The health of populations in fragile or conflict-affected environments, including their mental health, has been of increasing interest to public health researchers as they witness and experience significant traumas. This has resulted in the study of common mental health indicators in these populations, including of depression, anxiety, and post-traumatic stress disorder (PTSD). However, most of these measures were developed and tested in Western countries, and their applicability to other populations with different lived experiences has been a matter of debate. Additionally, other interpretations of trauma as developed by or in partnership with local populations are too often overlooked in the mental health literature and discourse. These oversights not only limits our understanding of trauma, but our ability to recommend potential policy solutions that could genuinely alleviate suffering. I conduct a scoping review of the literature on alternative measures of mental health responses to conflict-related trauma. I then describe the robust literature critiquing the overt emphasis on biomedical outcomes as opposed to culturally meaningful descriptions. Looking at contexts including Peru, Cambodia, and Palestine, I identify measures that have been used across contexts that attempt to take into account the framings used by affected populations. Aside from assessing the nature of this scholarship, I also identify a common theme discussed across this literature: that overmedicalized models of mental health are not only limiting, but can obscure social and political factors that lead to widespread trauma and suffering. This prevents research done in fragile settings from being impactful in pursuing justice and genuine healing.