In the late 1970s, South African mental institutions were plagued with scandals about human rights abuse, and psychiatric practitioners were accused of being agents of the apartheid state. Between 1939 and 1994, some psychiatric practitioners supported the mandate of the racist and heteropatriarchal government and most mental patients were treated abysmally. However, unlike studies worldwide that show that women, homosexuals and minorities were institutionalized in far higher numbers than heterosexual men, Psychiatry, Mental Institutions and the Mad in Apartheid South Africa reveals how in South Africa, per capita, white heterosexual males made up the majority of patients in state institutions. The book therefore challenges the monolithic and omnipotent view of the apartheid government and its mental health policy. While not contesting the belief that human rights abuses occurred within South Africa’s mental health system, Tiffany Fawn Jones argues that the disparity among practitioners and the fluidity of their beliefs, along with the disjointed mental health infrastructure, diffused state control. More importantly, the book shows how patients were also, to a limited extent, able to challenge the constraints of their institutionalization. This volume places the discussions of South Africa’s mental institutions in an international context, highlighting the role that international organizations, such as the Church of Scientology, and political events such as the gay rights movement and the Cold War also played in shaping mental health policy in South Africa.

The relationship between migration and mental health is controversial, contested, and pertinent. In a highly mobile world, where voluntary and enforced movements of population are increasing and likely to continue to grow, that relationship needs to be better understood, yet the terminology is often vague and the issues are wide-ranging. Getting to grips with them requires tools drawn from different disciplines and professions. Such a multidisciplinary approach is central to this book. Six historical studies are integrated with chapters by a theologian, geographer, anthropologist, social worker and psychiatrist to produce an evaluation that addresses key concepts and methodologies, and reflects practical involvement as well as academic scholarship. Ranging from the mid-nineteenth century to the present, the book explores the causes of mental breakdown among migrants; the psychological changes stemming from their struggles with challenging life circumstances; and changes in medical, political and public attitudes and responses in different eras and locations.

The asylum--at once a place of refuge, incarceration, and abuse--touched the lives of many Americans living between 1830 and 1950. What began as a few scattered institutions in the mid-eighteenth century grew to 579 public and private asylums by the 1940s. About one out of every 280 Americans was an inmate in an asylum at an annual cost to taxpayers of approximately $200 million. Using the writing of former asylum inmates, as well as other sources, Writing Mad Lives in the Age of the Asylum reveals a history of madness and the asylum that has remained hidden by a focus on doctors, diagnoses, and other interventions into mad people's lives. Although those details are present in this story, its focus is the hundreds of inmates who spoke out or published pamphlets, memorials, memoirs, and articles about their experiences. They recalled physical beatings and prolonged restraint and isolation. They described what it felt like to be gawked at like animals by visitors and the hardships they faced re-entering the community. Many inmates argued that asylums were more akin to prisons than medical facilities and testified before state legislatures and the US Congress, lobbying for reforms to what became popularly known as "lunacy laws." Michael Rembis demonstrates how their stories influenced popular, legal, and medical conceptualizations of madness and the asylum at a time when most Americans seemed to be groping toward a more modern understanding of the many different forms of "insanity." The result is a clearer sense of the role of mad people and their allies in shaping one of the largest state expenditures in the nineteenth and early twentieth centuries--and, at the same time, a recovery of the social and political agency of these vibrant and dynamic "mad writers."

The book describes key socio-political reforms that helped shape post-apartheid South Africa’s mental health system. The author interrogates how reforms shaped public, community-based services for people living with severe mental illness, and how features of this care has been determined, in part at least, by the relations between actors and structures in the state, private for-profit health care, and civil society spheres. A description of the development of South Africa’s post-apartheid health system, and the contentions that emerge therein, sets the stage for an analysis of the country’s most tragic human rights failure during its democratic period, namely the Life Esidimeni tragedy. The roots of the tragedy are not only framed as a loss of life and dignity as a result of political corruption and administrative mismanagement, but as a power differential that ultimately highlights an unjust system that relegates its most vulnerable citizens to commodities, without voice and without agency. The book concludes that the commodification of severe mental illness has been a product of neoliberal discourses that have shaped the economistic ways in which the post-apartheid South African state have governed poverty and severe mental illness. This book will be of interest to scholars of health, social and economic policy in South Africa.

Violence is one of the most important challenges, not only for public health systems, but also for public mental health. Violence can have immediate as well as long-term and even transgenerational effects on the mental health of its victims. This book provides a comprehensive and wide-ranging assessment of the mental health legacy left by violence. It addresses the issues as they affect states, communities and families, in other words at macro-, meso- and microlevels, beginning by describing the impact of violence on neurobiology and mental health, as well as the spectrum of syndromes and disorders associated with different forms of violence. The work moves on to tackle violence at the international—and intranational—level before zeroing in on the nature of violence in communities such as villages or city districts. It also examines the results of violence in the family. Each type of violence has distinct effects on mental health and in each chapter specific groups are explored in depth to demonstrate the heterogeneity of violence as well as the diversity of its outcomes in the realm of public mental health. Finally, the book addresses the notion of ‘undoing violence’ by detailing case studies of effective interventions and prevention occurring in countries, communities and families. These cases give us pause to reflect on the nature of resilience and dignity in the context of violence and mental health. All the chapters have been written by leading authors in the field and provide a state-of-the-art perspective. The authors, from different fields of expertise, facilitate interdisciplinary and international insights into the impact of violence on mental health.

Based on over two hundred and fifty psychiatric case files, this book offers a radical new departure from existing historical accounts of what is still commonly thought of as the most picturesque of Britain’s colonies overseas. By tracing the life histories of Kenya’s ‘white insane’, the book allows for a new account of settler society: one that moves attention away from the ‘great white hunters’ and heroic pioneer farmers to all those Europeans who did not manage to emulate the colonial ideal. In doing so, it raises important new questions around deviance, transgression and social control. Sitting at the intersection of a number of fields, the book will appeal to students and teachers of imperial history, colonial medicine, African history and postcolonial theory and will prove a valuable addition to both undergraduate and postgraduate courses.

During the apartheid era, thousands of South African political activists, militants, and refugees fled arrest by crossing into neighbouring southern African countries. Although they had escaped political oppression, many required medical attention during their period of exile. An Ambulance on Safari describes the efforts of the African National Congress (ANC) to deliver emergency healthcare to South African exiles and, in the same stroke, to establish political legitimacy and foster anti-apartheid sentiment on an international stage. Banned in South Africa from 1960 to 1990, the ANC continued its operations underground in anticipation of eventual political victory, styling itself as a "government in waiting." In 1977 it created its own Health Department, which it presented as an alternative medical service and the nucleus of a post-apartheid healthcare system. By publicizing its own democratic policies as well as the racist practices of healthcare delivery in South Africa, the Health Department won international attention for its cause and provoked widespread condemnation of the apartheid state. While the global campaign was unfolding successfully, the department's provision of healthcare on the ground was intermittent as patients confronted a fledgling medical system experiencing various growing pains. Still, the legacy of the department would be long, as many medical professionals who joined the post-apartheid Department of Health in South Africa had been trained in exile during the liberation struggle. With careful attention to both the international publicity campaign and on-the-ground medical efforts, An Ambulance on Safari reveals the intricate and significant political role of the ANC's Health Department and its influence on the anti-apartheid movement.

This open access book investigates psychiatry in Uganda during the years of decolonisation. It examines the challenges facing a new generation of psychiatrists as they took over responsibility for psychiatry at the end of empire, and explores the ways psychiatric practices were tied to shifting political and development priorities, periods of instability, and a broader context of transnational and international exchange. At its heart is a question that has concerned psychiatrists globally since the mid-twentieth century: how to bridge the social and cultural gap between psychiatry and its patients? Bringing together archival research with oral histories, Yolana Pringle traces how this question came to dominate both national and international discussions on mental health care reform, including at the World Health Organization, and helped spur a culture of experimentation and creativity globally. As Pringle shows, however, the history of psychiatry during the years of decolonisation remained one of marginality, and ultimately, in the context of war and violence, the decolonisation of psychiatry was incomplete.

This short book argues for the relevance of historical perspectives on mental health, exploring how these histories can and should inform debates about mental healthcare today. Why is it important to study the history of madness? What does it mean to voice these histories? What can these tell us about the challenges and legacies of mental health care across the world today? Offering an intervention into new ways of thinking – and talking – about ‘mad’ history, Catharine Coleborne explores the social and cultural impact of the history of the mad movement, self-help and mental health consumer advocacy from the 1960s inside a longer tradition of ‘writing madness’. Starting with a brief history of the relevance of first-person accounts, then looking at the significance of other ways of representing the psychiatric ‘patient’, ‘survivor’ or ‘consumer’ over time, this book aims to escape from dominant modes of writing about the asylum.

During a turbulent colonial and postcolonial century, African women struggled to control their own marital, sexual and economic lives and to gain a significant voice in local and national politics. This book introduces many remarkable women, who organized religious and political movements, fought in anti-colonial wars, ran away to escape arranged marriages, and during the 1990s began successful campaigns for gender parity in national legislatures. The book also explores the apparent paradox in the conflicting images of African women - as singularly oppressed and dominated by men, but also as strong, resourceful, and willing to challenge governments and local traditions to protect themselves and their families. Understanding the tension between women's power and their oppression, between their strength and their vulnerability, offers a new lens for understanding the relationship between the state and society in the twentieth century.