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Objective : This paper reports on overarching strategies which supported the establishment and sustainability of 9 mental health self-help organisations in seven African countries. Method : Eleven key informants were identified through snowballing and interviewed regarding their experience in the organisations. Thematic analysis of the interview data and other documentary evidence was guided by a coding scheme derived using a framework analysis approach to defining, categorising, mapping and interpreting textual data. Results : Sustainability strategies include: commitment to members’ advocating for their rights and rebuilding their lives within their communities; independent decision-making, user-led membership and leadership; financial selfsufficiency, alliances with donor organisations, non-governmental organisations (NGOs), disabled people’s organisations (DPOs) and ministries which support self-determination and promote control over agenda-setting and responsiveness to members’ needs. Organisations’ work include advocacy to destigmatise mental disorders and promote the protection of users rights, activities to improve access to health care and to income generation and social support, participation in legislative and policy reform, and capacity building of members. Conclusion : Self-help organisations can provide crucial support to users’ recovery in resourcepoor settings in Africa. Support of Ministries, NGOs, DPOs, development agencies and professionals can assist to build organisations’ capacity for sustainable support to members’ recovery. Keywords : Mental health, Self-help, Advocacy, Recovery, Africa

One of the major problems in psychiatric practice worldwide is inability to reach a consensus as regards a globally acceptable classificatory system for the different psychopathologies. Consequently, apart from the WHO’s International Classification of Diseases (ICD) that is expected to be universally applicable there are regional-based classificatory systems in some parts of the world. In Africa, a number of culture bound syndromes (CBS) have been described which have not been given international recognition. The possible consequences of this non-recognition are highlighted in this paper. Unfortunately there are serious constraints such as the relatively small number of psychiatrists on the continent, and inadequate funding for mental health research, which militate against producing an African classificatory system. Nevertheless, it is proposed that reports of African psychiatrists emanating from their research and clinical experience should be accorded adequate recognition in the WHO so as to assign these CBS their rightful placement in the International classificatory system.Key Words: Culture-Bound Syndromes; African Psychiatry; Classification; Recognition.

The Brain Fag Syndrome (BFS) is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as a culture bound syndrome. BFS is a tetrad of somatic complaints; cognitive impairments; sleep related complaints; and other somatic impairments. Prince first described this psychiatric illness associated with study among African students in 1960. There have been questions relating to the nosological status of the syndrome as to whether: BFS is an objective or subjective phenomenon; it is one phenomenon or a variant of other known disorders; it is a mental illness? These three questions pose challenges to the culture bound/depressive or anxiety equivalent approach to the condition. The scope of this paper is the scope of BFS history from its first reference in the psychological medicine to the most contemporary descriptions in transcultural psychiatry. The conceptual history of BFS is divided into four major perspectives: Traditional medicine, Psychoanalysis, Biopsychological and Transcultural psychiatry. This helps to outline some of the key issues, helps to clarify its nosological status, its present status and helps to set the stage for the future progress. From its conceptual history, BFS as a phenomenon, with its distinct presentations, is subjectively real and is best classified with the framework of psychiatry, psychology and or sociology. The existence of BFS is evidenced by case as well as epidemiological reports of the condition in different locations. However, its course, response to treatment and outcome deserve more attention than has been given.