Long distance relationships can be hard. So when Kwabena Kusi-Mensah’s wife took up her place at Cambridge shortly after their marriage, he decided there was nothing for it but to apply for a PhD himself.
“I’d always been curious about doing a PhD at some point, maybe much much later in life. I had a clinical problem that I’d been wrestling with, which was the academic question that set me on the path of ‘why don’t I equip myself with the skill to be able to answer this question’. But in terms of the timing – basically I was missing my wife.”
The couple had met in Nigeria, at the University of Ibadan, where Kwabena had completed an MSc in Child and Adolescent Mental Health, following medical school back home in Ghana.
“I did my psychiatry residency training, and that’s when I discovered child psychiatry. I’m from Ghana originally, but there were only two child psychiatrists in the entire country at the time when I trained, and no training programme. So I had to find the nearest place where they had a training programme, which was Nigeria.”
Understandably, after the long years of study, Kwabena wasn’t in an immediate rush to return to academia. But when the opportunity presented itself, he knew exactly what he wanted to research.
“The assessment tools that we normally use to assess children for various things, I found they were quite problematic in my environment. When it comes to measuring psychological constructs, there’s a lot of nuance and layers that the global south has to wrestle with, that don’t even enter the minds of most researchers in the global north.”
Although he was clear from the beginning of the necessity and value of what he was working towards, Kwabena’s goals sometimes felt out of kilter with the atmosphere of technological ambition he was surrounded by. But he remained committed to the impact he knew it could have.
“My department was very “sciencey” – very heavy on neuro-imaging, genetics, cutting edge biological psychiatry stuff. Everyone was looking into really amazing things, and it reinforced my imposter syndrome, because it felt like, these are the guys doing the real science, and you are here trying to figure out a problem that has been solved 50 or 60 years ago. But it’s still a major problem for most populations in the world.”
Having begun his research with the aim of creating a workable diagnostic tool, he found that he needed to approach the subject by taking a step back.
“I realised that even very fundamental questions, like how do people in West Africa conceptualise executive function, very basic questions have not yet been tackled or defined. So I had to go down that rabbit hole for four years and try to get some answers, before feeling, with that foundation laid, I can build on that and advance the work forward and now come up with practical tools, which is where I started from. I’m a clinician – I’m all about the patient sitting in front of me.”
Putting it into practice
Kwabena has now returned to his hometown, Kumasi, where he has taken up a post at his alma mater, Kwame Nkrumah University of Science and Technology. The role combines running a clinic with capacity for research, and when we speak he is delighted to have just been shortlisted for a Wellcome Award which he hopes will enable him to make the concept of a localised assessment tool a reality.
With, he estimates, around four child psychiatrists serving a national population of around 35 million, Kwabena sees it as a crucial step to equip primary care workers such as nurses and GPs with the ability to assess and diagnose mental health conditions and neurodevelopmental disorders. Currently dismissed as “a character flaw, or maybe it’s witchcraft”, conditions such as autism and ADHD are rarely recognised as such, denying children the chance to benefit from interventions.
“If the real foot soldiers of public education, which is the primary care workers, have the tools to assess kids in their communities, then we can begin to really bridge the gap and identify them. Then we can start worrying about referral pathways. Otherwise, we are just basically conscribing all these children to really bad outcomes.”
A recent investigation in Kumasi illustrated this neatly. A study of tro-tro drivers, the shared minibuses which are central to the country’s urban transport, found that almost 20% of them had attention deficit hyperactivity disorder (ADHD).
“That’s four or five times the adult average. It shook me, to think, if we do not pick these problems up and tackle them at the time when they need it, generation after generation, a whole swathe of perfectly intelligent young people are ending up performing less than they potentially could have.”
One couldn’t accuse Kwabena of failing to meet his own potential. While completing their studies at Cambridge, he and his wife had a baby daughter, tag-teaming the childcare while both pursuing PhDs. Living in Trinity accommodation, he made regular use of the Darwin gardens and punts, as well as attending Formal Halls. But the Study Centre was the focus of his College experience.
“My favourite place in College was the study room looking over the river. That was my zone; that was where I’d do a lot of my thinking.”
Having squeezed two PhDs and a baby into their first few years of married life, the couple are enjoying establishing a more settled routine back home. But a shared graduation weekend will provide a welcome opportunity to tick a few Cambridge boxes.
“I do miss Cambridge. It’s interesting – you spend four years there and then you realise how quickly the time goes by. So when we come for this graduation we’re going to go to the Fitzwilliam Museum, do some more punting, and cram in all the touristy stuff that we didn’t do. And I’m going to show my family the Darwin gardens.”
Kwabena will graduate on Saturday with a PhD in Psychiatry.
