Circulations et quêtes thérapeutiques en santé mentale au Sénégal

In this article we have chosen to focus on the circulations related to therapeutic mental health quests in the countries of the South through the example of Senegal. Mental health is not one of the priority health programs supported by the Global Fund, few countries in the South have specific mental health policies and programs, and it is not the subject of strong political and financial mobilization. According to WHO estimates, the majority of people with severe mental disorders are untreated and have diminished rights. With more accurate measurement of the disease burden, mental health has been included in the objectives of sustainable development and in overall public health. It is, in addition, a development issue given its social and economic costs to countries and families. Nevertheless, research on mental health in sub-Saharan Africa, whatever the discipline, is still too rare. Senegal was chosen for this research for two reasons: first, since French colonization, it has had an internationally recognized psychiatric range of services, and second Senegalese society is characterized by international migration and significant circular mobility, which anchors it in processes of globalization. The various circulations that contribute to structuring therapeutic pathways that are often long and chaotic before accessing psychiatric care are described mainly on the basis of anthropological data collected from people experiencing mental illness, either alone or supported by “their accompanying person(s)”. These data are based on field surveys conducted in several psychiatric services and mental health centers throughout the country. Consultations were followed in agreement with the medical and administrative authorities, observations and interviews were carried out with healers, sick people and their “companions” in order to understand the therapeutic pathways, the management of the disease and drug treatments as well as the representations of psychological disorders in a context of stigmatization of madness. The investigation continued beyond the walls of the psychiatric institution with healers, marabouts and representatives of mystical medicine in order to take into account the plurality of therapeutic remedies and the movements that take place at local, national and even transnational levels. The interviews were conducted either in French or Wolof (translated by an investigator trained in health anthropology). The circulation of actors, products and pract