Alien psychiatrists, most of them from Europe, provided what was known about the mental health and illness of Africans until a few decades ago. Even after departure from the shores of Africa, their views remained dominant among indigenous psychiatrists. Many of those views were based on limited empirical evidence. Some other views, based on well-conducted research, may have been affected by the perennial problem of valid ascertainment of mental and social phenomena. Recent studies, many of them conducted by local scientists, are beginning to offer different perspectives about the nature and profile of mental illness among Africans but are themselves not immune to paradoxes. An examination of both old and new perspectives provides an opportunity to reflect on the challenges of research in psychiatry and how far we still are from achieving consensus.