Effective mental health treatment, particularly with Indigenous populations, requires acknowledging the socio cultural and spiritual factors that shape individuals’ experiences and influence their understanding of illness and healing. This chapter examines the cultural determinants of mental health, focusing on Indigenous communities, and draws on insights from two “trawuns” (discussions) with Mapuche communities in southern Chile. These discussions reveal beliefs about well-being, health, and illness that influence the perception and significance of suicidal behaviors. To illustrate these concepts, the chapter presents a clinical case of a Mapuche female with bipolar disorder, analyzing how the tension between Christian and Mapuche worldviews affects both treatment and outcomes. Finally, it emphasizes the importance of collaborating with Indigenous spiritual guides and integrating traditional and spiritual practices into conventional mental health approaches to enhance their effectiveness.