Table 4. Central Components and Subthemes, Focus Groups .

Main Themes/Categories	Specific Subtopics/Recommendations for Route Construction
Meanings of mental health or spiritual harmony	Spiritual and mental harmony • Seek a spiritual balance with thoughts, emotions and actions. • Support and healing from Indigenous knowledge. Care and protective environment • Have a safe environment where permanent and sensitive care is taken. Supportive and understanding environment • Promote support, accompaniment, understanding, active listening, and empathetic communication in different spaces of life, mainly at home, in the community and at school. Mental health and wellness education • Adapt education to the needs of the community, the educational sector, the labor sector, the government sector, and other cooperating institutions. Basic needs guarantee • Have coverage of fundamental needs such as housing, services, food, education, and employment. Influence of the environment • Recognize the impact on mental health of the environment, including factors such as coexistence, living space and the environment and link them in understanding and addressing mental health. Importance of recreational spaces • Recognize recreational, sports and cultural spaces as settings to maintain mental health. Development of capabilities and opportunities • Enable the development and strengthening of skills in an environment that provides opportunities.
Barriers	Barriers to care • Difficulty accessing mental health resources and professionals. • Socioeconomic barriers that affect adequate care. • Delays on the part of health and administrative institutions to provide mental healthcare. • Lack of implementation of early attention services. Stigma, fear and shame • Public stigma and discrimination. • Self-stigma that prevents the search for support. Lack of intersectorality • Lack of coordination between the educational and health sectors, mainly. • Difficulties in communication between different entities. • Presence of limited and isolated actions. Lack of knowledge • Lack of mental health education. • Lack of knowledge of mental health programs and routes. • Lack of knowledge of the existence of support groups or other social resources. Socioeconomic factors • Economic conditions that prevent the guarantee of basic conditions of well-being and that hinder the maintenance of mental health or the seeking of care. • Unemployment and lack of job opportunities. Cultural challenges • Little contextualized approaches. • Difficulties in communication with Indigenous communities. • Little knowledge of cultural traditions in Western care.
Recommendations	Improvement in mental healthcare • Strengthening mental health resources and services. • Reduction of socioeconomic barriers for more equitable care. • Improvement of continuing professional education processes in mental health for low complexity levels of care. • Establishment of continuous mental health monitoring processes. • Implementation of early attention services. Integration of the approach of Indigenous communities with the Western approach • Coordination of the worldview of Indigenous peoples with Western practices. • Intersectoral integration for the recognition of different needs. Stigma reduction • Contextualized and culturally appropriate stigma reduction educational programs. • Promoting safe and supportive environments for seeking help. Intersectoral Coordination • Designation and strengthening of meeting spaces between the different sectors where responsibilities are agreed. • Improvement in coordination between the educational and health sectors, making use of other social and institutional resources that are required. • Establishment of clear communication protocols between entities. Education and awareness • Establishment of educational programs on mental health at the community level differentiated by age groups, with special emphasis on the education of families as adequate care, upbringing and support environments. • Mental health awareness and education in educational institutions and workplaces. Family and community support • Strengthening the family and community support network through the promotion of support groups. • Involvement of community leaders in the entire promotion, prevention, care, and monitoring process. Culturally appropriate and sensitive interventions • Development of interventions contextualized and sensitized to cultural diversity. • Training of health professionals in cultural competence. Strengthening working and educational conditions • Coordination of employment and educational opportunities. • Linking work environments in mental healthcare strategies. Holistic approach and public mental health • Development of broad and comprehensive approaches that address mental health from its foundations. • Care programs that promote emotional well-being from an early age in all environments.