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Decolonizing African Mental Health Laws: A Case for Kenya

Published online by Cambridge University Press:  13 December 2023

Paul Ochieng Juma*
Affiliation:
Centre for Human Rights, University of Pretoria, Pretoria, South Africa
Charles Ngwena
Affiliation:
Centre for Human Rights, University of Pretoria, Pretoria, South Africa
*
Corresponding author: Paul Ochieng Juma; pauljuma2009@gmail.com

Abstract

The aim of this article is to use a decolonial approach to interrogate Kenya's laws and policies that compel the admission and treatment of persons with psychosocial disabilities. Against the backdrop of the colonization of Africa, the article appraises the historical development of Kenyan mental health laws. It critically analyses domestic policies, legislation, court decisions and the Constitution as they apply to admission to healthcare facilities of persons with psychosocial disabilities and to the freedom to decide about treatment, in order to reveal the persistence of coloniality. It highlights gaps in the protection of equality, dignity and liberty. It also draws on pertinent provisions of the Convention on the Rights of Persons with Disabilities as a juridical method for translating a decolonial agenda into a normative framework. Ultimately, the article proposes a framework for decolonizing Kenya's mental health laws and policies.

Type
Research Article
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of SOAS University of London

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Footnotes

*

LLB (Catholic University of Eastern Africa), LLM, LLD (University of Pretoria). Doctoral student, Centre for Human Rights, University of Pretoria, South Africa. Corresponding author.

**

LLB, LLM (Wales), LLD (Free State). Professor, Centre for Human Rights, University of Pretoria, South Africa.

References

1 Convention on the Rights of Persons with Disabilities (CRPD), UN doc A/61/611 (adopted 13 December 2006, entered into force 3 May 2008); Protocol to the African Charter on Human and People's Rights on the Rights of Persons with Disabilities in Africa (adopted 29 January 2018, not yet in force).

2 World Network of Users and Survivors of Psychiatry “Implementation manual for the UN Convention on the Rights of Persons with Disabilities” (February 2008) at 9, available at: <http://psychrights.org/Countries/UN/0802CRPDManual.pdf> (last accessed 26 November 2021).

3 Mahomed, FStigma on the basis of psychosocial disability: A structural human rights violation” (2016) 32 South African Journal on Human Rights 490 at 491CrossRefGoogle Scholar.

4 CRPD, art 12.

5 Guidelines on the right to liberty and security of persons with disabilities, UN doc (adopted September 2015), para 4.

6 Id, para 10.

7 Purohit and Moore v the Gambia [2003] AHRLR 96 (ACHPR 2003).

8 Ngwena, C What Is Africanness? Contesting Nativism in Race, Culture and Sexualities (2018, Pretoria University Law Press), chap 3Google Scholar.

9 Edgerton, RBA traditional African psychiatrist” (1971) 27 Southwestern Journal of Anthropology 259 at 269CrossRefGoogle Scholar.

10 Wilkinson, MGMalawi's mental health service” (1992) 8 Malawi Medical Journal 1 at 10Google Scholar.

11 Brégain, GColonialism and disability: The situation of blind people in colonised Algeria” (2016) 10 ALTER: European Journal of Disability Research 148 at 151CrossRefGoogle Scholar.

12 Keller, RCPinel in the Maghreb: Liberation, confinement, and psychiatric reform in French North Africa” (2005) 79 Bulletin of the History of Medicine 459 at 471CrossRefGoogle ScholarPubMed.

13 Id at 472.

14 Ndetei, DMTraditional healers in East Africa” (2007) 4 International Psychiatry 85 at 85CrossRefGoogle ScholarPubMed.

15 Edgerton “A traditional African psychiatrist”, above at note 9 at 269.

16 Id at 270.

17 Id at 271.

18 Alanamu, TIndigenous medical practices and the advent of CMS medical evangelism in nineteenth-century Yorubaland” (2013) 93 Church History and Religious Culture 5 at 26CrossRefGoogle Scholar.

19 Au, S and Cornet, AMedicine and colonialism” in J Vandendriessche and B Majerus (eds) Medical Histories of Belgium (2021, Manchester University Press) 99 at 102Google Scholar.

20 Thabane, MPublic mental health care in colonial Lesotho: Themes emerging from archival material, 1918–35” (2021) 32/2 History of Psychiatry 146 at 151CrossRefGoogle ScholarPubMed.

21 Feierman, SHealing as social criticism in the time of colonial conquest” (1995) 54 African Studies 73 at 87CrossRefGoogle Scholar.

22 M Craven “Between law and history: The Berlin Conference of 1884–1885 and the logic of free trade” (2015) 3 London Review of International Law 31 at 31.

23 A Césaire Discourse on Colonialism (trans J Pinkham, 2000, Monthly Review Press) at 32.

24 Brégain “Colonialism and disability”, above at note 11 at 150.

25 T Modie-Moroka “A historical evolution of mental health services in Botswana: Past and present” (January 2016) at 2, available at: <https://www.researchgate.net/publication/318837827_A_historical_evolution_of_mental_health_services_in_Botswana_Past_and_present> (last accessed 23 November 2021).

26 Id at 4. Ethiopia is Africa's oldest independent country; apart from a five-year occupation by Italy, it has never been colonized.

27 Swartz, SMadness and method: Approaches to the history of mental illness” (2009) 37 Psychology in Society 70 at 71Google Scholar.

28 Swartz, SColonial lunatic asylum archives: Challenges to historiography” (2008) 34 Kronos 285 at 287Google Scholar.

29 Businge, PDisability and armed conflict: A quest for Africanising disability in Uganda” (2016) 3 Disability and the Global South 816 at 817Google Scholar.

30 A Binagwaho and R Freeman “Decolonization of the legal code: The end of colonial laws in Rwanda and a model for other post-colonial societies” (2021) 62 Harvard International Law Journal Online 95 at 105.

31 Keller “Pinel in the Maghreb”, above at note 12 at 470.

32 PD Coene “Therapeutic trajectories in 1950s Usumbura, Ruanda-Urundi: A historical research into colonial psychiatry and its limits” (Masters dissertation, Ghent University, 2020) at 12.

33 Vaughan, M Curing Their Ills: Colonial Power and African Illness (1991, Boston University African Studies Center) at 118Google Scholar.

35 MW Kang'ethe “The insanity of Kenya's ‘guilty but insane’ verdict” (2021) 6 Strathmore Law Review 13 at 21.

36 Swartz “Madness and method”, above at note 27 at 71.

39 JC Carothers The African Mind in Health and Disease: A Study in Ethnopsychiatry (1953, World Health Organization); JC Carothers The Psychology of Mau Mau (1954, Government Printer, Nairobi); see Coene “Therapeutic trajectories”, above at note 32 at 17.

40 Edgar, R and Sapire, H African Apocalypse: The Story of Nontetha Nkwenkwe, a Twentieth-Century South African Prophet (2000, Ohio University Press) at 34Google Scholar.

41 Jackson, L Surfacing Up: Psychiatry and Social Order in Colonial Zimbabwe, 1908–1968 (2005, Cornell University Press) at 127CrossRefGoogle Scholar.

42 Swartz “Madness and method”, above at note 27 at 71.

43 Other vagrancy-related offences were found in the laws of other British-controlled territories, such as Botswana (in secs 179 and 182 of its Penal Code 1964), Malawi (in secs 180 and 184 of the Penal Code 1930), Mauritius (secs 26 and 28 of the Criminal Code 1870), the Seychelles (secs 173 and 174 of the Penal Code 1952), Tanzania (secs 176 and 177 of the Penal Code 1930) and Zambia (secs 178 and 181 of the Penal Code 1930).

44 M Vaughan “Idioms of madness: Zomba lunatic asylum, Nyasaland, in the colonial period” (1983) 9 Journal of Southern African Studies 218 at 220.

46 P Bermingham “Criminal lunacy and colonial discourse in Ireland, 1833–1916” (PhD thesis, Nottingham Trent University, 2021) at 77.

47 H Deacon “Insanity, institutions and society: The case of the Robben Island Lunatic Asylum, 1846–1910” (August 2003) at 5, available at: <https://www.researchgate.net/publication/290948067_Insanity_institutions_and_society_The_case_of_the_Robben_Island_Lunatic_Asylum_1846-1910/citations> (last accessed 26 November 2021).

48 R Keller “Madness and colonization: Psychiatry in the British and French empires, 1800–1962” (2001) 35 Journal of Social History 295 at 307; Thabane “Public mental health care”, above at note 20 at 154.

49 AH Westbrook “Mental health legislation and involuntary commitment in Nigeria: A call for reform” (2011) 10 Washington University Global Studies Law Review 397 at 404.

51 SA Ndiaye-Ndongo et al “The history of mental health in Senegal: Healthcare and educational infrastructures” (2020) 41 Revista de Historia de la Psicología 45 at 46. Some of these laws include the French law of 1838 on Assistance to the Insane, Rwanda's Ordonnance du 22 août 1888, relating to infectious and epizootic diseases, and the French ordinance of 7 September 1840.

52 Coene “Therapeutic trajectories”, above at note 32 at 30.

53 Id at 43.

54 PI Garrido “Health, development, and institutional factors: The Mozambique case” (WIDER working paper 2020/131) at 2.

55 Keller “Madness and colonization”, above at note 48 at 309.

56 F Fanon The Wretched of the Earth (1963, Grove Weidenfeld) at 296–304.

57 Lunacy Ordinance of 1908 (Laws of Southern Rhodesia); L Jackson “Gendered disorder in colonial Zimbabwe: Case analyses of African female inmates at the Ingutsheni Mental Hospital, 1932 to 1957” (2012) at 74, available at: <https://sas-space.sas.ac.uk/4234/1/Lynette_Jackson_-_Gendered_disorder_in_colonial_Zimbabwe,_Cape_alalyses_of_African_female_inmates_at_the_Ingutsheni_Mental_hospital.pdf> (last accessed 27 November 2021).

58 Keller “Pinel in the Maghreb”, above at note 12 at 494.

59 M Mathai and DM Ndetai “Overcrowded prisons and low psychiatric provision: The situation of mentally ill prisoners in Kenya” in N Konrad, B Völlm and D Weisstub (eds) Ethical Issues in Prison Psychiatry (2013, International Library of Ethics, Law, and the New Medicine) 249 at 250–53.

60 Wilkinson “Malawi's mental health service”, above at note 10 at 11.

61 Id at 12.

62 F Njenga “Focus on psychiatry in East Africa” (2002) 181 British Journal of Psychiatry 354 at 354.

63 J Seroto “Dynamics of decoloniality in South Africa: A critique of the history of Swiss mission education for indigenous people” (2018) 44 Studia Historiae Ecclesiasticae 1 at 3.

64 N Maldonado-Torres “On coloniality of being: Contributions to the development of a concept” (2007) 21 Cultural Studies 240 at 243.

65 Fanon The Wretched of the Earth, above at note 56 at 249–50.

66 F Fanon Black Skin, White Masks (trans CL Markmann, 1967, Grove) at 2.

67 Hage, G Is Racism an Environmental Threat? (2017, Polity Press) at 38–39Google Scholar; Roy, A The Ministry of Utmost Happiness (2017, Hamish Hamilton) at 95Google Scholar.

68 Gallien, CA decolonial turn in the humanities” (2020) 40 Journal of Comparative Poetics 28 at 30Google Scholar.

69 Mignolo, WDelinking: The rhetoric of modernity, the logic of coloniality and the grammar of de-coloniality” (2007) 21 Cultural Studies 449 at 449CrossRefGoogle Scholar.

70 Ndetei, DM, Muthike, J and Nandoya, ESKenya's mental health law” (2017) 14 British Journal of Psychiatry International 96 at 96Google ScholarPubMed.

71 Judicature Act 14 of 1977 (Laws of Kenya), sec 3.

72 Ibrahim, MMental health in Kenya: Not yet uhuru” (2014) 1 Disability and the Global South 387 at 393Google Scholar.

74 London School of Economics “Hospital escapees highlight need for community mental health in Kenya” (5 February 2017), available at: <https://blogs.lse.ac.uk/africaatlse/2013/05/20/hospital-escapees-highlight-need-for-community-mental-health-in-kenya/> (last accessed 27 November 2021).

75 Kamundia, EChoice, support and inclusion: Implementing article 19 of the CRPD in Kenya” (2013) 1 Africa Disability Rights Yearbook 49 at 55Google Scholar.

76 Juma, PRight to self-representation for people with mental disabilities in Kenya's courts” (2019) 7 African Disability Rights Yearbook 81 at 86Google Scholar.

77 CRPD Committee cases: X v United Republic of Tanzania (Communication 22/2014 (31 August 2017), UN Doc CRPD/C/18/D/22/2014), para 7.6.

78 English Mental Health Act 1959 (Laws of Kenya).

79 Njenga “Focus on psychiatry”, above at note 62 at 355.

80 Mental Health Act of 1989 (Laws of Kenya).

81 Id at long title.

82 Article 48 Initiative (A48), Arthur's Dream Autism Trust (ADAT) and Southern Africa Litigation Centre “An exploratory study of the interaction between the criminal justice system and persons with intellectual and psychosocial disabilities in Nairobi, Kenya” (September 2021) at 6.

83 Criminal Procedure Code of 1930 (Laws of Kenya), cap 75.

84 Id, sec 166(1).

85 Id, sec 166(2).

86 Id, sec 166(3).

87 Kimaru and 17 Others v Attorney General and Others [2022] KEHC 114 KLR.

88 Wakesho v Republic [2021] KECA 223 KLR, para 57.

89 Republic v CMW [2018] eKLR, para 48.

90 Republic v SOM [2018] eKLR, para 19(c).

91 CD Aguilar “Ending the deprivation of liberty on the basis of disability” (A/HRC/40/54) at 9.

92 Persons with Disabilities Act 2003 (Laws of Kenya), at long title.

93 Person Deprived of Liberty Act 23 of 2014 (Laws of Kenya).

94 Mental Health Amendment Act of 2022 (Laws of Kenya).

95 Purohit, above at note 7, para 1.

96 Lunatics Detention Act of 1942 (Laws of Gambia).

97 African Charter on Human and People's Rights (adopted 1 June 1981, entered into force 21 October 1986).

98 Abbay, FAn evaluation of disability human rights under the African regional human rights system” (2015) 23 African Journal of International and Comparative Law 476 at 502CrossRefGoogle Scholar.

99 East African Community Policy on Persons with Disabilities, African Commission [2012].

100 Kessi, S, Marks, Z and Ramugondo, EDecolonizing African studies” (2020) 12 Critical African Studies 271 at 273CrossRefGoogle Scholar.

101 Runo, MIndependent living for persons with disabilities” (2012) 46 The East African Review 1 at 11Google Scholar.

102 Amuyunzu-Nyamongo, MThe social and cultural aspects of mental health in African societies” (2013) 1 Commonwealth Health Partnerships 59 at 62Google Scholar.

103 Ibid.

104 Kamundia “Choice, support and inclusion”, above at note 75 at 54.

105 United Nations “Chapter Two: The Convention in detail – Obligations of States parties under the Convention”, available at: <https://www.un.org/development/desa/disabilities/resources/handbook-for-parliamentarians-on-the-convention-on-the-rights-of-persons-with-disabilities/chapter-two-the-convention-in-detail-4.html> (last accessed 28 November 2021).

106 Goldsmith, SK et al (eds) Reducing Suicide: A National Imperative (2002, The National Academies Press) at 357Google Scholar.

107 Southern Africa Litigation Centre “The persistence of colonial vagrancy laws in Southern Africa” at 27, available at: <https://www.southernafricalitigationcentre.org/wp-content/uploads/2017/08/05_SALC-NoJustice-Report_The-Persistence-of-Colonial-Vagrancy-Laws-in-Southern-Africa.pdf> (last accessed 28 November 2021).

108 Ibid.

109 Gallien “A decolonial turn”, above at note 68 at 28.

110 Kessi, Marks and Ramugondo “Decolonizing African studies”, above at note 100 at 275.

111 Mkabile, S and Swartz, LSpiritual healers’ explanatory models of intellectual disability in Cape Town, South Africa” (2022) 26/1 Journal of Disability & Religion 1 at 3CrossRefGoogle Scholar.

112 Ndetei “Traditional healers”, above at note 14 at 96.

113 Constitution of Kenya, art 54; Persons with Disabilities Act, sec 26(1)(e).

114 X v United Republic, above at note 77, para 7.6.

115 Gallien “A decolonial turn”, above at note 68 at 33.

116 Maldonado-Torres “On coloniality of being”, above at note 64 at 243.