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This study explored the mental health-related beliefs and practices of Tongan Traditional Healers and Tongan workers in the Western-style mental health services in Tonga. The groups showed very different explanatory models and treatment methods for mental health difficulties. A variety of methods, similar to those reported in other Pacific communities, were used by the Tongan Traditional Healers. The Traditional Healers had a negative view of the Western-style system, feeling it did not address the real issues in mental health that they considered more culturally and spiritually-based. Western-trained staff were generally more accepting of traditional healing, and incorporated aspects of Tongan culture into their practice, but did not typically include traditional healing practices. This study aimed to inform efforts to foster more synergy and collaboration between traditional and western healing approaches in Tonga and with Tongans elsewhere. The results may be relevant to other Pacific peoples.