In this month's issue, Harpers magazine has a piece about mental health care (or the lack thereof) in western Africa that touched quite deeply on religion and the efforts of some religious leaders to deal with the mentally ill.

What I thought would be an exposé on the gullibility of the ill who are taken in by religious charlatans actually turned out to be about a system where the only people with a plan to help the mentally ill are those same religious leaders.

Now, there have been exposés on Ghana’s horrific mental health facilities, but this piece took a different tack. The fact that certain Ghanaians' idea of healing involved prayer instead of medicine matters less than the fact that the places offered by these leaders are the only places to which the mentally ill can go with any hope of being cared for. Ghana is many decades behind the rest of the world in terms of any mental health care at all. The piece is called “A Prayer’s Chance: The scandal of mental health in West Africa” tries to show what those in the "prayer camps" are doing about it.

Samuel Donkoh had just turned ten when he began to slip away. His brother Martin, two years his senior, first realized something was wrong during a game of soccer with a group of kids from the neighborhood. One minute Samuel was fine, dribbling the ball, and the next he was doubled over in spasms of laughter, as if reacting to a joke nobody else had heard. His teammates, baffled by the bizarre display, chuckled along with him, a response Samuel took for mockery. He grew threatening and belligerent, and Martin was forced to drag him home.

The episode marked the onset of a frightening metamorphosis. Martin couldn’t understand what was happening to his brother, for although he had seen many abodamfo (“mad” men and women, in the Twi dialect) on the streets, the conventional wisdom was that such maladies afflicted only those who deserved it — excessive drinking or drug use was a popular explanation — or were otherwise spiritually or morally compromised. Samuel, the sensitive, well-behaved son of devout born-again Christians, did not fit that mold. 

The article goes on to describe how his mother prays over Samuel – even reprinting the exact psalm she turned to – and sets up how the rest of the story will go.

What was to be done? The approach advocated by members of the Donkohs’ church — prolonged fasting and that brand of combative, focused prayer known as spiritual warfare — had brought little respite, but pursuing a medical route seemed fraught as well. Two of Agnes’s aunts had been diagnosed with schizophrenia, and repeated stays at Ghana’s largest mental hospital, in the capital, Accra, had not helped them. Infamous for its chaotic atmosphere and rampant abuse, the hospital, built in 1906 by the British colonial regime as an asylum for the criminally insane, had rather aggravated their situation. One aunt died alone, a vagrant outcast; the other subsisted on the margins of her hometown. Agnes resolved that a similar fate would not befall Samuel.

A family friend suggested a drastic course of action. He urged them to seek treatment at Nazareth Prayer Centre, a distant religious retreat, or “prayer camp,” renowned as a place where people struck with madness could be cleansed of the demonic forces holding them captive. Spurred by the Pentecostal revival that swept West Africa during the 1990s, these rural camps — some of which allowed families to stay for months or even years on end — had come to serve as alternative sites of care in a region where health services, particularly mental health services, were notoriously scarce and underfunded…