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This article examines the experiences of immigrants from British and French West African colonies in the Accra lunatic asylum in the first half of the twentieth century. Placing particular emphasis on how immigrants got into and out of the asylum, the article argues that immigrants were marginalized and manipulated by colonial psychiatric institutions to a greater extent than non-migrant colonial subjects in Gold Coast. In making this argument, the article argues for the value of adding colonial origin and subjecthood to the racial and gendered perspectives that have dominated the history of health and medicine in Africa to date. [ABSTRACT FROM PUBLISHER]