P-47 Participatory intercultural adaptation of the WHO mhGAP for Kaingang adolescents in Brazil: integrating indigenous knowledge and global mental health

Methods: Participatory action research developed in seven discussion groups were held in schools, community halls, homes of leaders, and craft spaces involving elders (Kofás), adolescents, teachers, artisans, health workers, and leaders (n=161). Thematic analysis followed six steps—familiarization, coding, theme generation, review, naming, and reporting and was conducted collaboratively by an intercultural mental health team that included Indigenous collaborators.

Results: Systems of care in the Kaingang territory are fundamentally collective and the Kaingang people reframes mental health through the Indigenous concept of Good Living (Bem Viver). The indigeous worldview reinforces the importance of spiritual domains and may reflect legitimate roles of traditional healers. Emotional distress is linked to identity and territory, and suicide is understood as collective suffering. As a result, culturally grounded care relies on traditional remedies, rituals, storytelling, and family- and community-based support systems. Schools, elders, and Indigenous Health Agents become central actors in recognizing, responding to, and co-managing mental health concerns.

Conclusion: The participatory intercultural adaptation of mhGAP contributes to recognise multiple forms of knowledge, including spiritual experiences and ancestral relation. Cultural interpretations can´t be considerered psychiatric symptoms within the biomedical paradigm. This study demonstrates that effective mhGAP implementation in Indigenous contexts requires more than technical adaptation—it demands intercultural collaboration, reflexive engagement, and redistribution of epistemic authority.