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End of Life Care – Article from our Experts

My name is Ato, and I’m working in Monrovia (Liberia) as a Psychiatric Nurse. It is with great joy and compassion for the mentally ill that drives me today to share personal experiences on “Care at the end of life”. This usually relates to age but, from our perspective at Benito Menni Health Centre, I see individuals who suffer from various forms of mental illness demonstrating a challenging “end of life”.

While most of us want to be mentally healthy, it can be difficult to know how to ask for help or how to start treatment. As you can imagine, poverty, knowledge deficit, and living in a remote area are factors that make it difficult to receive help. It is not different in Liberia, where residents have experienced a series of traumatic events, such as wars and Ebola outbreaks, in the past. These events have had many negative effects on the functioning, reasoning and life’s perception of many Liberians, and it’s yet not getting any easier for most of them.

As a Psychiatric Nurse, I find this very challenging, but also see it as an opportunity to make an impact in the lives of the vulnerable through the medications and various therapeutic activities we do with them at the Maria Josefa Recio Unit, like psychotherapy, musical therapy, occupational and recreational activities from a multidisciplinary approach. We also have an organized program that enables us to incorporate a continuous treatment for mentally ill residents, including care and support for their families.

At our facility, we have provided a therapeutic and eco-friendly environment that eases our patients when coming for our services. They comically refer to this place as “small America” signifying its serenity. This is the first point of contact, and it has thus far helped to establish a good therapeutic rapport. Moreover, residents verbalize that this therapeutic environment in which they receive care impacts their outcome, satisfaction, safety, staff efficiency and organization positively. Portraits of the institution’s founding Father and co-foundresses on the walls of the inner perimeter of our care home support the psycho-social and spiritual needs of the residents, their families, and staff. Not forgetting the presence of our Sisters.

Care and Mental Health: A New Beginning

Care and Mental Health in Africa

However, in Africa, Psychotherapy is not believed by the masses as a form of treatment for mental illness, due to various misconceptions and traditional believes. Here at the Benedict Menni Health Centre, we integrate counselling sessions for clients and their families. This creates awareness on mental health and helps clients gain insight on their presenting condition. On our daily schedule, we also help residents determine their thoughts, feelings, and behaviours through individual and group sessions. This teaches them how to practice healthy coping mechanisms when faced with challenging life situations.

Generally, people with mental illnesses see life as the “shades of night”. During these stages they need our support and reassurance. At the facility, we are fortunate to have quality and sufficient medications at our disposal that help manage our patients’ symptoms.

Finally, the continuity of care after patients have been discharged from the facility have been a huge menace with the numbers of relapses recorded over the last few years. Some patients become non-compliant due to lack of motivation from relatives, boredom, and the lack of financial support. Therefore, in our care home, we have designed a “Women Empowerment and Mentoring Business Development Program”. This aims at supporting our discharged clients in setting up a small business on their own through micro-finance provided by the facility. We believe this will help reduce the number of relapses, as our women will have the means to provide basic needs for themselves and their families. It also relieves them of the mental stress associated with life and recovery. This program, therefore, is intended also to uplift our clients, providing them a sense of belonging and value as an integrated member of the society.

At the facility, we continue to provide the necessary support for God and humanity. This describes what we, at Benito Menni Health Centre, consider ‘Care at the end of life’.

Using this medium, I like to give a big mention to all the members of our team (nurses, aid-nurses, social workers, occupational therapist, cook, janitors, securities etc.) for their continuous, holistic and accessible care rendered to the affected. To our provincial superior, Sr. Lourdes Sanz, our program lead, Mikel Tellaeche and all our Benefactors and Benefactresses, I say thank you for all the support given that enables us to present proper care to our residents/patients.  We believe “Mental Health is Total Health”.

Care and Mental Health_Ato Kwamena Sagoe



Written by:

Ato Kwamena Sagoe
Psychiatric Nurse at Benito Menni Health Centre in Monrovia (Liberia)
Province of England