Recent years have witnessed the growth of mental health activism across Africa. Often affiliated to psychiatric user/survivor organisations outside the continent, Africa-based advocacy groups draw on the provisions of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) in the fight for mental health justice. This is taking form within a historical context circumscribed by wide ranging calls for decolonisation, whether with regards to madness or knowledge and practices in/about the continent. This chapter explores iterations of the discourse of decolonisation across mad scholarship. In addition, it examines the contradictions confronted by mad activisms in Africa as they strive to articulate demands framed by the discourse of human rights. An important question here is how activist groups grapple with the problem of universalism and the imperative to make their demands politically legible in context-specific ways. The chapter concludes by considering the value of a communitarian notion like ubuntu as an alternative conception of personhood and justice to that enshrined in human rights.