This institutional ethnographic work uses the first author’s experience as an international development worker, educator, and community mental health nurse in West Africa to illustrate how official research and policy on mental health services reflect Western academic, corporate, economic, and cultural dominance. Focusing on a critical textual analysis of a survey intended to support funding applications to international aid/lending agencies, the authors show how official processes privilege Western policies/research approaches and subordinate local perspectives. If nurses, researchers, and policy-makers are to be effective in carrying out development work in Africa, they must learn to appreciate the subtle exertion of dominance inherent in Western approaches.The authors propose that understanding local knowledge be foregrounded rather than backgrounded to the complex global interpretive frames for international research and international development policy.