Mental health issues among indigenous communities and the role of traditional medicine

Abstract

Introduction: Mental health in indigenous communities is a relevant issue for the World Health Organization (WHO). These communities are supposed to live in a pure, clean and intact environment. Their real condition is far different from the imaginary; they are vulnerable populations living in difficult areas, exposed to pollution, located far from the health services, exposed to several market operations conducted to extract natural resources, facing criminal groups or illegal exploitation of land resources. These factors may have an impact on mental health of indigenous population. Methods: We reviewed all papers available on PubMed, EMBASE and The Cochrane Library until December 2018. We focused on those factors affecting the changes from a traditional to a post-modern society and reviewed data available on stress-related issues, mental distress affecting indigenous/aboriginal communities and the role of Traditional Medicine (TM). We reviewed articles from different countries hosting indigenous communities. Results: The incidence of mental distress and related phenomena (e.g. collective suicide, alcoholism and violence) among indigenous populations is affected by political and socio-economic variables. The mental health of these populations is poorly studied and described even if mental illness indicators are somewhat alarming. TM still seems to have a role in supporting affected people and may reduce deficiencies due to poor access to medical insurance/coverage, psychiatry and psychotherapy. It would be helpful to combine TM and modern medicine in a healthcare model to face indigenous populations’ health needs. Conclusion: This review confirms the impact of societal changes, environmental threats and exploitation of natural resources on the mental health of indigenous populations. Global Mental Health needs to deal with the health needs of indigenous populations as well as psychiatry needs to develop new categories to describe psychopathology related to social variance as recently proposed by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5).

The Impact of Climate Change on Mental Health: A Systematic Descriptive Review

“…A striking example is the traditional native populations. Different studies have considered the effect of climate change on native communities (such as first nations and aborigines), highlighting aspects of vulnerability and resilience (144,145). Among these populations, the elderly is a clear example of difficulty in re-adaptation.…”

Human Responses and Adaptation in a Changing Climate: A Framework Integrating Biological, Psychological, and Behavioural Aspects

“…Particular attention should be given to indigenous communities because they are exposed to more than one factor of vulnerability [ 56 , 70 , 71 ] and offer a striking example of coping difficulties [ 51 , 53 , 72 ]. They are often located in geographically peripheral and vulnerable regions [ 73 ] (such as the Arctic [ 74 ], but also Africa due to the strong effects of climate change and low adaptive capacity, small islands due to stronger storms and rising sea levels, Asian and African mega deltas, which are densely populated, often with vulnerability to a rise in sea level and low adaptive capacity [ 68 ]), several communities face ethnic discrimination, racism, prejudice, bullying, disempowerment [ 75 , 76 , 77 ], and grief associated with the loss of homelands and their traditional way of life. Vulnerability stems from colonial intrusion into a traditional lifestyle, rapid modernization, and cultural assimilation policies, which cause a loss of traditional knowledge and limit traditional adaptation strategies [ 78 , 79 ].…”

Anxiety and depression in two indigenous communities in Bangladesh

“…The extent of mental health issues in indigenous communities and the extent to which mental illness indicators are a real concern (referred to by Cianconi et al ., 2019 , as ‘alarming’) are to be contrasted with the limited mental health resources available to such communities. There has to be a concern that there has been a failure to recognise the needs of such communities or that known needs have been ignored, but one also has to acknowledge the challenge faced by governments such as those in Bangladesh where there are only 220 psychiatrists and 50 clinical psychologists for a population of 163 million (Alam et al ., 2020 ), and indigenous people are primarily found in remote areas with a weak communications and transport infrastructure.…”