Continuing a critique of global mental health, this chapter brings further examples to elaborate the point that distress is not simply a biomedical issue, but located within the social, political, cultural, economic, and environment context of the individual. Whether they live in Malawi or Sri Lanka, or the UK, people draw strengths from what they know. Their traditions, cultures, and lived experiences are all contributing to their dealings with distress, even when they are falling apart. The chapter goes on to examine the alternative approaches that are emerging and argue that these are based within a development paradigm rather than within narrow biomedical approaches. Most suffering happens within poverty, disasters, and conflicts that are strongly connected to issues around development. In that, we point out that human beings are inherently capable of finding solutions when they have the freedom to develop. These might include spiritual practices, traditional medicine, religions, as well as biomedical notions of health and health care. And it is here too that opportunities for structural responses become important. Social systems, infrastructure, and relational experiences must be considered in challenging environments and systems that generate distress for people. Based on our own collaboration, and experiences with individuals and communities that are suffering through uncertainty and dangers of life, we propose a collaborative framework for insiders and outsiders to find solutions to challenges. This framework proposes some prerequisites that are important in moving beyond colonial legacies and coloniality. Trust, conformity, humility, equal participation, genuine engagement, and ownership and responsibility are all required in collaborating as equal partners. Regardless of the collaboration, whether to produce new knowledge or to find practical solutions, we argue that it is paramount to understand what works for people within their own context.