Psychiatry, religion and culture all assert considerable power over individuals. A human rights approach can rebalance this power. I want to address the question: should the law allow someone to consent to what she believes to be a cure, but what others consider to be “inhuman or degrading treatment” which is banned under international law?

Traditional and spiritual healers deliver the bulk of mental health ‘services’ in Nigeria, Africa’s most populous country. They profit from the populist belief that madness is caused by demonic possession. As a result people labelled as mad are hyper-stigmatised and families urgently want to rid the devil from their afflicted relative. Within this delusional belief system, beatings, lashings, burnings and rapes drive out the evil spirits. The colonial lunacy law provides precisely zero protections against arbitrary internment, chemical and physical restraints, and non-consensual electroshock in psychiatric hospitals. The tiny amount of psychiatrists are hospital-based and overstretched. Mental health services are largely absent from primary healthcare, save in some EU-funded pilot projects. Both the psychiatric and the traditional healing industries are unregulated, unmonitored and susceptible to corruption. Ill-treatment is carried out with impunity because perpetrators are never punished.