Dignity in mental health care across Africa: a narrative review

Mental health disorders contribute substantially to the burden of disease across Africa, yet access to timely, culturally responsive, dignified care remains limited. Dignity in mental health care encompasses respect for autonomy, human rights, cultural identity, and meaningful involvement in care decisions. This narrative review examines gaps and opportunities in the delivery of dignified mental health services across African contexts. Relevant literature published between 2010 and 2025 was identified through structured searches of PubMed, Scopus, MEDLINE, African Journals Online (AJOL), PsycINFO, and Google Scholar. Studies addressing access, dignity, stigma, legal and policy frameworks, system reforms, cultural influences, and community involvement in mental health service delivery were included. These topics were synthesised thematically. Although not conducted as a systematic review, the search and study selection process was guided by PRISMA principles to enhance transparency and rigour. Five key domains emerged: structural and systemic barriers, including underfunding, workforce shortages, and weak governance; stigma, cultural beliefs, and social exclusion that limit help-seeking and undermine dignity; human rights concerns, including coercion, neglect, and inadequate safeguards; policy and legislative gaps, particularly weak implementation and enforcement of mental health laws; and emerging innovations such as task-shifting, digital platforms, school-based programmes, and collaboration with traditional and faith-based healers that show potential for culturally responsive, dignity-affirming care. Advancing dignified mental health care in Africa will require strengthened rights-based systems, culturally responsive service delivery, meaningful service-user involvement, sustained investment, improved governance, and more effective implementation of mental health policies. Community-based innovations offer promising pathways toward equitable, rights-based, and dignified mental health care.