Structural Adjustment As Metaphor and Lens: Considering the Recent Passage of the Mental Health Act in Ghana, or, an Emerging Space for "Mad" Studies Globally

Tuesday, 17 July 2018
Essya NABBALI, Independent scholar, Canada
"We are at a point in our work when we can no longer ignore the empires and the imperial context in our studies." —Edward Said, Culture and Imperialism (London: Vintage, 1994)

On 1 December 2012, Ghana passed a Mental Health Act (Act 846) to replace legislation from 1972 that had never been implemented. It came, after eight years of advocacy and the technical support of the World Health Organization (WHO), with hope of transforming the mental healthcare system as it existed at the time of colonial rule.

Heralded as a major milestone in justice work, Act 846 promises to decentralize mental healthcare from the three psychiatric institutions, concentrated in urban centres along the southern coast, per colonialist investment patterns. Furthermore, it seeks to allow the provisions for private psychiatric facilities and to relegate the oversight of alternative forms of therapy to a governing body for whom the Chief Executive Officer is the Chief Psychiatrist. In other words, Act 846 advances the medicalization of madness or the idea of "mental illness" as biologically rather than socially (over)determined, finding "solutions" in psychiatry (and a multi-billion dollar psychopharmaceutical-industrial complex).

This paper considers the sociohistorical locationing of Ghana and the trajectory being heavily influenced by international relations, such as the WHO. But a closely related, and perhaps more pressing debate to the place of sovereign power in a global context is the space and very circulation of counter-politics. The past 50 years in Canada has witnessed a burgeoning field of critical "Mad" studies to challenge the (bio)politics of psychiatry. How might we contribute to concerns of the increasing rise of psychiatry (e.g. Mills 2014; Titchkosky & Aubrecht 2015) and business of madness (Burstow 2015) without reproducing the violence of intervention, adjustment, and therefore, empire?