Responding to mental distress in the Third World: cultural imperialism or the struggle for synthesis?

This paper questions the appropriateness of some of the 'help' that has been given in mental health in 'developing' countries, particularly Africa, and examines some of the complex ideological issues underlying different cultural understandings of the aetiology and treatment of mental illness. Some personal experiences, illustrating examples of the imposition of culturally inappropriate ideology in the teaching of psychiatry, are described. In conclusion, some principles of good practice are suggested which could form the basis of a synthesis between cultures, and maximise the possibility of Western aid in the field of mental distress being more culturally appropriate. This article is freely available as a chapter in Development and Culture.