Colonial psychiatry (nineteenth–twentieth century)

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Abstract 

Colonial psychiatry gradually took form between the beginning of the “conquest” and the turning point of independences. The establishment of specific asylum institutions accompanied the emergence of medical professions and the appearance of a psychology of colonized populations. While mental health assistance was deployed according to different forms and temporalities depending on the empires and territories involved, it nevertheless contributed to reproducing the racial, gender, and class inequalities present in colonial societies.

The administrative wing of Blida-Joinville psychiatric hospital in 1958
The administrative wing of Blida-Joinville psychiatric hospital in 1958. Source : Wikipedia

The institutional rise of colonial psychiatry

Colonial administrations were confronted from the outset by the treatment of mental patients, especially those accused of disturbing the social order. However, supervision of mental patients was far from being a leading colonial concern. For lack of adapted organizations, management of mental patients was frequently entrusted to prisons or military hospitals, as in New Zealand and the Dutch Indies. Some colonies put in place evacuation measures, which aimed to transfer patients to metropolitan asylum institutions. In the case of the French colonial empire, Indochina and Senegal followed on the heels of Algeria, whose transfer system began operating in the mid-1840s.

While the first colonial asylums were created in the early nineteenth century, their institutional rise began in earnest in the 1860s. For example, Australia built large urban and rural institutions, and India counted 26 asylum institutions at the turn of the century. These openings followed the implementation of legislation adapted from the metropole and other colonies: the laws in effect in New Zealand and Australia were inspired by British laws, while the Lunacy Act applied in Kenya drew on the one adopted in India in 1858.

The colonial territories of the French empire suffered from delays in these various domains. Supporters of colonial psychiatry invoqued the “influence” of French civilization to make up for lost time. The movement found a significant echo at the Psychiatric Congress of Tunis in 1912, which marked the birth of French colonial psychiatry. In the ensuing years, Indochina (1918), Morocco (1920), and later Tunisia (1932) established their own institutions. In Algeria, the first psychiatric hospital at Blida-Joinville was established only in 1933, after a century of debate and aborted projects.

Between the walls, the reproduction of colonial inequality

Despite this institutional expansion, psychiatric hospitalization remained a solution of last resort for colonized populations, which quite often continued to mobilize their own explanatory schema for madness—such as being possessed by djenoun in Algeria—and sought out traditional healers, such as dukun in the Dutch Indies. Similarly, the lack of asylum facilities and the prolonged hospitalizations limited the number of available places; patients were hospitalized in overcrowded asylums, when they were not held at temporary sites or prison institutions.

In some colonies, “Europeans” and “indigenous people” were treated in distinct institutions, with a view to maintaining “colonial order” and avoiding contact deemed to be potentially dangerous. When racial differentiation did not occur between institutions, it was present within the hospital on the scale of sections, and added to the sexual and medical divisions that traditionally structured asylums. The distinctions extended to all areas of daily life, and were justified by the notion that colonized populations were accustomed to a harsher and more rudimentary lifestyle. In Indochina and the Dutch Indies, agricultural work, whose therapeutic value was emphasized by doctors, involved only “indigenous” patients, with the local climate being seen as an obstacle to involving “European” patients in labor.

Inequality was also present among medical staff. Indian medical officers were long restricted to subordinate roles, with superintendent positions, which were notably in charge of asylums, being reserved for “Europeans” until 1914. Transformations came slowly in this field; for instance, while Algerians represented over 50% of medical staff at the Blida-Joinville psychiatric hospital in 1961, they held only one of the institution’s 27 management positions.

Psychiatric theories steeped in racial stereotypes

Colonial psychiatry, called “racial psychiatry” or “ethnographic psychiatry” depending on the context, helped to reproduce and diffuse racial prejudices. During the first half of the twentieth century, it gradually formed an independent field structured by a theoretical corpus and the emergence of scientific networks under the authority of a few figureheads. Antoine Porot (1876-1965), considered as the founder of the “Algiers school,” devoted a large part of his research to “North African psychiatry.” This school worked simultaneously on the promotion of “mental hygiene” and the introduction of shock therapy in Algeria, and exerted considerable influence on Angelo Bravi, the leading figure of Italian colonial psychiatry. In Kenya, the doctor J. C. Carothers (1903-1989) became the primary representative of an “East African school” of psychiatry during the 1940s.

Among the recurring considerations expressed by these doctors was the notion that distance from or contact with Western civilization determined the evolution of mental pathologies among colonized populations. Using clinical observations and conceptual borrowings from anthropology, colonial psychiatrists identified the primary psychological “traits” of “indigenous people,” whom they described as having limited intellectual development. This work led to a series of characteristics and generalizations charged with racial stereotypes, which Professor Porot and his collaborators brought together beneath the notion of “primitivism”: credulity and unfitness for abstraction were accompanied by impulsive behavior primarily dictated by emotions. Through the neuropsychiatric formulation of racial difference, these theories contributed to the legitimization of colonial domination, as well as the legal and social inequality to which it led. 

It was this “pathologization” that in the 1950s drew the criticism of Frantz Fanon (1925-1961), the anti-colonialist activist and former psychiatrist from Blida-Joinville psychiatric hospital. This work opened the way for consideration of local beliefs and cultural models with respect to mental illness, an approach reflected after independence by the emergence of ethnopsychiatry.

Translated by Arby Gharibian