Abstract
BACKGROUND: This study investigates the complex inter-relations among mental health, food security and climate anxiety in the Emberá-Dobidá paediatric Indigenous community in Caldas, Colombia. Although the community was displaced due to armed conflict, our focus is on the subsequent environmental changes driven by climate change that have emerged as independent stressors in the new territory. These stressors have compounded the community's vulnerabilities, with particular impacts on children and youth. By framing territory not merely as geographic space but as a sociocultural and symbolic construct, the study adopts a Latin American critical perspective to analyse health disparities. METHODS: A mixed-methods study was conducted involving the paediatric population aged 6-16 years (n=40) from the Emberá-Dobidá Indigenous community, along with 65 caregivers representing 25 families. In-depth interviews explored community perceptions of environmental changes, food security and mental health. A cross-sectional correlational analysis used two culturally adapted instruments, the Pediatric Assessment of Community Emotional and Spiritual Health Scale and the Colombian Household Food Security Scale, to assess paediatric mental health and food security. RESULTS: Qualitative findings revealed two key themes: 'Increased Heat in Recent Years' and 'Disconnection from Water and Cultural Identity'. Quantitative results showed significant correlations between food insecurity, spiritual disharmony and mental health problems, including emotional distress and suicide risk. Notably, 30% of children were at risk of suicide, and 50% exhibited emotional problems. The findings demonstrate that environmental degradation and disrupted territorial ties are not only ecological but also psychological and cultural stressors. CONCLUSIONS: Mental health in Indigenous communities, understood as spiritual harmony, must be addressed through culturally grounded approaches that integrate traditional ecological knowledge, food security and the recovery of territorial connection. From a Latin American perspective, territory is not a passive backdrop but an active determinant of health shaped by power, memory and resistance. Our findings call for climate-resilient, community-driven interventions that reterritorialise public health responses in Indigenous settings.