Va'a fakalelei 'atamai: Restoring the mind in the Kingdom of Tonga

Objective: We aim to report on the practice of psychiatry in the Kingdom of Tonga. Method: We provide a description of the findings from a visit to Vaiola Hospital and data provided by the chief psychiatrist of Tonga. Results: The practice of psychiatry in Tonga reflects the difficulties of providing health care in a middle-income micro state. Interesting features include the use of kava as a calmative for some acutely disturbed and anxious patients, the high proportion of patients receiving treatment with fluphenazine decanoate and the possibility that the observed increase in psychosis among Tongan migrants to Australia is at least partly due to a high prevalence of psychosis in Tonga itself. Conclusions: A prevalence of psychosis study would need to be undertaken to confirm the report of a higher rate of psychosis in Tonga compared with that in Australia