Imperial Bedlam: Institutions of Madness in Colonial Southwest Nigeria (review)

Combining African history with the history of mental illness, this book begins with a deceptively simple question: How did colonial institutions determine whom to confine? Jonathan Sadowsky’s answer sidesteps the debate over whether mental illness is real in an absolute sense or socially constructed and instead focuses on the ways it has been produced in a particular time and place—colonial southwestern Nigeria. Proceeding from the assumption that the identification of insanity conveys important social meanings, he effectively uses the history of two mental institutions (the Yaba Lunatic Asylum in Lagos and the Aro Mental Hospital in Abeokuta) to draw conclusions about colonial policies, their effects on individuals, and their implication in the production of “scientific” knowledge.

The book begins by charting the history of colonial mental health interventions in southwestern Nigeria. The first state-sponsored mental institutions in Nigeria date to the early twentieth century, when colonial administrators and Nigerian journalists noted with alarm the growing number of lunatics on the streets of Lagos and other urban centers. But until the 1930s very little money was spent on these purely custodial institutions. For the next twenty years reformers worked to convince officials of the desirability of a curative mental hospital, but little action was taken. Therapeutic approaches were introduced only in the 1950s, largely through the initiatives of Nigerian psychiatrists and in concert with Nigeria’s transition to independence. Readers unfamiliar with Nigerian history will find this section quite clear, although a map of the relevant geographic area is surprisingly absent.

One of Sadowsky’s major contentions is that asylum policy reveals in microcosm the dynamics of the Nigerian colonial state and in particular the contradictions inherent in “Indirect Rule.” Until World War Two the administrative model for much of colonial Africa was governance through “native authorities” following and attempting to preserve what colonial officials deemed as local African customs. “Indirect Rule,” Sadowsky writes, “contained several goals—economic benefits for the metropolitan country, the alleged benefits of civilization for the colonized people, the preservation of ‘tribal’ customs—that were incompatible. Asylums—even dreadful as they were—were associated with the benefits of civilization. The expense of a truly modern asylum, though, was incompatible with the economic goals of colonialism. At the same time, financial restraint was justified by the goal of preserving the African way of life” (34). As a result of these contradictions, the government drifted into a middle policy, creating asylums yet avoiding significant investment in treatment, vaguely acknowledging the social changes colonialism wrought but also denying responsibility for them.

Not only was policy shaped by the colonial context, but so was mental illness itself. Although he is unwilling to posit that colonialism created mental illness, an argument associated with Frantz Fanon, Sadowsky contends that colonialism strongly determined the symptoms and content of mental pathology. He uses patient records to treat “raving” as a valid object of social analysis whose content carries political and cultural significance. His rich source materials provide compelling evidence of colonialism’s meanings for certain individuals, as Christianity and the symbols of government authority featured prominently in the rantings of the confined. “Persecutory delusions” was a commonly noted symptom in patient records, along with resentment and aggression. These attributes were predictable, Sadowsky notes, in a colonial society which was persecutory itself. Yet this is not to imply that the confined were only deemed mentally ill by colonizers: African family and community members generally agreed with colonial psychiatrists’ decisions regarding who was mad and who was not.

If the colonial context overdetermined many symptoms and diagnoses of madness, it also was reflected in scientific writing on African mental illness. In general, British psychiatric literature emphasized Africans’ difference from Europeans and treated Africans as representatives of a race rather than as individual patients. The writings of the three most important colonial psychiatrists with Nigerian experience seem relatively liberal on matters of race when compared to those dealing...