- The Culture of Mental Illness and Psychiatric Practice in Africa ed. by Akyeampong, Emmanuel, Allan G. Hill, and Arthur Kleinman
In The Culture of Mental Illness and Psychiatric Practice in Africa, Emmanuel Akyeampong, Allan G. Hill, and Arthur Kleinman, as well as the contributors to this undertaking, shed light on mental illness in Africa and the way interventions are handled by psychiatric institutions and experts, including physicians and nurses. All the volume’s chapters, which study treatments used to deal with common and chronic mental disorders, have been well researched and well written.
Apart from the book’s thirteen main chapters, the editors provide an enlightening introduction, detailing the origin of the publication “in a working group at Harvard University on ‘Health, Healing, and Ritual Practice’” (p. 1). The group itself is part of an interdisciplinary and interschool research project of the Committee on African Studies known as the Africa Initiative: “The volume thus emerged out of conversations between a psychiatrist and non-psychiatrists about the history, culture, and practice of psychiatry in Africa” (p. 1). The editors here discuss such thematic topics as “Social Change and Mental Health in Africa, 1930s–1960s” and “Economic Decline and Political Instability in Independent Africa,” and give an overview of the book (pp. 1–23).
Chapter 1, “A Historical Overview of Psychiatry in Africa” (pp. 24–49), is written with admirable historical and political expertise by Akyeampong, who is well versed in the intellectual terrain the volume addresses. He begins by asserting that mental illness, which many Africans see as a taboo, never curable, “is a phenomenon in all societies” (p. 24). He notes that [End Page 146] the predominance of preliterate societies in the sub-Saharan region of the continent before the nineteenth century means “fewer written records on medical systems that could enable us to study mental illness in precolonial Africa and the efficacy of traditional African therapeutic systems” (p. 24). The establishment of mental asylums throughout West Africa was “part of the infrastructure of colonial rule” (p. 24). Sub-Saharan Africa’s foremost or first mental asylum was established in the former British colony of Sierra Leone; it was the Kissy Lunatic Asylum, “a facility that was used for all types of dependent people” (p. 24).
Vikram Patel and Dan Stein utilize their contribution in chapter 2 for exploring what is known as “the concept of common mental disorders (CMDs), which include depression, anxiety, and the presentation of these and other mental health problems through somatization” (p. 10). The challenge of psychiatric care in West Africa is exhaustively discussed as chapter 3 by Ursula Read, Victor Doku, and Ama de-Graft Aikins, while mental health and destitution, with the example of Ghana, constitutes chapter 4, written by Ama de-Graft Aikins. Alan Flisher, Andrew Dawes, Zuhaya Kafaar, Crick Lund, Katherine Sorsdahl, Bronwyn Myers, Rita Thom, and Soraya Seedat have coauthored “Children and Adolescent Mental Health in South Africa,” (chapter 5), which they gratefully dedicate to their fellow contributor, Alan Flisher, who died before the publication of the volume.
The remaining eight chapters provide similarly useful topical information on several crucial themes: psychiatric education at the Fann Hospital in Senegal, authored by Rene Collingnon (chapter 6); an exploration of women’s mental health in the Ghanaian capital of Accra, which utilizes a survey of 3,200 adult women in a broad age group, coauthored by Alan Hill and Victoria de Menil; the outcomes of the 1994 reorganization of the healthcare system of South Africa (chapter 8), discussed by Pamela Collins; caregiver burnout with respect to professional development and training (chapter 9), discussed by Giuseppe Raviola; chapters 10, by E. Okello Seggane, and 11, by Shoda Raja, Sarah Wood, and Michael Reich, thematic reviews of the infrastructure of psychiatric treatment, harping urgently on four studies from 2007 conducted by BasicNeeds, examining the provision and adequacy of pharmaceutical drugs to psychiatric institutions in Ghana, Uganda, Kenya, and Tanzania, and showing how “traditional, Muslim, and Christian healers represent real alternatives to Western...