When Idoko, a 23-year-old man living in rural Benue State, north central Nigeria, began hearing voices, withdrawing from family and speaking incoherently, his family’s first call was not to a psychiatrist. They took him to a local faith-based prayer group, where members pray over people believed to be afflicted by spiritual forces. When he showed no signs of recovery, the clan head advised them to take him to a renowned traditional healer.
Idoko was chained to a tree for the first six weeks, and was given doses of a herbal concoction prepared by the traditional healer. His condition improved, and by the fourth month, he was sent home with a long list of instructions. He relapsed after a couple of months and was eventually referred to a specialised psychiatric hospital more than 200km away. I met Idoko in Benue State more than a decade ago and have followed his story since. I have permission to use his story.
This is not an unusual story. Depression, anxiety, psychosis and substance use disorders affect nearly 150 million people on the continent. Yet the majority receive no formal care – partly because there is hardly any available. Millions of people are receiving care, or being held, in settings the law does not see. For many across Africa, prayer camps, traditional healers and community elders are the first port of call during a mental health crisis. Many patients have suffered serious human rights violations in these settings.
