“What I do not see and others see in me”: mutual aid for suicide recovery in Colombia

ABSTRACT

Purpose

In response to the rise in suicidal behaviour and the strategies to address it, community actions represent a comprehensive approach to the factors influencing this situation. The aim of this study was to analyse the influence of mutual support on the recovery of individuals who experienced suicidal behaviour and attended community mental health groups.

Methods

A qualitative study was conducted in 2023. Focus groups were used as a data collection technique, followed by thematic analysis. Participants were selected based on convenience from mutual support groups registered with the Ministry of Health of Colombia.

Results

Two main themes were identified in the thematic analysis. The first theme, “Own Reasons Through Others,” was composed of categories such as “What Others See in Me” and “The Importance of Being in the Same Boat.” The second theme was titled “The Community as a Space for Suicide Prevention,” with categories including “Human Rights for Recovery” and “What We Can Achieve Together.”

Conclusions

Pluralism, understood as the integration of diverse perspectives, is crucial for addressing complex phenomena such as mental health and community interventions. The study demonstrates how mutual aid groups and their members can generate collective and policy actions effective for managing suicidal behaviour.

Introduction

The majority of suicides occur in regions with poorer living conditions (Oquendo et al., 2024), and adverse socioeconomic conditions are associated with a higher risk of suicidal behaviour (Hawton & Pirkis, 2024). In 2016, 79% of suicides occurred in low- and middle-income countries (World Health Organization [WHO], 2023). In the current global context, societies face increasingly complex and multifaceted challenges in the realm of mental health. Suicide, in particular, emerges as a painful manifestation of human suffering that necessitates profound reflection and a broader understanding of its social and ontological context (Dowie, 2020).

Although depression at any age (Abdoli et al., 2022; Gao et al., 2022; Shorey et al., 2022), psychoactive substance use (Meurk et al., 2022), and lack of adherence to therapeutic processes (Pompili et al., 2013) have been described as factors associated with suicidal behaviour, other psychosocial variables have become more relevant, especially during and after COVID-19. These social factors have exposed and increased care and social gaps in different populations (Alegría et al., 2023; Ambrosetti et al., 2021; Tall & Biel, 2023), opening the doors to interventions that strengthen community agency beyond health service delivery settings.

Rather than viewing it merely as a fatality, it is crucial to understand suicide as an opportunity to explore suffering and the essential role of the environment in the recovery process (Gordijn & Ten Have, 2020). In this regard, pluralism becomes a fundamental perspective. This mode of thought, which acknowledges the existence of multiple ways of seeing and understanding reality, is relevant not only in practical applications (concrete dimension) but also in the theoretical development of ideas (theoretical dimension). Pluralism allows for the examination of diversity and complexity from various angles, facilitating a more comprehensive understanding of complex phenomena such as suicide (Fenton, 2018).

Community strategies for mental health recovery

The Brasilia Principles underscore the importance of establishing community-based services, such as Mutual Aid Groups (MAGs) and Support Groups, aimed at strengthening community support and promoting well-being (Patel et al., 2018). Consistent with this, recommendations for mental health recovery advocate for a human rights-based approach and an individual-centred focus (van Ginneken et al., 2021).

The community is defined as a group of individuals who share common characteristics or needs (Brunton et al., 2017). Community support is based on relationships grounded in mutual respect, cooperation, and local backing. This approach involves creating and maintaining spaces of trust and reciprocity, facilitating the achievement of both individual and collective goals aimed at improving various conditions and well-being (Frantell et al., 2019; Redvers et al., 2024). Simultaneously, community participation is understood as a process in which collaborative relationships are developed and maintained, allowing stakeholders to work together to address health-related issues (Agudelo-Hernández, Giraldo-Álvarez, et al., 2024).

This process involves building relationships based on trust and mutual support from various roles and collaborating to develop strategies, interventions, programmes, services, and policies that benefit both individuals and the group as a whole (Durrance-Bagale et al., 2022). It also encompasses identifying and understanding local needs and issues and seeking and implementing solutions through a collaborative approach that strengthens the role of communities as central actors in solution-building. This is achieved through the effective use of community resources and networks, ensuring long-term sustainability (Brunton et al., 2017; WHO, 2023).

Community strategies serve as settings for maintaining existing relationships and creating new connections between individuals. These new connections facilitate the formation of friendships and stable relationships, which form the basis of community support and solidarity (Kelly et al., 2019; Landau, 2018). It is crucial to emphasize that friendships, developed over time through shared experiences and emotional connections, are an essential component of social life. These relationships not only enhance happiness and life satisfaction but also improve quality of life by providing emotional and financial support (Demir et al., 2015). The construction of these relationships is based on reciprocity and equality, resulting in the formation of a supportive and trustworthy environment (Agudelo-Hernández, Peralta Duque, et al., 2024).

Within these organizations, the concept of emerging mutuality, referring to the process of creating new connections through reciprocity, even in the presence of individual differences. Although initial interactions often rely on similarities, community spaces also encourage engagement with diverse individuals, allowing for the exchange of values and experiences, which facilitates the formation of friendships (Campbell & Burgess, 2012). As individuals share and find common ground in community-facilitated spaces, these connections tend to strengthen reciprocity (Lauer et al., 2024).

It has been shown that the establishment of MAGs contributes to improvements in self-esteem, self-efficacy, self-management, and recovery from various mental health conditions, particularly those associated with psychoactive substances, suicide, or grief (Agudelo-Hernández & Rojas-Andrade, 2024). While most studies demonstrate a significant impact on mental health issues, it is also considered that the development of these groups promotes mental health itself (Deuter et al., 2020; Richards, 2019). The creation of support networks that accompany individuals during crises is crucial for advancing the construction of meaning and hope (Agudelo-Hernández, Peralta Duque, et al., 2024).

Mutual aid in mental health from a social ontology perspective

The meanings and understandings of health are not static or universal but are constantly created and recreated within cultural and relational contexts. This perspective leads us to consider that community interventions should not only adapt to biological realities but also to the narratives and social constructions that communities generate about suicide and mental health. Thus, solutions are not imposed from the outside but are co-constructed with the communities, respecting and enhancing their own ways of understanding and addressing these issues (Gergen, 2020).

Social ontology is an essential theoretical framework for understanding how individuals work together to form collective agents. Toumella (2016) argues that collective intentionality and group agency are fundamental for joint action, allowing individuals to coordinate and act as a coherent whole oriented towards common goals. This theoretical approach is particularly relevant in the context of community health interventions, where the focus is not only on individual action but also on how communities, viewed as collective agents, can coordinate efforts to address health issues effectively and sustainably (Toumella, 2016).

Bourdieu and Wacquant (2007) propose that social systems have a dual existence: an objective and a subjective one, with the latter being a social representation constituted by individuals. The interplay between these forms gives rise to the complete truth of the social world. It is thus not possible to separate individual meanings from community construction, and these are largely connected through a sense of communality (Bourdieu, 1999).

This suggests a social and pluralistic ontology, which explains community leadership through individual empowerment and vice versa, through the capacity for agency. This suggests a social and pluralistic ontology, which explains community leadership through individual empowerment through the capacity for agency. According to Deleuze and Guattari (2000), it is the movement that codifies, orders and structures, involving deterritorialization, reterritorialization, subversion and questioning. Therefore, agency is related to possibility and potency (Ema-López, 2004).

The term potency refers to a creative act that exceeds the given constraints to attempt to establish something unforeseen or not entirely dominated by the play of the possible—something, in a sense, impossible. Thus, we can say that potency overflows power; that is, the constraints present in a specific context-moment. Hence, agency is a relational situation that produces connections from a multiplicity regardless of heritages or descents, but through contagions, epidemics, and the wind (Deleuze & Guattari, 2000). Agency generates new connections, moving beyond concepts such as subject and structure, leading to a social and pluralistic ontology, where an individual influences and mobilizes others indirectly.

Giddens (1986) considers that group actions facilitate conditions for change and the continuity of systems that create a union between action and structure. In other words, agency is the union of possibilities, and action is a consequence of agency, in an analytical-theoretical and non-linear sense. Thus, agency is a condition of possibility, and action is the process generated by the potentialization of acts that facilitate action, which in turn creates connections to generate possibilities and mobilize the environment or community.

The present study

Mental health interventions should not be limited to addressing individual symptoms or deficits, but rather must encompass the social and developmental contexts in which mental health challenges emerge (Gergen, 2020). This perspective aligns with the pluralistic approach advocated in qualitative research standards, emphasizing the importance of understanding participants’ lived experiences within broader societal frameworks (Levitt et al., 2018). Particularly in the field of community mental health, it is essential to examine how individuals interact with their environments and how social structures influence mental health outcomes. Community-based interventions, therefore, are pivotal in addressing the social and political determinants that extend beyond clinical treatment alone.

In this study, pluralism was considered fundamental to analysing how different perspectives and experiences interrelate to form a comprehensive understanding of mental health within community settings. Levitt et al. (2018) emphasize the significance of pluralistic and contextually grounded approaches in qualitative research, particularly when exploring complex phenomena such as mental health interventions. Community interventions offer an integrated perspective that not only takes into account medical and biological factors but also addresses the social, cultural, and political dimensions that shape the well-being of entire populations (Ardila-Sánchez & López-López, 2024). This multi-faceted approach is crucial to comprehending the intersection of mental health and social factors in a holistic manner.

Based on these principles, the present study aimed to analyse, from an ontological perspective, the influence of mutual aid on the recovery process of individuals who have experienced suicidal behaviour and participate in community mental health strategies. By focusing on the lived experiences of participants, this study sought to explore how mutual aid functions as an alternative or complementary mechanism to traditional mental health services. Thus, it was hypothesized that people who participate in mutual aid groups might find recovery mechanisms in meeting others, while at the same time providing help just by being.

The qualitative design, consistent with the standards set forth by Levitt et al. (2018), facilitates an in-depth understanding of the subjective realities of those involved, while also grounding the analysis in a broader social and cultural context. Through this lens, the research contributes to a deeper understanding of mutual aid as a community-driven, pluralistic intervention in mental health recovery.

Materials and methods

Study design

This study adopted a qualitative research design to explore the subjective realities and lived experiences of participants in their social and cultural contexts. Qualitative methods are particularly well-suited for examining how individuals perceive, interpret, and make sense of their environments, with a focus on the meanings they attribute to their actions and interactions. In alignment with this, the study aimed to understand how mental health is shaped within group settings by investigating shared meanings and social dynamics among participants. This approach facilitated an in-depth examination of group influences on mental health, providing rich, context-specific insights.

The study followed recommended guidelines from the Journal Article Reporting Standards (JARS) for Qualitative Research (Levitt et al., 2018), ensuring a structured approach to the research process. Focus groups were employed as the primary data collection method. This technique was chosen for its ability to generate in-depth discussion on sensitive topics, allowing participants to engage with the study’s core themes in a collaborative setting. As per JARS-Qual guidelines, detailed documentation of the recruitment, selection, and participation process was provided to ensure transparency.

Procedures included defining clear objectives, selecting participants through community leaders and mental health professionals, developing targeted probing questions based on initial participant analyses, and choosing moderators familiar with the groups. Each focus group session was conducted in locations chosen by the participants themselves to foster comfort and openness, with informed consent obtained prior to participation. This approach adhered to the principle of participant engagement emphasized by JARS, ensuring that the study respected participants’ autonomy and fostered a collaborative environment.

Focus group questions were designed to explore key aspects of group influence on mental health, such as: “How do others in the group influence your mental health?”, “How do you influence the mental health of others?”, “What aspects of the group contribute to recovery?”, and “What has the group helped you with in your daily life?” This methodology aligns with the APA’s emphasis on developing open-ended, contextually relevant questions that facilitate the co-construction of knowledge between researchers and participants.

Procedure and participants

Participants were selected based on convenience from the MAG (Support Groups) registered with the Ministry of Health of Colombia that responded to the invitation: one group in Caldas, one group in Amazonas, one group in La Guajira, and one group in Risaralda. The study was conducted during the last semester of 2023. The number of participants in each focus group is described in Table I. The recruitment process involved working with community leaders and mental health professionals to identify suitable participants.

Table I.

Focus group participants.

Group Origin	Age (average)	Additional Characteristics	Issues/Situations Addressed	Number of Focus Group Participants		Total Group Members
La Guajira	26	Indigenous community	General mental health/suicide	10	20
Risaralda	46	Productive cooperative	Violence/suicide	15	25
Caldas	28	Artistic network	Bipolar disorder/suicide	8	30
Amazonas	32	Environmental community	Multiple diagnoses/situations/suicide	5	15

Analysis

Data were analysed using thematic analysis which involves identifying, analysing and reporting patterns or themes in qualitative data following the checklist according to the consolidated COREQ criteria (Tong et al., 2007). This method involved coding the data and developing themes that reflected the experiences and perspectives of the participants. Member checking was used to validate the interpretations, which enhanced the credibility of the findings. Thematic analysis was used to systematically explore recurring themes related to the influence of group dynamics on mental health. This method allowed for the identification of nuanced themes while ensuring that the research process was clearly documented and repeatable.

Member checking was conducted to ensure that participants could review and confirm the interpretations of their contributions, thus enhancing the credibility of the findings. In addition, a triangulation approach was used to validate the themes by cross-referencing data from different participants, groups, and municipalities. This process provided a multi-faceted view of the data, improving the trustworthiness of the results.

The analysis was conducted concurrently with data collection, allowing for adjustments to the focus group questions and methodology in response to emerging themes. This iterative process is a key feature of qualitative research. Data collection continued until saturation was achieved, ensuring that no new themes or insights emerged during the final rounds of analysis. The process of reflexivity, an important aspect of qualitative research, was also incorporated. Researchers maintained a reflective journal to document how their own backgrounds and potential biases may have influenced the data collection and analysis process, ensuring a transparent account of how findings were co-constructed with participants (Braun & Clarke, 2024).

Ethical considerations

This study followed ethical guidelines consistent with the Declaration of Helsinki and was approved by the Ethics Committee under Act CB02 of 2023 from University of Manizales. Informed consent was obtained from all participants, and their confidentiality was maintained throughout the study. No identifying information was included in the data analysis or the reporting of results.

Maintaining confidentiality, respecting participant autonomy, and ensuring voluntary participation are fundamental ethical principles in qualitative research. These considerations were rigorously adhered to throughout the study, with participants regularly updated on the study’s progress and given the opportunity to withdraw at any time. This revision incorporates key elements of qualitative research methodology including transparency, participant validation, data triangulation, and the ethical considerations necessary for rigorous qualitative inquiry.

Results

Two themes were identified in the thematic analysis. The first theme was “Personal Reasons through Others,” consisting of categories such as “What Others See in Me” and “The Importance of Being on the Same Boat.” The second theme was “The Community as a Suicide Prevention Space,” with categories including “Human Rights for Recovery” and “What We Can Do Together.”

Personal reasons through others

This theme described aspects related to the characteristics of MAGs that highlight or enhance skills and abilities through group agency. Some of these capabilities or skills were framed within the concept of reasons for living. As mentioned by “N,” a young woman:

In the group, we can discover reasons for living that we had hidden, which time or pain had made us forget. In the group, we understand well what Buddhism says. There is a window that only I see, another that others and I can see, another window where what I do not see in myself and others see, and another window that no one can see. It is increasingly difficult to find someone who looks at you with the eyes of the soul to see what is hidden. In the groups, it is achieved; the reasons come to the surface. [N_03C]

Additionally, comments related to the sense of belonging, or as Toumella (2016)describes it, the feeling of being in the same boat, were noted. For example, “J,” a young man, mentioned:

We do not know what to do if we are alone, but in the group, you ask yourself, what would such a person do if this happened to them, and the answers are relieving; it is like what others leave in you that helps so much. [J_01A]

Similarly, “H,” an adult woman, stated:

When loneliness or anxiety comes, the group appears as comfort, the group and the faces of each person … Imagining or remembering each one is simple, like any memory … But remembering or imagining the group is something different, powerful … you remember a feeling … of power, of happiness, of not being alone anymore. [H_08R]

Regarding the mechanisms through which these processes occur, “L,” a young man, noted: “We are not so different, but what is different here makes us strong. We are not different for wanting to die, as we sometimes think in silence; we are different for what we do to hide from death.” [L_06G]. To this comment, “P,” a woman from the same group, added: “Or to confront the anxiety, which is the same.” [P_05G]. “O” also mentioned: “But these differences become strong because they are not hidden; there is no reason for shame but pride in being … Unintentionally, they [other members] teach it.”

When exploring the handling of conflicting aspects within the group, the importance of having a facilitator or someone fulfilling these roles was highlighted. The group dynamics also influence conflict resolution in other social spaces. In this regard, “R,” a young woman, said:

Kindness does not always flow, we do not always want to trust, we do not always want others to trust us, but it is important to have those principles, someone to remind us that to improve, we need to trust, and that here you can trust because it is a space different from the world as it is. [R_04A]

“Na”, facilitator of the MAG in Caldas, commented: “It is important to make the group’s values effective, knowing that they exist to alleviate tensions.” [Na_08C]. “G,” a man from the same group, added: “There are tensions, of course, but the values, which are agreements, protect us from hatred, and this way of resolving problems we take with us to reality, and it helps, it is like carrying a bit of the group with you.” [G_07C]. “L,” a young woman, also mentioned: “I think tensions are allowed in the group because they can be resolved, and they help us … Unresolved problems also carry weight”. [L_01G]

The community as a suicide prevention space

This theme highlighted the characteristics of MAGs and other community actions for suicide prevention. These actions include the mobilization of human rights as an element of suicide recovery. Not only those rights related to health services and stigma but also those related to social inclusion, the right to work, education, and housing. In this regard, “M,” an adult man, mentioned:

If there is something painful in this suicide process, it is knowing that you are small in the system, that you are oppressed, that you do not belong to the system you inhabit because of sensitivity, because you do not want to accept some things, and, above all, that you cannot change it. [M_02C]

Complementing “M,” a young woman, “K,” said in the same group:

But in the group, you realize that you do not have to numb yourself to deal with the feeling of not belonging … Here you see that you can change things, that you have a voice, a voice composed of many tones. [K_04C]

Other actions carried out by the MAGs include those that go beyond therapeutic mental health and are related to mobilizing resources to address socio-political factors, especially stigma and the sense of belonging. “D,” a young man, stated:

When you attempt suicide, you are left with a mark, and it is not the scar from cutting; it is the scar of the suicide attempt, and it seems that the stigma does not allow that scar to stop hurting until you meet others who have gone through something similar, and it starts to take on different meanings, it hurts a little less. [D_02C]

“K,” a young man, added to this comment: “It is not that we have a club of suicides; we have a group that seeks respect and seeks it together, that when sadness tries to silence our voices, we all defend ourselves, from these marks that he [D] mentions, but also other difficulties.” [K_04R]. Regarding these difficulties, some members of the MAG in Risaralda mentioned: “You realize all that you can do here; I never thought I was good with plants or honey.” This comment was complemented by “M,” a female group leader: “Or for business … Here we teach each other, but we also look for ways to train ourselves with government courses and programs … The idea is that every woman who joins the group can start her own business”. [M_02R]

At this point, the possibility created by community actions to mobilize social and political resources is noted. As mentioned by “S,” a young woman from the rural cooperative: “We already know how and where to seek help when what we need is more than psychiatric appointments.” [S_04C]. Or as described by “Me”, a woman from the same group: “We know how to handle emotions better; we learned it together, but we also know how to manage the resources we have, and all that is needed to want to live.” [Me_04R]. Regarding political mobilization, “Z,” a young woman, described:

One has life knowledge, then when one becomes ill, one acquires knowledge from the doctor on how to get better, but that is not enough, apparently … In the group, one realizes that to improve mental health, medical knowledge is not enough; one needs to know what rights one has, how to assert them, in addition to knowledge from others, about mental health and life in general. [Z_07G]

To this, “H,” a young man, added: “It improved me to know that I could decide about my life, and that if I needed advice, I could choose whom and when to ask for it.” [H_04A]. “L,” a young woman, also described: “The advice might be the same, but when it is given by someone who inspires confidence, a peer, for example, it is heard.” [L_01G]. “M” also added:

There is never as much wisdom as in the advice of a friend. Wisdom may need mutual trust and wisdom. Health services have knowledge on one side that does not become wisdom; for that, a life where knowledge is applied is needed, and that is what we have in the group that is not found in a consulting room. [M_02C]

Discussion

In light of the growing increase in suicidal behaviour and its association with social and political factors, community actions such as MAG play a crucial role in mental health. These groups provide ongoing support and facilitate relationships that can lead to profound transformations both at the individual and collective levels. This study aimed to analyse the influence of mutual support on the recovery of individuals who have experienced suicidal behaviour and participate in these peer support strategies, addressing the topic from an ontological framework. The hypothesis initially proposed is confirmed, since it is found that the experience of others and one’s own, in a scenario of trust, could be central elements of recovery from suicidal behaviour.

This study reaffirms that MAGs are conducive environments for fostering commonality and strengthening the sense of community. These groups not only contribute to psychological well-being through the enhancement of socio-emotional skills and the dissemination of mental health information but also serve as platforms for recognizing and advocating for rights. Study participants suggest that these environments have the potential to mobilize comprehensive solutions that address the understanding of suicide as a crisis requiring public and policy responses. Political action must transcend individual and pre-existing social structures, emerging as a relational and pragmatic process that produces novel effects in a specific context (Ema-López, 2004).

MAGs are essential in the field of mental health, as they offer constant support and facilitate relationships that enable significant transformations in individuals. These groups allow their members to maintain their identity and autonomy while providing support and fostering mutual empowerment (Frantell et al., 2019). Additionally, they function as political devices by providing opportunities for participation and agency over their own lives and environments (Agudelo-Hernández & Rojas-Andrade, 2024).

Community support is based on mutual recognition and often develops in spaces that create a sense of community, whether in geographic settings or in groups created for specific purposes such as participation in health decisions. The social infrastructure, composed of the physical structures of communities, is crucial for creating platforms that facilitate both individual and collective development. These platforms not only guide interaction but also strengthen interpersonal relationships (Klinenberg, 2018; Lauer et al., 2024).

In this context, agency is understood as a relational capacity that goes beyond individual action, constituting a shared force that allows for modifications both in contextual and normative aspects. In the focused groups, agency is conceptualized as an emergent outcome of relationships rather than a property of the individual, allowing for the establishment of individual responsibilities within the framework of collective action (Gergen, 2020). Mutual aid is seen as a process of creating connections and possibilities (Frantell et al., 2019).

From a biopolitical perspective, suicide can be understood as an extreme reaction to a system that not only regulates life but can also generate intolerable conditions of existence (Dowie, 2020). This perspective highlights the importance of recognizing the political nature of acts of desperation and adopting an approach that challenges the social and political structures perpetuating the cycle of hopelessness and marginalization (Cañón Buitrago, 2021).

Relational community engagement is presented as a key strategy for addressing the social determinants of health and improving outcomes in mental health interventions. Townsend (2013) emphasizes that the ability of groups to function as coherent and goal-oriented agents is crucial for the success of community interventions. This reinforces the idea that community engagement involves not only the participation of individuals in isolation but the promotion of collective action that allows communities to effectively act in the promotion of their health and well-being (Townsend, 2013).

Through community actions, individuals can redefine their relationship with power structures that attempt to control and manage their lives (Ema-López, 2004). These actions not only aim to prevent suicide but also to create spaces of mutual support and solidarity, where individual and collective experiences of suffering are valued (Redvers, 2024). Toumella (2016) describes this process as the “we mode,” where activities and states have an ontologically individualistic characteristic but occur through the real interaction of individuals in a tangible world. It follows that social systems, as interconnected structures formed by individuals and their interrelations, are ontologically emergent. This form of community agency is evidenced in the groups, where the mobilization of individual skills and knowledge through contact and relationships with others is observed. Participants highlight “the group and the faces of each person” as a reflection of this collective dynamic.

This relational dynamic is manifested in what Badiou (2004) calls the agency of possibilities, where joint action becomes a process of creation rather than simply the production of a social phenomenon. This process becomes a political manifestation encompassing a wide range of representations, such as bodily and symbolic agency, beyond the subject and its interaction (Agudelo-Hernández, Peralta Duque, et al., 2024). Lazzarato (2018) refers to this phenomenon as an “Event.”

An Event does not resolve a problem but opens new possibilities, exploring and enhancing aspects of each person through the experience in the interviewed groups. This ontology of multiplicity surpasses a dichotomous and deterministic view of mental health, constructing from the void, not as absence but as a shared space where new ways of being for or against can emerge, pointing to the unbearable aspects of an era. According to Lazzarato (2018):

A new mix of bodies (a new possible relationship of the collective being expressed in new modalities of decision-making, definition, objectives, etc.) and new expressions, of which the statement “another world is possible” is one result. What is expressed does not describe or represent bodies, but manifests a new existence, whose effectiveness is measured by the becoming of the bodies that this existence makes actual.

(p. 11)

Limitations

Limitations of the study include the convenience sampling, given the participants’ prior knowledge in mental health and human rights, and the lack of exploration of categories such as ethnic focus, other forms of violence, and rurality. Additionally, potential negative effects of participation in the groups for other individuals should be considered. It is also highlighted that other cultural aspects have not been described and that it is not authored by a person with lived experience.

Future research could address the longitudinal impact of the groups and peer relationships on suicide behaviour recovery strategies and complement with quantitative approaches. The implications of this study include an ontological approach to understanding social or community support in addressing suicidal behaviour beyond health services. This contributes to the design of precise and participatory community strategies for addressing suicide as a public issue.

Conclusion

Suicide, when considered a public issue, concerns society as a whole. In this context, MAGs emerge as conducive environments for promoting a sense of community and strengthening psychological well-being. These groups not only contribute to psychological well-being through the enhancement of socio-emotional skills and dissemination of mental health information but also serve as platforms for recognizing and advocating for other rights. MAGs have the potential to mobilize comprehensive solutions that address suicide as a crisis requiring collective interventions.

Community actions, such as peer groups, are presented as a fundamental strategy for addressing the social determinants of health and improving outcomes in mental health recovery. These actions, based on developing trust-based relationships, allow individuals to actively participate in creating strategies more aligned with their human needs, strengthening communities, and enabling them to take an active role in managing their health and well-being. Collective actions, as demonstrated in this study, go beyond the sum of individual actions, constituting a realization of human possibilities.

As implications of this study, the possible recovery mechanisms of MAGs are highlighted. These are proposed as a scenario for learning and action based on knowledge, both in mental health and rights. Therefore, these recovery scenarios as autonomous systems generate action because they acquire a strategic functioning as a basis for participants to promote their respective interests and values.

The increase in freedom, the greater perception of capabilities and better communication tools, make new ideas emerge. Mutual aid groups leave the way open for innovation, even in a political sense. These changes that arise from group experiences tend to be transmitted to other types of environments or relationships: to the family, to work, to other friends, to institutions.

Biographies

Felipe Agudelo‐Hernández MD, is a general psychiatrist and child and adolescent psychiatrist, Ph.D. in Social Sciences, Childhood and Youth. He is an advisor for the implementation of the mental health public policy in Colombia and the community‐based rehabilitation strategy. Aside from mental health services, his research interest is in mental health mutual aid groups and other community recovery efforts, especially for severe mental disorders and suicidal behaviour. He has led national risk management strategies for adolescents and children at risk of suicide, with an intercultural approach. He is a clinical professor of paediatrics at the University of Manizales. https://orcid.org/0000-0002-8356-8878

Lina Valeria Cuadrado MD, MSc in Community Mental Health. Email: linvalecupa@gmail.com, ORCID: https://orcid.org/0000-0001-6104-307X

Andrés Camilo Delgado-Reyes Psychologist, PhD in Psychology. ORCID: https://orcid.org/0000-0003-1781-808X. As research interests he points to health services and paediatric mental health. ORCID: https://orcid.org/0000-0003-4064-230X.

Funding Statement

The author(s) reported there is no funding associated with the work featured in this article.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data available on request from the authors.

Patient consent statement

Written informed consent was obtained from the parents. All participants signed the consent.