I FIRST became aware of mental illness when accompanying my father to see a patient. Dad, a family doctor in Stirling like his own father, had been asked by the police to help with an elderly man who seemed to have gone mad. I’m not sure if Uncle Archie was a blood relative or a family friend but there he was, in his usual plus fours, shouting at a young policeman and waving his walking stick at him. In those days, farmers delivered tractor loads of manure to houses every autumn and Archie was standing on top of his personal dung heap. Dad greeted him, talked for some time, then he and the constable helped him down from the fragrant pile. I later learned that he had been sent to the Bellsdyke asylum near Larbert – which was a great loss, for Archie Allan was a well-known painter. For many years, his massive and dramatic oil painting of two Clydesdale horses ploughing a field had dominated a wall of the Smith museum in Stirling.

Baldie Broon, too, would probably have been declared insane nowadays and kept under heavy sedation. Tall, slightly stooped, draped to the ankles in a thick overcoat, winter or summer, he spent hours a day walking the myriad paths in the woods round Stirling Castle, talking quietly to himself, occasionally striking bizarre poses. He was well read, a regular user of the public library in town, and would hold forth on the most unlikely subjects to anyone who cared to walk with him, as several of us schoolkids did.

In Africa, psychiatric facilities are scarce and underfunded, the deranged being dealt with in general hospitals or by lengthy and expensive stays at a traditional healer’s home. I had never come across an actual straitjacket in Britain but was grateful for the moth-eaten one that was produced one afternoon in Zululand after a blissfully euphoric girl, shards of glass in each hand from the nursing station window she’d just smashed, attempted to cut open anyone’s neck within range. Four of us backed her into a corner then rushed her with mattresses from the ward beds. The largest cook from the hospital kitchen was summoned and kindly agreed to sit on top of the Demented One until we had fitted the straitjacket.

Swaziland had more resources, with the insane arriving in police vans, often in chains. This never seemed to discourage hawkers, who were unconcerned that their potential customer was a paranoid schizophrenic in shackles.

Philamon, a middle-aged man from Mambane, a remote settlement overlooking the coastal plains of Mozambique, would certainly not have survived the trauma of an understaffed mental hospital but he did recover after a few weeks with a traditional healer. An industrious and mild-mannered clerk, his heart had been broken when his only daughter died of malaria, barely a year after he’d lost his wife. To relieve the misery, he’d begun to smoke cannabis and drink cheap cane spirit.

A beefy policeman brought Philamon to casualty, raving and cursing. The neat, reserved bookkeeper I had known was unrecognisable. He was filthy, covered in burrows and papules caused by scabies, and wore only a singlet, decrepit shorts and gym shoes. He was jabbering away about the Gadarene swine, having been a staunch member of an African church in better days, and was quoting chapter and verse. This did not go down well with the officer. Sergeant Tertius Dlamini was a Zionist, and both his clan and his church abhorred pork – to be mistaken for one was the ultimate insult.

Dr David Vost studied at Glasgow University and now works at a hospital in Swaziland.