sense of identity. Patients may have to cope with fear about their future while simultaneously dealing with stigma and the demands of treatment.

For Kitiki,  psychological support became an important part of navigating the illness.

“People need to understand what cancer patients go through. Sometimes you need someone to talk to, someone who will simply stand by you,” he says.

His experience has changed the way he views vulnerability and relationships.

“The biggest lesson cancer has taught me is that anyone can be affected,” he says. “People can leave and anyone can fall into depression and isolation; nothing in life is guaranteed.”

His story reinforces a growing understanding in healthcare: treating the body without considering the mind can leave an important part of a patient's wellbeing unattended.

When a career is suddenly disrupted

For professional athletes, psychological distress can also emerge when the career around which their identity and livelihood are built is suddenly disrupted.

Former Harambee Stars goalkeeper Patrick Matasi says his suspension over match-fixing allegations had a profound emotional impact as he faced uncertainty about his career and public scrutiny over allegations he has denied.

Away from the football pitch, he says he withdrew from the world.

“From the 27th of March I locked myself in the house. I was sleeping during the day,” he recalled.

For a professional athlete, football can represent much more than employment. It can provide identity, income, social connection and a sense of purpose.

A sudden disruption can therefore affect several aspects of life at once.

Matasi's experience highlights the importance of mental-health support for athletes, particularly those dealing with career setbacks, public criticism, financial uncertainty or isolation.

His family became an important source of support during the difficult period.

His experience is also a reminder that public success does not make people immune to psychological distress.

Prevention beyond the hospital

Kenya's response to suicide prevention is increasingly extending beyond hospitals and specialist mental-health facilities.

During the 2026 World Suicide Prevention Day observance, the Ministry of Health launched a Handbook on Suicide Prevention for Religious Leaders, developed in collaboration with the Interreligious Council of Kenya and other partners.

The initiative recognizes the role religious leaders play in communities and the likelihood that people experiencing emotional or personal difficulties may approach them before seeking formal healthcare.

Kenya Red Cross Deputy Secretary General for Programmes Joe Mbalu said the organization’s 1199 hotline had received 7,394 mental-health and psychosocial-support calls in 2026, including more than 600 suicide-related crisis calls.

The organization said the suicide-related crisis calls were responded to through its interventions.

Dr Mercy Karanja, Head of the Division of Mental Health at the Ministry of Health, says suicide prevention cannot be left to mental-health professionals alone.

Families, schools, workplaces, religious institutions, civil-society organizations and healthcare providers all have a role in recognizing distress and helping people access care.

That broader approach is important because the factors associated with psychological distress often extend beyond healthcare.

Unemployment, financial insecurity, gambling-related losses, stigma, chronic illness and social isolation can all affect mental wellbeing.

Counselling and medical treatment are important, but so are the social structures that help people withstand difficult periods.

A conversation can open the door to help

For Mwende, one of the hardest parts of her experience was feeling that she had nowhere to turn.

She never called a suicide helpline during her darkest period because, at the time, she did not know there was a number she could call.

Looking back, she says she did not necessarily need somebody to solve every problem confronting her.

She wanted someone to notice that she was struggling. Someone to ask how she was doing. Someone willing to listen without judgment.

A family member who notices a loved one withdrawing can start a conversation. A friend can encourage someone struggling to seek professional help. A colleague can recognize a significant behavior change rather than simply dismissing it. Religious and community leaders can provide support while connecting people to appropriate services.

Listening does not replace professional treatment. But it can become the bridge to it.

For someone experiencing an immediate mental-health crisis or who may be at risk of harming themselves, urgent professional help is necessary.

For everyone else, prevention often begins much earlier, by creating environments where people feel safe talking about emotional pain.

For Mwende, recovery has not meant forgetting what happened. It has meant moving forward despite it.

She describes herself as progressing rather than completely recovered, acknowledging that healing can be uneven and that difficult memories do not disappear simply because treatment has begun.

Her story offers a more realistic picture of recovery: not a sudden transformation, but treatment, support, setbacks and gradual steps forward.

For mental-health professionals, the challenge is to make those steps easier to take.

For families and communities, it is to ensure that reaching out is met with compassion rather than shame.

And for society, it is to recognise that suicide prevention begins long before a crisis becomes an emergency.

Sometimes it begins with noticing that someone has become unusually quiet.

Sometimes it means sitting beside a person who is struggling and listening without judgment.

Sometimes it means helping them find a counsellor, doctor or other professional.

And sometimes, it begins with the simplest question: How are you?

For Mwende, that question could have made a difference when she felt most alone.

Today, her story carries a different message that a person can move through an extraordinarily difficult period, receive help and continue rebuilding.

The darkness may be real, but it does not have to be the end of the story.