Paper short abstract:

The case study of the development of a local Tonga psychiatry, that drew on medical anthropology and transcultural psychiatry, provides a propitious case study to explore the biomedical imperialism vs cultural adaptation dialectic informing debate on Global Mental Health.

Paper long abstract:

The Global Mental Health (GMH) movement has revitalised questions of the translatability of psychiatric concepts and the challenges of community engagement in countries where knowledge of the biomedical basis for psychiatric diagnosis is limited or challenged by local cultural codes. In Tonga, the local psychiatrist Dr Puloka has successfully established a publically accessible psychiatry that has raised admission rates for serious mental illness and addressed some of the stigma attached to diagnosis. On the basis of historical analysis and ethnographic fieldwork with healers, doctors and patients since 1998, this paper offers an ethnographic contextualization of the development and reception of three key interventions during the 1990s that included collaboration with traditional healers and the formulation of hybrid terms. Dr Puloka's use of medical anthropological and transcultural psychiatry research, informed a community engaged brokerage between the implications of psychiatric nosologies and local needs. As such it reveals deficiencies in current polarised positions on the GMH project and offers suggestions to address current challenges of the Global Mental Health movement.