Thomas Adeoye Lambo

Decolonising Psychiatry

Excerpt from Learn Our History | Vol. 9

Professor Thomas Adeoye Lambo is recognised as one of the most eminent African psychiatrists of his generation. Born on 29 March 1923 in Abeokuta, Nigeria, Lambo completed his medical training in Birmingham, England, before training as a psychiatrist at the Maudsley Hospital in the early 1950s. Lambo returned to his native Nigeria in 1954.

It is important to understand the landscape of Nigerian mental health care during the colonial period.

The Lunacy Ordinance of 1906 empowered the colonial governor to establish a lunatic asylum when necessary and defined a ‘lunatic’ as any person of “unsound mind,” including “idiots”.

The first buildings designated as asylums were the Calabar Asylum in southeastern Nigeria (in 1903) and the Yaba Asylum in Lagos (in 1906). Other asylums were built in Zaria, Kano, Sokoto, Lokoja and Port Harcourt.

In Nigeria, colonial asylums and colonial prisons were functionally the same. In 1915, for example, with the Yaba Asylum already overcrowded, several cells in Lagos Prison were converted into a so-called lunatic asylum.

Further evidence that British colonial policy did not include providing genuine care for patients is that no psychiatrists were employed in these asylums for most of the colonial period.

Lambo returned to Nigeria only a few years before the colonial government would introduce the 1958 Lunacy Act, a law that mandated the involuntary detention of mental health patients at the discretion of a medical practitioner or magistrate. This colonial remnant remains a legal precedent in Nigeria today.

On his return, Lambo set up the Neuropsychiatric Hospital Aro in Abeokuta and, in doing so, oversaw the transformation of Nigeria’s mental health services. Lambo pioneered a culturally sensitive model of diagnosis and treatment, doing away with the one-size-fits-all approach of British colonial psychiatry and introducing a patient-centred approach.

Lambo’s breakthrough development was the Aro Village System, an outpatient and community treatment that in 1956 saw three hundred psychiatric patients placed in local villages.

The Aro Village System employed psychiatric professionals, relatives, co-tenants, neighbours and the wider community in a patient’s care.

Lambo observed “comparatively quick recovery, lack of chronicity and better therapeutic response”, which he attributed to the “favourable social and environmental factors inherent in the community to which the mentally ill are exposed”.

Lambo also included traditional doctors within the scope of his programme of treatment. It should be noted that Nigeria had a well-established system of traditional medical practice prior to colonial intrusion. Contrary to popular belief, traditional African medicine was an effective therapeutic tool.

In 1957 Canadian psychiatrist Dr Raymond Prince took up a position at Aro Hospital and described how:

“The Yoruba people, among whom I found myself, had developed a sophisticated and internally consistent system of medicine and psychiatry that included aetiological explanations and treatment methods which were often at variance with West approaches.”

Prince is further quoted as saying:

“Western psychiatric techniques are not demonstrably superior to many of the practices of the Yoruba.”

The legacy of Professor Thomas Adeoye Lambo is one of cross-cultural success; he brought together both western and indigenous knowledge systems and, in doing so, achieved a great deal nationally and internationally.

Lambo’s transformation of Nigeria’s psychiatric services not only allowed for dramatic improvements in the recognition, diagnosis and treatment of mental illness in Nigerians; it also highlighted to Nigerians the inadequacies of colonial rule, in particular the inability of the British to bring ‘progress’ to disadvantaged Nigerians.

Lambo’s successes in the 1950s and beyond begged the question - could Nigerians govern themselves better than the British?