Im | possibilities of collaboration. Community psychiatry and spiritual healing in rural Southwestern Ghana

Drawing on extensive ethnographic fieldwork carried out between 2013 and early 2022 in Nzemaland, a rural border area in southwestern Ghana, this thesis focuses on a particular Global Mental Health promoted practice: that of collaboration between psychiatry and so-called ‘unorthodox’ therapeutic resources (i.e. traditional and spiritual healing). Conceived of as an instrumental practice for the decentralisation of services and the general improvement of mental health provision, ‘collaboration’ is rooted in a long history of therapeutic pluralism in the country (and the area), but was promoted as an innovation within the framework of the ‘Mental Health Act’, a new law passed in 2012 with the aim of reforming the national mental health care system in line with WHO guidelines. Looking at everyday practices of 'collaboration', that is what people (psychiatric nurses, charismatic pastors, traditional healers, patients, family members) actually do across different therapeutic traditions and at the intersections of different ideas of mental suffering and care, this thesis aims to challenge any dualistic conceptualisation of religious/spiritual experiences and mental health as separate spheres. At the same time, I also propose to question the ways in which the practice of 'collaboration' itself is framed at the national and international level, what contradictions it entails, what kind of care it contributes to make possible and/or impossible in light of current debates concerning the impact of economic inequalities, the role of psychopharmaceuticals and neurobiological reductionism, the tensions between care and control in mental health care. By doing so, I would also like to suggest the idea that a border area substantially framed as ‘remote’ in national terms and generally overlooked in the ever-growing scholarship on mental health in Ghana could be a crucially ‘global’ site to observe how Global Mental Health is made, unmade and remade in people’s everyday lives beyond its discursive dimension.