Black Skin, White Coats: Nigerian Psychiatrists, Decolonization, and the Globalization of Psychiatry by M. M. Heaton (review)

Heaton’s work focuses mainly on the Western construction of mental illness as well as the concomitant policy approaches in colonial Nigeria. Well researched, this corpus serves as an important resource of policy background in understanding the political and economic policies behind the treatment of the mentally ill in colonial and post-colonial Nigeria. The book is divided into six chapters, each with two or more subsections. In an excellent introduction the author presents the work of Lambo, the first Nigerian psychiatrist. He recaptures how Lambo had organized the first Pan-African Psychiatric Conference as an effort toward the decolonization of Western conceptualization of mental health disorders in colonial Africa. According to Heaton, the aim of Lambo was to bridge the gap between traditional African conceptions of mental illness and western ideologies with the goal of achieving a more holistic and universal mental health treatment. The overarching concern of Heaton in this work is to crystallize Lambo’s efforts to ensure that cultural particularities factor into mental health policies and influence the political, economic, and social dimensions of mental health issues.

In the first chapter, Heaton addresses the issue of policy in detail. He examines, for example, the policy of confinement of people with mental illness in the asylum system as introduced by British colonial powers in 1958. Pointing out the pitfalls of the asylum system as a policy, Heaton views it as wanting in adequate therapeutic treatment. The reason why is because it was based on insufficient scientific and medical knowledge of African worldviews by the colonial powers. Moreover, the policy was faulty because it was grounded in the unfounded colonial ideological construction of the African mind as inherently inferior to the Western mind. This chapter uncovers the political and economic reasons why mental health institutions during the late colonial period in Nigeria remained underfunded. In chapter two, Heaton evaluates how Lambo established a new direction in conceptualizing mental illness. Accordingly, Lambo advocated a cross-cultural, national, and international definition and system of treatment for people with mental illness in Nigeria.

Chapter three recounts how western-trained Nigerian psychiatrists investigated why Nigerians and other black immigrants in the United Kingdom developed mental illnesses in the 1950s and 1960s. The colonial construction of mental illness resulted in the medicalization and pathologization of African immigrants for the purpose of social control. The author concludes that decolonization, among other things, is necessary to adequately provide effective mental health policies for African people. The next chapter explores the research efforts of Nigerian psychiatrists in redefining mental health diagnoses such as schizophrenia and depression. Heaton discloses how these psychiatrists deconstructed the biased Eurocentric ethnopsychiatric researchers and showed them to be inherently racist and wanting in the scientific universality that they purported to represent. Furthermore, the Nigerian psychiatrists, as Heaton reports, examined the colonial mental health diagnoses and the policies and concluded they were founded on the prejudiced ethnopsychiatric studies. The author critically discusses Nigerian psychiatrists’ attempts to incorporate traditional healing methods for mental illness into the Western therapeutic method. This is the concern of chapter five. In doing so, such attempts, Heaton observes, are geared toward recognizing the importance of cross-cultural therapeutic treatments. This embraces a globalizational undertone by trying to sustain the tension and dynamics between local and global knowledge in spite of the difficulties such a process entails.

Chapter six examines the importation of Western psychotropic drugs and substances into Nigeria between the 1950s and 1980s, along with their perilous effects not only on psychiatric patients, but also among individuals who use them recreationally. The chapter discusses the role played by Nigerian psychiatrists in becoming gatekeepers between the Nigerian community and the international community to ensure that only appropriate drugs and proper dosages are available to Nigerians. As gate-keepers, they also helped to manage the side effects of Western medications.

Overall, the author provides in-depth information on the mental health system in Nigeria during the...