Paper short abstract:

This paper explores competing discourses among biomedical and religious healers in Ghana to claim authority over the treatment of mental illness. It suggests that these polarising discourses may fail to engage with the social impact of mental illness as it experienced by those afflicted.

Paper long abstract:

Mental illness provides fertile ground for contested practices of diagnosis and healing since its causation remains unclear. Nonetheless, Ghanaian health professionals, supported by global psychiatric experts, overlook such uncertainty to present an authoritative knowledge of mental illness as a medical condition amenable to scientific intervention. In this discourse families are portrayed as reluctant to use psychiatric services out of 'ignorance' and mental illness is said to be viewed by the lay person as a 'spiritual disease'. Despite the poor conditions of the overcrowded psychiatric hospitals, and the damaging side effects of psychotropic drugs, psychiatric services are promoted as optimal and 'modern' treatment. However ethnographic research among people with psychosis and their families reveals that the causes of mental illness remain subject to conjecture rather than certainty, and the failure of antipsychotics to bring about a cure challenges the veracity of the psychiatric discourse. The gap between the claims of biomedical practitioners and the relapsing course of mental illness experienced by informants is filled by Christian, Islamic and 'traditional' healers who promise superior healing power. However attempts to claim either scientific or religious authority over mental illness set a false polarity between the spiritual and biomedical which may fail to engage with the experience of mental illness by those afflicted in which its impact is felt most as a disruption of the social self. The notion of 'social suffering' offers a contrasting approach to mental illness which encompasses spiritual, physical as well as social domains.