Colonial psychiatry in Africa: A distorted Science? Practice, Knowledge, and Power

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Colonial psychiatry in Africa: A distorted Science?
Practice, Knowledge, and Power
Author: Li Zheng (Elise)
"scientist was a perfect vehicle for colonial ideology", by Octave Mannoni
Introduction:
Asylums, hospitals, and doctors, established by the colonial authorities in colonies, served not only
for the purpose of curing the mental illness, but also carrying the social and political connotations of
medical practice and scientific knowledge. Psychiatry was introduced to cope with the pathological
insanity and “madness” of Africans through scientific categorization and medical diagnosis. Colonial
psychiatry, in the context of colonial rules in 20th century colonial Africa, represents a set of
discourse in the form of mental health institutions and practices, and development of
ethnopsychiatry as a scientific subject. The term “colonial psychiatry” connect the pathological
definition, diagnosis and treatment with the perpetuation of power structure of domination and
subordination, representing a trend in the colonial governance in the 20th century, in which the
Western-ruled African colonies were the most exemplary and thoroughly studied with ample
amount of institutional records.
Colonial psychiatry in Africa is predominantly referred to the medical practices with officially
sanctioned mental health institutions in 20th century
1
. However, other than the traditional account
of colonial rules, colonial psychiatry calls for analysis of post-colonial perspective to investigate the
underlying formula of colonial expression – how the less coercive approaches could imply the power
of knowledge and its institutional practice. Therefore, during the encounter of Western “progressive”
modernity with Africans who were in rather “sedentary” status, the application of colonial psychiatry
had revealed the imposition of colonial power and knowledge via the medical treatment into the
social and ideological realm.
A number of scholars and their works have given concentration on the historical records from a
post-colonial perspective, examining the colonial psychiatry as part of colonial governance and
1
For example, The Abbasieh asylum near Cairo opened at the turn of the twentieth century, the first British
institutions in sub-Saharan Africa appeared in the 1910s, the French hospitals in North Africa broke ground
only in the 1920s, and the Fann Psychiatric Clinic in Dakar scarcely preceded decolonization. See R. C. Keller,
Colonial madness: psychiatry in French North Africa, Chicago: University of Chicago Press, 2007.

ideology, among which M. Foucault stands as the initial and most provoking one with the notion of
“power-knowledge” relations through everyday practices
2
. In his book The Birth of the Clinic, he
interprets the nature of "medical rationality" as a modern and western discourse, which framed the
language to determine the status of patients, acting as a productive rather than repressive power
3
.
More recently, scholars, namely M. Vaughan and J. McCulloch, have also focused on the
psychological construction of colonial rules in Africa. McCulloch convincingly demonstrates that
ethnopsychiatry played an important role in the construction of the colonial subject, arguing that
this was the "most enduring" contribution of this "modest science"
4
, while Megan Vaughan argues
that European medicine in Nyasaland may have "played an important part in constructing 'the
African' as an object of knowledge, and elaborated classification systems and practices which have
to be seen as intrinsic to the operation of colonial power."
5
Richard Keller examined the psychiatry
research and practice in French North Africa, bringing new insight into the contribution and
limitation of “Algerian School” as both colonial perpetuators and scientific pioneers, revealing the
diverse nature of the so-called civilization mission. Similar approach and perspective has been
employed in several other scholarly accounts, namely Sloan Mahone (on East Africa)
6
, Shula Marks
(on South Africa)
7
, Marianna Scarfone (on Italian Lybia and Horn of Africa)
8
and extending further
onto the studies of other former colonial countries
9
.
By summarizing and analyzing the underlying power structure of colonial psychiatry, this essay is
aimed at providing a comprehensive framework of the knowledge and its reification in the personal,
institutional and political practice. The accounts are centered on three parts:
1) The practice: how the doctors, hospitals and colonial asylums served the purpose of finding out
normality and insanity, and developed into a theoretical coherent idea of “African Mind”.
2
Such as the creation of “welfare”; see the discussion of H. L. Dreyfus and P. Rabinow, Michael Foucault:
Beyond Structuralism and Hermeneutics, Briton, 1982, pp.126-42.
3
Foucault, M., The Birth of the Clinic: An Archaeology of Medical Perception, London: Tavistock Publications,
1973, p.xviii.
4
McCulloch, J., Colonial Psychiatry and the African Mind, Cambridge: Cambridge University Press, 1995, p.167.
5
Vaughan, M., Curing Their Ills: Colonial Power and African Illness, Oxford: Polity Press, 1991, p.27.
6
Mahone, Sloan. East African Psychiatry and the Practical Problems of Empire, in Psychiatry and Empire.
Palgrave Macmillan UK, 2007. 41-66.
7
Marks, Shula. What is colonial about colonial medicine? And what has happened to imperialism and health?,
Social History of Medicine 10.2, 1997, pp. 205-219.
8
Scarfone, Marianna, Italian colonial psychiatry: outlines of a discipline, and practical achievements in Libya
and the Horn of Africa, History of psychiatry 27.4, 2016, pp. 389-405.
9
See chapters about Fiji, Dutch East Indies and Trinidad, in Mahone, Sloan, and Megan Vaughan, eds.
Psychiatry and empire. Basingstoke: Palgrave Macmillan, 2007.

2) The mechanism: how the practice and knowledge has underpinned itself as a form of power,
providing rational accounts for political control, social construction, and furthermore, a pervasive
belief of legitimacy of European domination. The interpretation and justification of power was
ultimately presented in forms of knowledge.
3) The essence: how the Enlightenment European mind of dualism and division justified the
perpetuation of power mechanism – black and white, good and evil, light and dark. the colonial
psychiatry reflected the essence colonial rule of othering the others, deprecating the depraved. It
existed not only in Africa, but also universal in its essence. It set up and exemplified the power of
discourse, serving both for practical purposes (maintaining social order and promoting “civilization”),
and as the ultimate proof of superiority over African natives.
The practice of colonial psychiatry
The “insanity of Africans”, as the core feature of colonial psychiatry, should be understood within a
specific culture in a historical context. The term came into existence in 19th Century in India, but
mainly focused on the treatment of Europeans in the colonial areas and a part of “tropical
medicine”
10
. However, in respond to the growing contact with natives, the treatment and study of
mental conditions turned to the indigenous people. In the case of African colonies, the “insane
Africans” became the previously alien inmates of European doctors, hospitals, and asylums.
The doctors, in the first place, were the initial contacts of Africans, and first-hand practitioners of
colonial psychiatry, not only by practicing medical treatment and care, but also by their effort trying
to find a "normal" mind of Africans. For instance, J. C. Caruthers, the director of Kenya's main mental
hospital from 1938 to 1951, the African medical researcher Carothers in 1930s tried to find
"untouched" Africans and to build "ancient cultural modes"
11
. This collective psychological trait of
Africans as a whole concept was set as basis of diagnosis of African colonial psychiatry.
The discovery the mental illness and “abnormal status”, as well as the identification of the
“normal” ones, set the form of practice through the constant contact between doctors and patients.
This reflected the trends of the medical science after 19th century with a focus on the bipolarity
between “normal” and “pathological”, especially when people referred to the life of a certain group,
10
Kapila, Shruti. The making of colonial psychiatry, Bombay Presidency, 1849-1940. Diss. School of Oriental
and African Studies (University of London), 2002.
11
M. Vaughan, Health and Hegemony: representation of disease and the creation of the colonial subject in
Nyasaland, in D. Engels and S. Marks (eds.), Contesting colonial hegemony: state and society in Africa, London:
British Academic Press, 1994, p.176.

society or even race. These concepts were arranged in a space whose profound structure responded
to the healthy/morbid opposition
12
. Setting up stereotypes of “normal” and “abnormal” was widely
employed as an effective approach of identifying psychiatry, taking place at both the level of the
individual, and the level of group. The madness was not only used in describing madmen, but
Africans in general. Colonial Psychiatrists concluded with the set of language in a cultural and racial
way, defining their cultures as pathological and pathogenic, resistant to the change which was
necessary for them to adopt healthy habits and lives
13
, claiming that “The Africans in the twentieth
century...were simply not equipped to cope with civilization”
14
.
The Africans, with their innate psychological traits rooted in the biology and culture, were
regarded “abnormal” or “pathological” in the Western discourse; while the deviation from the so-
called “African way of life”, such as urbanization and contact with Western civilization, would render
risk of insanity (which defined as “isolated, impoverished urban dwellers' behavior”). This seemingly
paradoxical view was joined and justified with the development of anthropology in the same
historical period, when the examination of an “exotic” being in the cultural periphery prevailed in
the practice of psychiatry, formulating the so-called “ethnopsychiatry” in the colonial sphere. Both
the approach of ethnopsychiatry and the understanding of “African Mind” were locally developed
colonial knowledge, a "science" that viewed all African patients as uniformly and simply “African”
without concern for their nationality, ethnicity, or class, much less their individuality.
Ethonopsychiatrists tended to be long-term residents of colonial societies, the science they
produced reflected all the tensions and peculiarities of the settler class to which they belonged. It
was more a pseudo-science with some eccentric and insulated nature from the colonial metropole,
but in some cases (mainly French North Africa) also an experiment field of psychological innovation.
Those views echoed those of the settler communities, thus provided the theoretical
underpinnings for the beliefs about the mental processes characteristic of African individuals, what
could be expected of them, thus applied in diagnosis and treatment; and ultimately for
understanding of the mental processes of Africans by the settlers, a distinctive “African Mind”, as
the product of a biologically distinctive African brain, and additionally family life and culture.
This knowledge served not only medical purposes, but also possible means in conducting
surveillance and governance. As early as 1913, officials in Kenya were touting courses in
anthropology to be taken in tandem with the Tropical African Sevices course at the Imperial Institute,
12
M. Foucault, The Birth of the Clinic, p.35.
13
M. Pearson, The Politics of Ethnic Minority Health Studies, in T. Rathwell and D. Philips (eds.), Health Race
and Ethnicity, Dover: Croom Helm, 1986, p.102
14
M. Vaughan, Curing Their Ills, p.107.

encouraging officers to pursue studies and attain "anthropology training", with an emphasis on the
practical needs of colonial officials, suggesting that they would benefit from approaches separate
from the normal academic course and should, instead, focus on such issues as "primitive law", the
"race question", and the transition away from traditional social organization as a result of culture-
contact
15
.
The construction of hospitals, range from caring to the coercive, served as the institutions of
practicing and disseminating such views in forms of diagnosis and treatment of illness, and exercised
wider control over them. The construction of the hospitals from French colonial policy, i.e. the “mise
en valeur” in overseas territories, referred to the effort to create “geographically and culturally
specific innovations” designed to improve a “decadent place”
16
. The establishment of asylums in
every country of the Maghreb was thus accompanied by the creation of a network of local places
dedicated to the control of mental illness.
In this sense, the establishment of Western-style asylums was not merely oriented toward a
more ‘‘humanitarian’’ form of confining patients, but was also part of a development of techniques
to enable close control of the territory. This bring to the second point of this essay – the power and
control of colonial psychiatry in the context of colonial rule.
Knowledge, power, and dominance
The aim of maintaining social order rendered the most direct application of colonial psychiatry. In
British Nigeria, the colonial press lamented the problem of mad Nigerians roaming the streets of
Lagos, and called upon authorities simultaneously to preserve public order and to take pity on
deranged Africans, while the Nigeria's colonial prisons and asylums were “functionally equivalent”
17
.
Diagnosis and surveillance was applied to pathologize the Africans as social beings, even served with
the “liberal conscience” by feeding on a partly secularized Christian ideology which represented
anything "medical" as an act of benevolence and salvation
18
.
15
McCulloch, Jock. Colonial psychiatry and the African mind. Cambridge University Press, 1995.
16
Keller, Richard C., Colonial Madness: Psychiatry in French North Africa, University of Chicago Press, 2008.
17
Sadowsky, J., Imperial Bedlam: Institutions of Madness in Colonial south west Nigeria, Berkeley, 1999, p.25.
18
Vaughan, M., Health and Hegemony: representation of disease and the creation of the colonial subject in
Nyasaland, in D. Engels and S. Marks (eds.), Contesting colonial hegemony: state and society in Africa, London:
British Academic Press, 1994.

Under the risk of colonial upheaval, and disintegration of the African society (by the modern
influences) was appearing and seemed to be an alert to colonizers
19
. There should be a new force of
law. Many colonial governments adopted some form of legislation for the control and care of
“lunatics”, such as in Nyasaland's legislation of Native Lunatics Ordinance of 1913 which stated that
“Any district magistrate upon the information of any informant to the effect that such informant had
good cause to suspect and believe that he is lunatic...may hold an enquiry as to the state of mind of
such suspected native”
20
.
In addition to factual control in extreme cases, what left unsaid is that Africans need to be
patronized due to their mental defect, for the sake of themselves. In the writings of the East African
School, they placed the “naturally leucotomized” African alongside the “childlike” African
21
. Health
as a significant policy sphere emerged as a welfare service valued by the subject population
22
.
In colonial Kenya, “villagization” as well as “home hygiene” programs were carried out as policies
for dealing with the Mau Mau uprising, to build control and exercise “normality” and “social order”
in the name of “social welfare”, and most significantly, to retain the colonial arrangement. Hospitals
were given authority over those issues where psychological evaluation might play a significant role,
such as interviewing the accused in criminal proceedings or providing commentary on social
processes or movements that appeared to be “psychological” in nature
23
. Anticolonial sentiments
were often taken to confirm that a person already deemed to be acting oddly was insane. Under
certain circumstances, political factors deeply influenced diagnostic process.
What gives an even more deep-lying indication, is that the authority of knowledge, in turn,
endorsed the control as a legitimate social measure. It was the rapid growth of knowledge in form of
science –a depicted, provable “truth” – that played the vital part in construction of “the African” as
an object of this knowledge, thus laid the basis of power arrangement. The institutionalization of
madness by scientific classification, with tribute to humanity and rationality, deciphered social
problems by labeling groups with differently defined “illness” as the guidance of making solutions.
Through the western trained medical practitioners' representation and account of “African
intelligence, sexuality, and psyche”, this elaborated classification system was seen as intrinsic to the
19
Vaughan, M., Curing Their Ills: Colonial Power and African Illness, Oxford: Polity Press, 1991
20
See Nyasaland Protectorate, Native Lunatics Ordinance (No.5 of 1913).
21
See F.W. Vint, "A preliminary note on the cell content of the pre-frontal cortex of the East African native", in
East African Medical Journal, ix (1932), which was criticized in M. Vaughan's account of "health hegemony".
22
C. Young, the African colonial state in comparative perspective, New Haven: Yale University Press, 1994,
p169.
23
Mahone, Sloan. "The psychology of rebellion: Colonial medical responses to dissent in British East Africa."
The Journal of African History 47, no. 2 (2006): 241-258.

operation of colonial power
24
, promoting a psychological language with which to discuss the
dilemmas faced by colonial administrations.
Historically, science has played an important role in the triumphal progression of colonization.
Western medical science, which developed after the Enlightenment and elaborated during 19th and
20th century, served primarily as tools of facilitating settlement settle in tropical Africa, shaping the
material basis of everyday life
25
. Colonial knowledge, including new medical understandings and
technologies, enabled European powers to have a foothold in the mysterious continent. More than a
tool of economic exploitation, it was also a form of cultural imperialism, in some extent monolithic
and totalizing in scope, systematizing and formalizing in form
26
. It was no accident that it also set the
mechanistic basis and presenting approaches of colonial psychiatry, facilitating the mental health
practices.
The verdict of “madness” was supported and justified by an institution, of which a doctor
endowed with the power of decision and intervention. This connection between empirical and
theoretical evidence was so strong that could make the judgment intact, “can be entirely stated in
its truth”
27
. On the other hand, the Africans were simply not able to stand any progressive form, for
“the stage of development reached by the average native is that of the European boy aged between
7 and 8 years old”
28
. This endowed the patronage of doctors over patients
29
, and could be
interpreted as power in form of knowledge, perpetuating the colonial control through the inception
of western ideas and power structures. This construction was of certainty, and positively imposed
the idea as “norm” in the nature
30
.
This domination of knowledge in form of science was in some extent absolute and monolithic.
The pre-existing African healing systems of both physical and mental illness were effective; however,
the colonizers regarded them as “dangerous” (of course not only in terms of health). The power of
colonial medicine lay not so much in its direct effects (although it was significant), but also in its
ability to provide a “naturalized” and pathologized account of those subjects, helping produce a
24
M. Vaughan, Curing the Ills, p.8.
25
T. Ballantyne, Colonial Knowledge, in S. E. Stockwell (ed.), The British Empire: themes and perspectives,
Oxford: Blackwell Pub., 2008, p.185.
26
B. M. Bennett, Science and empire: knowledge and networks of science across the British Empire, 1800-1970,
NY: Palgrave Macmillan, 2011, pp.15-8.
27
M. Foucault, The Birth of the Clinic, p.95.
28
Dr. H. L. Gordon in Nairobi, 1930s, worked to provide the scientific proof for the racial inferiority. See H. L.
Gordon: An Inquiry into the correlation of Civilization and Mental Disorders, in East African Medical Journal,
vol.12. These biological facts were cited to attest to the innate psychological inferiority of Africans.
29
Pearson, M., The Politics of Ethnic Minority Health Studies, in T. Rathwell and D. Phililips (eds.), Health, Race
and Ethnicity, Dover: Croom Helm, 1986.
30
M. Foucault, The Birth of the Clinic, p.36.

concept of “the African” and an account of the effects of social and economic change which was
plausible and socially relevant to colonial administrators, even in the African themselves.
The essence of colonial rules
Through the creation and imposition of objective “knowledge” of psychiatry, the colonizers had
implemented and perpetuated the colonial rule over Africans in an endurable way. Regardless of the
direct or indirect form of ruling, the medical and psychological discourse had provided an
instrumental referral of maintaining social order and colonial management, with implication of
western superiority.
The logic of colonial rule was demonstrated through the practice of psychiatrist and power of
knowledge, as Keller accounts in his book Colonial madness: psychiatry in French North Africa:
Those same theories went on to constitute the backbone of colonial technologies
of control and domination, by attributing the same traits not only to the mentally
ill, but to the entire population. In sum, the study of lunatics and mental illness
enabled the formulation of more general theories about the nature of African
Islamic psychology, that established its inferiority and justified the necessity of
political control.
31
This form of “crude representations of the world” functioned to perpetuate an artificial sense of
difference between self and other, and to preserve the illusion of control over the self and the
world
32
. The need for control, and the constant threat of loss of that control, necessitates the
projection of difference on to some “Other”, and all images of the “Other” derive from the same
deep structure.
The clear boundary and perception of “self” and “other” separated the colonizer from the
colonized, mapping out the picture of domination in a deep-rooted manner. Stressing the difference
between rulers and ruled justified the necessity of racial segregation.
In addition of “Othering”, the diagnosis of psychiatry even escalated to the “Other of others”. In
1935 Dr. Shelley and Dr. Watson (Nyasaland Government medical officers) were sent to discover and
investigate the “mental disorder in Nyasaland Natives”. In some lunatic Asylums, they've found a
high percentage of inmates suffering from “schizophrenic delusion”, and could be attributed to an
31
Keller, R. C., Colonial madness: psychiatry in French North Africa, Chicago: University of Chicago Press, 2007,
p. 43.
32
S. L. Gilman, Difference and Pathology: stereotypes of sexuality, race and madness, Ithaca: Cornell University
Press, 1985, p18.

“African” one, who imitated the white man in dress and behavior and who therefore threatened to
disrupt the ordered non-communication between rulers and ruled, were defined as “mad”, the
“Other” of “Others”
33
. Any of the deviation from certain “custom” was to be identified, of which
customs and norms were inadequate rule, but legal and cultural categories that were deemed by the
colonizers
34
.
Colonial psychiatry allied itself closely to civilizing missions as it assembled knowledge about
"indigenous psychologies"
35
. Beyond the immediate demand of social order, in the construction of
the colonial subject, colonial psychiatry had complex interrelationship with other forms of medical,
scientific, and bureaucratic practice in colonial Africa, especially closely collaborating with social-
anthropology in defining and implementing “civilization”. The burgeoning professions of psychiatrist
and mental therapist in French ruled Maghreb Africa subscribed to the colonial “civilizing mission”,
which emphasized that scientific and technological innovation could provide opportunities, not only
to demonstrate a commitment to colonization as a project, but also to “outshine metropolitan
programs and demonstrate the capacity of colonialism to rejuvenate a society”
36
.
If Africans could be proved scientifically different, then the civilization of them should be carefully
designed, guided and controlled. In a debate on racial equality issues, Carothers's work was cited to
oppose the equal treatment to African natives, for "the emerging from the pre-literate stage would
take a very long time before they are eligible of equality"
37
. The inner inferiority rooted in Africans
was intact, as the contacting with western, modern culture could lead to the insanity of them. In this
sense, the emphasis on black pathology is mirrored by an emphasis on perceived cultural and racial
deficits which policies have presumed to try to rectify.
All these accounts of colonial psychiatry pointed to the fact of West hegemony. The 20th century
Africa saw a transformation from a pre-modern rule (such as magic-dominated society) to a
scientifically "valid and testable" one, and probably a western one, with implication of a "theoretical
hegemony". As McCulloch asserts, European mental medicine changed scientific parameters to
produce an inferior African image through the mind, rather than the body and skin colors
38
. Some of
33
M. Vaughan, Curing Their Ills, p.101.
34
Ibid, p.103.
35
Keller, R., Madness and Colonization: Psychiatry in the British and French Empires, 1800-1962, in Journal of
Social History, 35.2 (2001), 295-326.
36
R. C. Keller, Colonial Madness, p.77.
37
See Federation of Rhodesia and Nyasaland, Federal Assembly, “Votes and Proceedings of the Federal
Assembly”, 1st session, 1st Parliament: 1954/5 (Salisbury, 1955).
38
J. McCulloch, Colonial Psychiatry and the African Mind, pp.34-5.

the African elite even "internalized" these aspects of colonial ideology, stressing the need of
assimilating into the "superior" western practice and culture.
The actual social impact sometimes remains contentious. Vaughan argues that the discourse of
colonial medicine and colonial psychiatry, and the prevalence of “otherness” was an alienating
rather than an integrating one, therefore preventing forming of hegemonic rule
39
. On the other hand,
this influence lying deep inside the mentality of both colonizers and indigenous, exerting a ruling
pattern on the “should-be” social order, from the social structure to individual perceptions,
promoting colonial rules and new form of control through a “progressive” ideology, not only
institutional ones. They offered “evidence of the civic virtue of settler societies”
40
, proving the
ultimately "benevolent" nature of colonialism through their symbolic value. It can sometimes be
paradoxical, as Sadowsky has argued, the culture relativism factor in ethnopsychiatry had conceded
that “what was mad in one culture might be sane in another”, trying to preserve an African way of
life. “Europeans could not know what madness was to Africans, and that Europeans should therefore
not be imposing alien cultural forms. “Nevertheless, this hesitation only restricted to mental illness,
not other areas.
We could not merely denounce colonial psychiatry only as to confinement and control, failing to
connect with psychiatrists' daily experiences dealing with patients in clinical practice; but colonial
psychiatry, by insisting on a distinct and incommensurable “African Mind”, asserting innately
inferiority and subjectivity under the cover of knowledge of illness, was the reflection and
manifestation of essence of colonial rule.
Conclusion:
Colonial Psychiatry in history was a series of observations, diagnosis and treatment of mental illness
and insanity in Africa, developed and implemented via individuals and institutions, forming a
coherent knowledge subject and acted through the power of scientific knowledge as both tools and
discourse itself. Having applied a scientific explanation with “solid empirical basis”, the colonizers
had “othered” the African people by creating stereotypes of “normal” and “abnormal”, and
conducted “right” treatment and “proper” way to deal with the racially divided people. It should be
mainly interpreted as a colonial discourse, implying a kind of superiority and cultural domination
over the inferior. The practice, power mechanism and essence of colonial psychiatry offered a way
39
M. Vaughan, Health and Hegemony, p.191.
40
J. McCulloch, Colonial Psychiatry and the African Mind, pp.34-5.

of understanding colonial rules, direct or indirect, in a new discourse and rationale of colonial
control perceived by both colonizers and colonized people.
Bibliography:
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3) H. L. Gordon, “An Inquiry into the correlation of Civilization and Mental Disorders”, in East
African Medical Journal, xii (1935).
4) F.W. Vint, "A preliminary note on the cell content of the pre-frontal cortex of the East
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achievements in Libya and the Horn of Africa, History of psychiatry 27.4, 2016, pp. 389-405.
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colonial subject in Nyasaland, in D. Engels and S. Marks (eds.), Contesting colonial hegemony:
state and society in Africa, London: British Academic Press, 1994.
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