The story of legacy

How the violent colonial history and legacy of mental health defines our experience of mental health today
Tom Osborn
In the midst of the Mau Mau independence revolution in Africa, British Psychiatrist J.C. Carother concludes that the natives’ culture, with its “brutal oaths and obscene rituals,” makes them susceptible to anti-colonial resistance. He finds the natives to rely on “magical” modes of thinking, to be driven by “an irrational force of evil,” and “dominated by bestial impulses.” These must be signs and symptoms of a mental illness. He diagnoses the entire community with “mass psychosis,” labeling their desire for freedom as a mental illness. His recommendations would be the basis of a brutal takedown of Mau Mau fighters.

It is May 1954 in British Colonial Kenya. Twenty-five thousand Brits live among a native population of five million. The Governor is a man they call Sir Evelyn Baring II, and by all accounts, he is the right man for the job. He is an Oxford man, the son of Evelyn Baring I, the Earl of Cromer, who was renowned as the “Maker of Modern Egypt.” Sir Baring brings a wealth of experience: Ex-Governor of Southern Rhodesia and Ex-High Commissioner for Southern Africa.

But Evelyn Baring has a problem, a big problem: a violent uprising from the natives demanding freedom from colonial rule. Every morning, Evelyn Baring wakes to reports of guerrilla attacks, raided farms, burnt homes, and skirmishes between the native population wielding guns, machetes, and bows, and the British police.

What should Evelyn Baring do? He could deploy the army, arrest the leaders of the uprising, or declare a state of emergency—and eventually, he would do all of these. But first, he calls in the psychiatrists. This is a psychological war, one that Dr. John Colins Carothers, MD, PhD, can help him win through a careful study of the psychology of the natives who were fighting for their freedom.

Dr. Carothers' The Psychology of Mau Mau informed the British Colonial response in Africa
Dr. Carothers' The Psychology of Mau Mau informed the British Colonial response in Africa

Dr. Carothers embarks on what he considers a careful scientific examination. His findings are stark and disturbing, concluding that the natives’ culture, with its “brutal oaths and obscene rituals,” makes them susceptible to anti-colonial resistance. He finds the natives to rely on “magical” modes of thinking, to be driven by “an irrational force of evil,” and “dominated by bestial impulses.” These must be signs and symptoms of a mental illness. He diagnoses the entire community with “mass psychosis,” labeling their desire for freedom as a mental illness. This report—captured in "The Psychology of the Mau Mau" and "The Mind of Man in Africa"—became the foundation of the British response, framing the conflict not as a struggle between black and white, but between the sane and the mentally ill. There would be mass detentions, mass displacements, assassinations, and mass killings: tens of thousands would die. For in the fight against the insane, nothing must be left to chance.

The stories of J.C. Carothers and Evelyn Baring are not isolated. These stories form the canon that is the introduction of Western-derived psychiatry and psychology to many parts of the Global South. In Kenya, we first encountered “formal” psychiatry and psychology through colonial administrators, where scientific methods were misused to justify colonial dominance. We first encountered mental health when the lunatic asylum was introduced as the primary form of care—indeed, the legendary Mathari Hospital was first born as the Nairobi Lunatic Asylum. We first encountered mental health when a mental health diagnosis often meant deprivation of individual, social, and political liberties.

This is the story of the legacy of mental health. This is the story of the foundation upon which we stand. This story of legacy invites us to be honest about the foundations of our current mental health systems. It invites us to humility. It invites us to acknowledge that Western nosology of disorders is not universally applicable. It invites us to reckon with a legacy that has led us to build a caregiving model that treats mental health problems as if they were medical diseases like malaria, assuming specific causes, symptoms, and treatments. This approach ignores the complexity of mental health issues.

This is the story of legacy.

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