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Psychiatry on Tobago in 1989

Montpelier Health Centre, Bristol BS6 5PT

An unstructured observation concerning low rates of observed psychological disturbance was explored by estimating rates of suicide, and psychotropic drug use. Recorded suicide, overdose, and ‘minor’ tranquilliser and antidepressant use were strikingly low on Tobago, when compared with the United Kingdom. Tobagonians were unlikely to medicalise distress by presenting with overt psychological symptoms. Most local doctors felt that patients preferred spiritual support, e.g. from charismatic religious groups and traditional healers (some using obeah). A rich network of social and recreational groups may also give important support, as may ‘liming’ (a local conversational pastime). Tabanka (a local culture specific syndrome) may also be a non-medical outlet.