Frantz Fanon was born in Martinique, to a family of mixed racial background. Early in his life, he encountered racism at the hands of the French army in Martinique and this became a major influence in his views of the experience of colonisation by European powers. Fanon served with Free French during World War II and continued to encounter institutionalised racism despite his own meritorious military service. After the war, he studied medicine in Lyon and qualified in psychiatry in 1951. During his psychiatric residency in Saint Alban, he absorbed the ideas of Francois Tosquelles, a Catalan-born psychiatrist whose emphasis on the role of culture in psychopathology had a profound effect on Fanon's thinking about psychiatry. After working as a psychiatrist for a brief period in France, Fanon moved to Algeria in 1953 where he was chef de service at the Blida-Joinville Psychiatric Hospital. In Algeria, he became involved in the struggle for independence and was an active member of the Algerian Front de Liberation Nationale (FLN). His activities saw him deported from Algeria in 1957 and, after a peripatetic period, he died of leukaemia in 1961 in the United States.

Fanon is, perhaps, the most celebrated example of a psychiatrist as a political figure. He is best known for his tome The Wretched of the Earth Reference Fanon(1), which yoked a discussion of the effects of colonial power and politicised racism with a discussion of the mental health of colonised people. Like Che Guevara, Fanon was a medical practitioner active in revolutionary politics. Unlike Che, however, Fanon also pursued a project of reform in the practice of psychiatry in Algeria, creating a dialectic of philosopher of psychiatry and street fighter Reference Adams(2). Indeed, Fanon's double life as a colonial-era psychiatrist and an FLN activist has invited much criticism in revisionist views of his life. One of Fanon's biographers referred to him as a ‘talented hater’Reference Macey(3), whereas his other critics simply cannot look past his complicity in atrocities perpetrated by the FLN Reference Fulford(4). This view begs the question of whether psychiatrists (or any medical practitioners) acting in roles in public life are beholden to professional codes of conduct. This is particularly salient to psychiatry in the light of the other exemplar of the psychiatrist-politician, the alleged war criminal Radovan KaradžićReference Silove(5).

Regardless of such ad hominem critiques, the influence of politics on Fanon's psychiatric project and vice versa requires some consideration. Fanon identified colonial psychiatry in Algeria as Eurocentric and as exerting a hegemonic cultural influence upon the population as a perpetuation of the coloniser-colonised dynamic. The cultural estrangement and institutionalised racism brought about by Eurocentric psychiatry created ontology of ‘the Other’ in the colonised, forcing them to constantly question ‘Who am I?’. Although much of the psychiatric material in Fanon's The Wretched of the Earth Reference Fanon(1) and Black Skin, White Mask Reference Fanon(6) (his other famous work) was co-written and possibly anecdotal Reference Hopton(7), his main contribution to the field of psychiatry was the requirement of a common culture between psychiatrist and patient Reference Verges, Gordon, Sharpely-Whiting and White(8). Fanon reformulated the Lacanian notion of meconnaissance in le stade du miroir Reference Lacan(9) to the alienation of the colonised ‘Other’ from cultural, social and political elements, through internalisation of injustice perpetrated by the coloniser Reference Fanon and Geronimi(10). Fanon rejected European psychiatry in Algeria as it presented a means of conforming to the psychology of the colonised. Madness was therefore sociogenic in Fanon's view, and so psychiatric treatment, in the tradition of Pinel, took place in psychiatric institutions that functioned as engines of social change. Indeed, Fanon has been described as a ‘social psychiatrist driven by humanism to unmask inhumanity’Reference Adams(2). Unlike the well-documented misuses of value-based psychiatric diagnosis for political repression in the former Soviet Union and in modern China Reference Robertson and Walter(11), Fanon's work highlights a little understood abuse of psychiatric power.

How does Fanon's legacy fit within contemporary neuropsychiatry? Some may argue a moral and historical equivalence between colonial and post-colonial era psychiatry in Algeria and new world countries such as Australia, New Zealand, the USA and Canada. It can be reasonably argued that, putting aside controversies around Fanon's revolutionary politics and his enthusiasm for political violence, his real contribution to psychiatry was the acknowledgement of the place of injustice and power relationships in the lives of those suffering mental illness, as well as the depiction of Western psychiatry as a hegemonic cultural phenomenon Reference Hopton(7). The imposition of Western models of mental disorder on non-Western cultures, based on de-contextualised and reductionist ideas, replicates the perpetuation of the coloniser-colonised theme in Fanon's work.

Transcultural mental health, in true Fanonian tradition, is not a means of manipulating other cultures into the framework of Western models of mental illness, but rather the integration of questions of power, justice and sociocultural influences into our understanding of the patient. It also speaks of the way in which we must understand the highly influential contexts of politics, history and social power on the ontological and epistemic questions of mental illness, and the values implicit in the work of mental health professions. This has been argued to be one of the basic assumptions of ‘post-modern’ professional ethics, which acknowledges the complex relationship between the patient, the clinician and the broad social context Reference Robertson and Walter(12).