Meaning
Not right in the head — mad, mentally unstable, or behaving foolishly and irrationally. To say a person's 'head nuh good' is to call them crazy or say their mind is disturbed, whether in real concern about mental illness or, more lightly, in exasperation at wild or senseless behaviour. Blunt and everyday, the phrase covers the whole range from genuine madness to plain foolishness, and 'him head nuh good' can be a serious worry or a half-joking complaint depending on how it is said.
Examples
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Di way him a gwaan, him head nuh good.
The way he's carrying on, he's not right in the head.
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Yuh head nuh good? Why yuh do dat?
Are you crazy? Why did you do that?
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Since di accident, dem seh him head nuh good.
Since the accident, they say his mind isn't right.
Origin
Literally 'the head is not good' — the head standing for the mind; a plain Patois way of describing madness or foolish behaviour.
How it’s used
Ranges from a serious statement of mental illness to a light 'are you crazy?'. Compare 'mad', 'head gone'.