Conceptions of Mental Health and Well-being in the Indigenous Wiwa Community of Colombia

Abstract

Background: Indigenous populations worldwide face disproportionately high rates of suicide and mental health challenges. In Colombia, these issues are intensified by poverty, armed conflict, territorial exploitation, and limited access to culturally appropriate care. To address this issue, the Indigenous communities and the Colombian government developed the Guidelines for the Care of the Spiritual and Mental Harmonies of Indigenous Peoples and Communities. However, the Indigenous Wiwa community was not included in this process, and their perspectives on mental health remain largely unexplored. Methods: This qualitative, exploratory study aimed to understand how members of the Wiwa community who live in Kemakumake conceptualize mental health. Data was collected using a combination of photovoice, semi-structured interviews, and participant observation, prioritizing voices of the participants. Thirteen participants (11 community members and 2 community health providers) were recruited through snowball sampling to explore culturally grounded perspectives on mental health and well-being. An inductive thematic analysis was carried out using Dedoose software. Results: One main theme emerged from the photovoice process: “Madre Tierra as a foundation for wellbeing and the importance of cultural preservation”. Participants emphasized nature, sacred sites, and traditional practices as central to health. Three additional themes emerged from interviews and observation: (1) Ruama Sunica: Health from Thought, Body, Nature, and Spirituality; (2) Healing Through Tradition: The Role of the Mamo (spiritual leader) and Ancestral Practices; (3) Sources of Imbalance: Environmental Harm, Western Influences, and Marital Issues. Findings highlight the Wiwa’s holistic and relational understanding of mental health, centered on cultural identity, spirituality, and harmony with the environment. Conclusion: This study affirms the Wiwa’s holistic conception of mental health as rooted in spirituality, collective life, and harmony with nature. It highlights challenges between intercultural policy and Indigenous autonomy, particularly in remote contexts. Climate change and Western influence impacts emerge as urgent. Participatory, culturally grounded methodologies proved essential for ethical knowledge co-creation and decolonial inquiry.