What kind of in-patient psychiatry for Africa? Report from Zimbabwe

The expanding global mental health field has paid little attention to evaluating the culture of psychiatry prevailing in in-patient settings across Africa. For example, in Zimbabwe in-patient psychiatry has been heavily pathologising, with over-reliance on the diagnosis of schizophrenia and on antipsychotic polypharmacy. It is not helpful that the next generation of African doctors are learning unmediated Western psychiatry, with little credence given to background cultural factors and mentalities shaping presentations. Some of the psychiatric and social consequences of this for patients in Zimbabwe are discussed.