The head psychiatrist at Tonga's Vaiola hospital says the government needs to make the mental health sector a higher priority, following the death of a patient.
Mapa Puloka has been speaking at the country's first mental health symposium aimed at creating awareness of the sector.
Dr Puloka said there were about 10 patients in the psychiatric ward when he first started working there over 20 years ago but now there are about 40.
He said since one of his patients killed another in August, a number of changes have been implemented.
"Our unit [is] now only concerned with acute psychiatric emergencies and also only cases referred from the courts and the prison and the police but gradually it has been increasing, the number of admissions in the ward. Our number of patients in our register is about over 2,000. The number of patients that we are actually able to follow up is actually on 120 in the community."
He also said up to 60 percent of cases he saw were drug related.
A multi-faceted approach is needed with a growing drug problem affecting many of the patients he deals with, Dr Puloka said.
"Very bad because so many times we have patients who become psychotic because of the drugs, especially marijuana but worse is the methamphetamine."
He said the legal, health and education sectors need to work together to treat people dealing with mental illness.