Mental health determinants, stigma, and disparities among indigenous communities in Bangladesh: A narrative review

Background Indigenous communities in Bangladesh experience substantial mental health inequities shaped by stigma, structural deprivation, and culturally unsafe care, particularly in the Chittagong Hill Tracts (CHT) and tea-garden settlements Methods We conducted a narrative review of peer-reviewed empirical studies indexed in PubMed, Scopus, Google Scholar, Google, and BanglaJOL (inception to 10 December 2025). We documented study identification and screening using a PRISMA 2020-style flow diagram for transparency (without claiming a systematic review) and synthesized findings using a socio-ecological framework (individual, interpersonal, community, and structural levels) Results Thirteen studies met inclusion. Community-based screening studies commonly reported elevated anxiety and depression (often ∼47–59%), with variability by ethnicity, setting, and measurement tool. Across studies, key determinants and barriers clustered at multiple levels: individual distress and comorbidity; interpersonal/family dynamics and gendered stigma; community-level language loss, discrimination, and explanatory models of illness; and structural constraints including geographic isolation, costs, limited services, and cultural-linguistic discordance Conclusions The evidence consistently indicates a high burden and large treatment gap. Priorities include culturally safe, community-based outreach; co-designed anti-stigma and literacy interventions; language access and cultural mediation in frontline services; and financing and governance reforms that reduce geographic and financial barriers and ethically strengthen disaggregated equity monitoring. Limitations: Evidence is dominated by cross-sectional designs, convenience sampling, and instruments with limited cultural/linguistic adaptation, constraining causal inference and generalizability.