Addressing epistemic injustice in the mental healthcare of Indigenous people in Bangladesh: Implications for global mental health.

Abstract

Indigenous peoples across the world are at disproportionate risk of mental health problems. Colonial hegemony, cultural infiltration, language loss, land grabbing, limited access to healthcare services, including mental health, and geographical isolation - all in synergy - contribute to the heightened risk of developing mental health problems. Epistemic injustice, apparently unrelated, yet another major determinant - can also contribute to the higher prevalence of mental health problems among Indigenous peoples. Systemic exclusion and marginalization of Indigenous people from the generation, dissemination, and validation of knowledge - the central concept of epistemic injustice - provides an opportunity to reflect on the disproportionate rates of mental health problems. If epistemic injustice is left unaddressed, the impetus for Indigenous peoples to participate in conventional health practices would be greatly impeded. In this article, I present the case of Bangladesh, where the conventional mental healthcare system has historically been ignorant of the inclusion of Indigenous people's perspectives and lived experiences, eventually perpetuating epistemic injustice. Finally, I provide a framework to address epistemic injustices to reform mental healthcare in Bangladesh that can inform a system equipped with equitability, accessibility, cultural sensitivity, human rights, social justice, and collaborative alliance - key tenets of global mental health.