Participatory intercultural adaptation of WHO’s mhGAP for Indigenous communities in Brazil
Abstract
WHO’s mhGAP provides evidence-based guidance for mental health care in non-specialist settings, but its biomedical orientation does not reflect Indigenous cosmologies, languages, developmental expectations or collective care systems. In Brazil, Indigenous adolescents experience mental health challenges shaped by territorial insecurity, cultural disruption, structural violence and limited access to culturally safe services. This presentation discusses a participatory intercultural adaptation of mhGAP for Kaingang adolescents in the Guarita Territory. Participatory action research was informed by reflexive deliberation, contextual grounding, epistemic negotiation and ethical power-sharing. An Intercultural Mental Health Team of Indigenous and non-Indigenous health workers, traditional specialists, educators, leaders and researchers co-led the process. Data were generated through discussion groups with 161 participants, interviews with traditional healers and analysis of Indigenous mental health guidance. Indigenous collaborators led interpretation and member checking to ensure cultural validity and protect sensitive knowledge. Mental health was framed through good living, linking body, mind, community, territory and spirituality. Traditional healers, elders, families, schools and Indigenous Health Agents were identified as central actors in care, alongside biomedical services. The adaptation highlighted the need to distinguish spiritual experiences from clinical symptoms, avoid pathologising culture, and address structural violence, cultural disruption and collective suffering. The process informed an intercultural guide integrating Kaingang epistemologies with mhGAP. The presentation will show how cultural adaptation can become an ethical and political process of shared decision-making, rather than a technical exercise, offering transferable lessons for culturally safe mental health care in Indigenous communities.
Related
- Socioeconomic vulnerability associated with schistosomiasis in indigenous communities of southern Brazil
- Intercultural pathways to indigenous mental health: the integration of ayahuasca in community care in the Yaqui intercultural medicine clinic in Sonora, Mexico
- Operational and intercultural challenges of mass rabies vaccination in the Maxakali Indigenous Territory
- Empowering Indigenous futures: advancing the 4Ms education model in American Indian and Alaska Native communities
- Silence as relational adaptation: Strategic communicative practices of Chinese partners in Sino-Western intercultural marriages
BibTeX
@article{godoy2026participatory,
title = {{Participatory intercultural adaptation of WHO’s mhGAP for Indigenous communities in Brazil}},
author = {MGC Godoy and IAV Dias and PTC Jardim and AJ Grande and X Zourntos and J Murdoch and R Gibson and SG Anderson and S Harding and D Parmar and PG Emilio and VT Cappellari and E Ribeiro and R Emmanuel and A Abdulkadri and P Dazzan},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.318},
url = {https://doi.org/10.1093/eurpub/ckag169.318},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Participatory intercultural adaptation of WHO’s mhGAP for Indigenous communities in Brazil
AU - MGC Godoy
AU - IAV Dias
AU - PTC Jardim
AU - AJ Grande
AU - X Zourntos
AU - J Murdoch
AU - R Gibson
AU - SG Anderson
AU - S Harding
AU - D Parmar
AU - PG Emilio
AU - VT Cappellari
AU - E Ribeiro
AU - R Emmanuel
AU - A Abdulkadri
AU - P Dazzan
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.318
UR - https://doi.org/10.1093/eurpub/ckag169.318
AB - WHO’s mhGAP provides evidence-based guidance for mental health care in non-specialist settings, but its biomedical orientation does not reflect Indigenous cosmologies, languages, developmental expectations or collective care systems. In Brazil, Indigenous adolescents experience mental health challenges shaped by territorial insecurity, cultural disruption, structural violence and limited access to culturally safe services. This presentation discusses a participatory intercultural adaptation of mhGAP for Kaingang adolescents in the Guarita Territory. Participatory action research was informed by reflexive deliberation, contextual grounding, epistemic negotiation and ethical power-sharing. An Intercultural Mental Health Team of Indigenous and non-Indigenous health workers, traditional specialists, educators, leaders and researchers co-led the process. Data were generated through discussion groups with 161 participants, interviews with traditional healers and analysis of Indigenous mental health guidance. Indigenous collaborators led interpretation and member checking to ensure cultural validity and protect sensitive knowledge. Mental health was framed through good living, linking body, mind, community, territory and spirituality. Traditional healers, elders, families, schools and Indigenous Health Agents were identified as central actors in care, alongside biomedical services. The adaptation highlighted the need to distinguish spiritual experiences from clinical symptoms, avoid pathologising culture, and address structural violence, cultural disruption and collective suffering. The process informed an intercultural guide integrating Kaingang epistemologies with mhGAP. The presentation will show how cultural adaptation can become an ethical and political process of shared decision-making, rather than a technical exercise, offering transferable lessons for culturally safe mental health care in Indigenous communities.
SN - 1101-1262
SN - 1464-360X
ER -