We Are Like You is a collaborative project between the Aita Menni Hospital of Arrasate – Mondragón (Gipuzkoa, Spain) and the Saint Benedict Menni Health Center of Monrovia (Liberia), both belonging to the Order of the Sisters Hospitallers.
The project aims to improve the health conditions of patients in the health center, and treat patients with mental illness and/or suffering from substance abuse and mental handicaps.
For this purpose, the project includes plans for the building and renovation of installations in order to incorporate specialized consultation facilities for mental disorders and a nursing unit to the Benedict Menni Center, as well as training programs for local health teams for the care of mentally ill patients.
The project follows the mental health policy guidelines promoted by Liberia’s Ministry of Health and Social Welfare and the measures implemented at the Grant Mental Hospital, with which those behind the project work closely.
Closed in July 2014 due to the outbreak of Ebola, its reopening requires the construction of 3 new facilities:
From the experience gained in the Aita Menni Hospital regarding psychological support for victims of disasters or violence, a program of Liberian psychosocial community intervention will be held, aimed at both Ebola survivors and family members of those killed by the virus, as well as health professionals. The project will always be aimed at groups that can be classified as follows:
The country has experienced two successive civil wars between 1989 and 1996 and between 1999 and 2003, with more than 200,000 dead and a reconciliation process that has not yet been completed. This has left a society traumatized by the violence suffered or inflicted and with a great need for psychological support.
Community Psychosocial Intervention Program
The Step Down Unit -the name given to the unit- will be a convalescence unit coordinated with the Grant Mental Health Hospital, the only mental hospital with 80 beds at its disposal, run by the Ministry of Health and funded and organized by the JFK Hospital.
The most common pathologies treated at the Grant Mental Health Hospital are:
The average stay is no greater than 21 days.
The convalescence based “Step Down Unit” offers the following services:
Since the commissioning of this unit, and drawing on the experience brought by Aita Menni Hospital over its 115 year history in the management of patients with mental illness, we can say that the grouping of patients by pathology will lead to two sub-units/care units: the Mid-Term Stay Unit and the Intellectual Disability Unit.
Details of each sub-unit are given below:
1. Mid-Term Stay Unit, partnered with a Psychosocial Rehabilitation Service, structured in workshops (gardening, agriculture, sewing, hairdressing, craftsmanship, etc.) for patients with mental illness due to substance abuse. The Unit will have 10 beds, a day service center and workshops for occupational therapy that will provide resources for patients’ daily needs and for their interaction with their surroundings. This Unit would be associated with:
Currently the predominant profile is that of a male, 30 to 35 years old and a drug user.
In addition, community psychosocial support will be provided to prevent social exclusion and promote the patient’s return to their surroundings.
2. Intellectual Disability Sub-Unit (mild to moderate mental handicap), with a 10 bed capacity, partnered with a structured Psychosocial Rehabilitation Service, made up of workshops, with the aim of acquiring skills in order for patients to be able to return to their surroundings
To attract patients, referrals from other health centers through pre-existing channels shall be made use of.
Procedures for collecting and filing patient data shall be used in accordance with Liberian Law and with the Aita Menni Hospital’s levels of quality.
Types of mental handicap:
With a population of around 4 million inhabitants, an estimated 10,000 people may suffer from severe mental disability and 2,000 of them from heavy mental disability.
In addition, psychosocial community support will be provided to prevent social exclusion and promote the patient’s return to their surroundings.
The Ministry of Health and Social Affairs runs a program called “Wellness Centers”, which was expected to create a network of mental health centers, one for each of the 15 state counties, with the ability to serve the mentally ill and the possibility of having 4 beds for the hospitalization of acute cases. Of these 15 centers, only one remains in operation, the Phebe Hospital. The Grand Gedeh and Sinoe centers, which should be up and running from 2012, are still not operational.
The San Benito Menni Health Center will join the “Wellness Centers” network, and will be able to handle between 1,000 and 3,000 specific mental health patients a year, referred from other health centers in the Montserrado County.
This is a key element for progress, development, the mutual transfer of knowledge and the future sustainability of the project. We can distinguish three levels:
At the next level, this being a more advanced stage, one should consider the possibility of sending the best professionals abroad, in order for them to see how other healthcare environments are run. These experiences have a dual purpose; first to get to know different realities (cultural, human resources and technical) and, on the other hand, to generate the desire to help and work with those Western professionals who receive, accompany and work with them.
The fact that the project is supported by the experience and knowledge brought by the Aita Menni Hospital guarantees seriousness in its implementation. Aita Menni currently features specific units for the treatment of all types of patients, combining psychiatric and psychological aspects, pioneering the combination of work systems and the understanding of people and mental illness from a multidisciplinary perspective.
WE ARE LIKE YOU aims to help the following social groups:
Residents of the Benedict Menni Health Center area
The violent outbreak of Ebola in the spring of 2014 forced the closure of the center in July. Even though the country was declared free of Ebola a year later, new outbreaks cannot be ruled out, which means that it is necessary to build three new facilities to ensure the safety of those attending the Health Center’s consultations:
Mentally ill patients discharged from Grant Hospital
The project includes the implementation of a Convalescence Unit to provide a place of welcome and care for:
Patients requiring psychological and social support programs
Patients with mental and behavioral disorders that require outpatient care
A network of outpatient centers exists that takes part in the “Wellness Center Program”, promoted by the Ministry of Health and Social Welfare in the 15 counties of the country. However, since this network is incomplete and Montserrado County, where Monrovia is located, has a large population, we believe that the Sisters Hospitallers center can take part in the outpatient care of patients with mental and behavioral disorders.
Patients with dual diagnosis (substance abuse and mental illness)
There are some programs that address these problems, including one from the Liberian Red Cross focused on women that are victims of extreme violence and drug abuse. The program includes various types of workshops to provide women with skills that will help them find a job or start a small business.
The Medium-stay Unit, covered by the project, can accommodate dual diagnosis groups that do not fit into existing programs, as well as cases referred by health centers.
Mentally handicapped patients
Mental disability is the great enigma of statistics and reports on mental health in Liberia.
With a population of 4.4 million inhabitants, an estimated 10,000 people suffer from severe mental disability and some 2,000 from heavy mental disability.
Often, our social environment rejects and stigmatizes these patients.