Forensic psychiatry in Africa: prospects and challenges

Forensic Psychiatry has a history that dates back almost two thousand years, and has evolved into a recognised discipline with a robust background of scientific enquiry, mostly because mental health care has always had an important interface with the law. 1 Nevertheless, even in the developed world there are differences between countries with respect to the extent forensic mental health services have developed. This has been exacerbated by the differences in legal systems, resources and priorities in each country. Consequently comparisons and cooperation between forensic psychiatrists internationally has been difficult. 2-4 In Africa, which is the second largest and most populous continent and containing an immense diversity of languages, religious traditions, ethnic groups and sociopolitical systems forensic psychiatry has largely remained underdeveloped within the context of a pervasive neglect in the provision of mental health services. 5 The situation is compounded by the dearth of information about forensic services on the continent. As described by an eminent African psychiatrist, “the practice of forensic psychiatry in Africa is shrouded in both mystery and confusion”. 6 In addition to the lack of appropriate facilities, most countries in Africa have, on average, one psychiatrist per one million inhabitants. Moreover many psychiatrists have migrated to developed countries, leaving a small number of mental health professionals burdened with large numbers of patients. 6 In most countries there are few coordinated initiatives to involve all stakeholders, such as the police, departments of justice, prisons and hospitals, in the development of forensic mental health services