Intercultural pathways to indigenous mental health: the integration of ayahuasca in community care in the Yaqui intercultural medicine clinic in Sonora, Mexico

Background: Indigenous peoples experience substantial mental health and substance use disparities while remaining underserved by conventional healthcare systems. Despite growing evidence for psychedelic-assisted therapies, Indigenous knowledge systems and Indigenous-led models of psychedelic care remain underrepresented. This paper describes the establishment and implementation of the Yaqui Intercultural Medicine Clinic in Sonora, Mexico, an Indigenous-led, community-based program integrating ayahuasca within an intercultural therapeutic framework.

Methods: We present a community case study documenting the development, therapeutic model, implementation processes, and lessons learned from the clinic. The program was developed collaboratively by Yaqui traditional authorities, local healthcare workers, Indigenous medicine practitioners, psychotherapists, and external partners. Care combined individual and group psychotherapy, ceremonial ayahuasca, sweat lodge rituals, family and community engagement, peer support, and culturally grounded activities including Yaqui language, music, dance, and land-based practices. A naturalistic mixed-methods research protocol was implemented alongside clinical care to assess safety and therapeutic outcomes. The clinic provided care to 130 patients; psychometric outcomes from 37 patients have been reported previously.

Results: The implementation experience demonstrates the feasibility of culturally adapted psychedelic-assisted care within Indigenous territory when grounded in community ownership and collaboration between Indigenous and biomedical knowledge systems. Key facilitators included endorsement by traditional authorities, locally embedded staff, family and community involvement, continuous intercultural training, and intertribal knowledge exchange. The program developed multiple pathways into care and extended its focus beyond symptom reduction and abstinence toward psychosocial functioning, cultural identity, community participation, and collective wellbeing. Implementation was nevertheless constrained by geographic isolation, limited resources, workforce limitations, and legal uncertainty surrounding ayahuasca.

Conclusion: The Yaqui Intercultural Medicine Clinic provides a rare example of Indigenous-led, community-based psychedelic care embedded within a broader intercultural mental health approach. To address mental health in Indigenous communities, models of care including use of psychedelic medicines requires revitalisation of Indigenous knowledge systems, authority over healthcare practices, and the right of communities to define their own pathways to healing. The case study therefore illustrates an alternative to therapeutic innovation largely situated within Western biomedical institutions, and calls for greater attention to Indigenous sovereignty, reciprocity, and historical and contemporary inequities.