(Princeton University Press. 1960)
It is remarkable that the most comprehensive review of mental health and suicide in Africa was written in the 1960′s. This fact underscores how little we know today about the reality of mental health need and suicide in Africa.“Homicide, suicide and mental illness in Africa” was compiled and edited by Paul Bohannan, a Rhodes Scholar and professor of Social Anthropology at Oxford in 1960 and provides a rich ethnographic assessment of mental health, homicide and suicide in west Africa at the end of European colonial rule of the region.
This timeless must read volume work was conceived after Dr. Bohannan and his colleagues stumbled into a cache of judicial and police documents belonging to the British Colonial Lords in East Africa. This discovery prompted Paul and his collaborators to compile and analyze similar data sets from other regions of the continent from Uganda, to Kenya and Nigeria. This regional ethnography on mental health and suicide provided the first descriptive empirical report on homicide, suicide and mental health in West Africa. Among other things the authors asks questions such as how do suicide rates in Africa compare with other parts of the world, what factors drive homicide, suicide and mental health in the region and finally what is the response and impact of suicide on the local community.
Among other things the author makes the interesting observation that homicide rates among Africans in Africa were significantly less than Africans living in the United States and Europe, emphasizing the need for a contextual consideration for homicide. On the other hand the authors’ studies suggest that suicide in Africa was not as rare as previously assumed.
Data on suicide rates were particularly difficult to obtain in the region since it was considered such a taboo subject among local communities and thus rarely formally reported. Despite these limitations, the authors make the interesting observation that suicide in the region was driven by such factors as loss of status, childlessness, impotence, adultery and vengeance. Furthermore unlike in the west, African communities perceive suicide as having major negative spiritual ramifications in the communities. Thus tribal leaders go to great lengths to prevent suicide, making it an effective bargaining chip between dissatisfied citizens (who might threaten suicide) and tribal leaders. Unfortunately, this particular volume fails to explicitly capture or address the role of mental health in driving suicide in the region.
Beyond giving a global overview of the role of homicide suicide and mental health in West Africa, the authors focus on specific local communities to explore specific trends and patterns unique to those communities. In Ghana, the authors reported similar forms of mental illness as those observed in Europe. The authors make the argument that witchcraft in the region makes it difficult to fully study mental health, since a lot of classic mental health cases are typically ascribed to witch craft in the region. Thus, the authors spend considerable time contemplating the similarities among the symptoms observed in the mentally ill in the region and those thought to be possessed by evil spirits.
So much has changed in Africa since 1963 when this volume was originally published still the thematic relevance of the subject has only become more pressing. The Colonial governments are long gone, geographical boundaries have been redrawn and most of the countries in the region have all won their independence since 1963 completely altering the social and geopolitical landscape of the region. Still the mental health need remains largely the same. More significantly it is remarkable that there has been almost no follow up study to this volume. The lack of widespread interest in mental health in Africa is understandable- it neither seems like an urgent or important need. With limited resources to devote to all the health concerns in the region, funds naturally get allocated to health concerns perceived as more urgent and important. Unfortunately, mental health care in the region has not been thus prioritized.
While there are clearly limitations and weaknesses with the current volume- the most obvious being how dated the information in it is- this ethnographic study provides an important historic foundation for health workers and researchers interested in mental health in the region.
Mental health is a complicated and notoriously difficult public health challenge- even in the west with all the available resources. Still as a first step it is time we allocate some resources to simply understand the current status of mental health need in Africa at least as a prelude to future action.
Cover Photo by UnSplash via Pexels: Creative Commons