Artificial intelligence systems are often presented as universal, yet their interaction paradigms remain predominantly text-first, limiting alignment with primarily oral languages and communicative practices. Using Guaraní, an official and widely spoken language of Paraguay, as a motivating case, this work examines how language support risks remaining symbolic when spoken interaction is reduced to a speech-to-text interface. We explore an oral-first, multi-agent framing in which turn-taking, repair, shared context, and governance are treated as core components of interaction rather than peripheral features. By separating language understanding from the conversation state and permission mechanisms, the architecture makes conversational structure and control explicit, enabling reasoning over interaction dynamics rather than isolated commands. Framing conversational coordination as a cognitively motivated reasoning problem over shared state connects insights from human dialogue to the design of AI systems that are more interpretable and responsive in oral and low-resource settings.

Mental health communication in India is linguistically fragmented, culturally diverse, and often underrepresented in clinical NLP. Current health ontologies and mental health resources are dominated by English or Western-centric diagnostic frameworks, leaving a gap in representing patient distress expressions in Indian languages. We propose the Cross-Lingual Graphs of Patient Distress Expressions (CL-PDE), a framework for building cross-lingual mental health ontologies through graph-based methods that capture culturally embedded expressions of distress, align them across languages, and link them with clinical terminology. Our approach addresses critical gaps in healthcare communication by grounding AI systems in culturally valid representations, enabling more inclusive and patient-centric NLP tools for mental health care in multilingual contexts.