Explores how psychiatry in Ghana was never just about medicine; it was about migration, exile, and the politics of who gets to stay and who must be cast out. For centuries, mental distress in West Africa has been subject to a mix of healing, harming, ritual, and regulation. In African Pharmakon, Nana Osei Quarshie questions conventional narratives about colonial psychiatry. Instead of displacing African therapeutic traditions, he argues, European psychiatric institutions in fact built upon them, adapting long-standing techniques of social control and healing. With a focus on Ghana, Quarshie explores the shifting landscape of West African mental health practices, tracking their transformation from shrine-based rituals to colonial asylums and modern psychiatric institutions. Combining extensive archival research and ethnographic fieldwork, including the first scholarly examination of patient records from the Accra Psychiatric Hospital, Quarshie identifies five enduring techniques that have shaped the treatment of mental distress: spiritual pawning, logging, manhunting, mass expulsion, and pharmacotherapy. Rejecting the simplistic opposition of Indigenous healing versus colonial oppression, African Pharmakon provides a nuanced account of how psychiatric care in Ghana became a tool of empowerment as well as exclusion. This pioneering study reframes our understanding of psychiatry and mental health governance in West Africa, past and present.