The impact of environmental challenges and social exclusion on mental health

A phenomenological study on the river gypsies of northern Bangladesh

Bibliographic Data

ID24217848
AuthorsMd Monirul Islam (0000-0001-5875-433X, Jatiya Kabi Kazi Nazrul Islam University), Nafiul Muid (Islamic University), Arpita Datta (0000-0002-5933-801X, Premier University), Sanjoy Biswas (North South University), Mostafa Kabir Siddiqui (Uttara University), Emu Datta (Premier University), Chaity Puja (Gopalganj Medical College & Hospital), Saiful Islam Sohan (New Model Degree College)
Year2026
Volume13
Publication date2026-01-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueCambridge Prisms Global Mental Health (JOURNAL)
Journal identifiersISSN: 2054-4251 • E-ISSN: 2054-4251
PublisherCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/gmh.2026.10292
OpenAlexW7214786980
LanguageEN
References cited39

Bede (“river gypsy”) communities in Bangladesh live with recurrent flooding, riverbank erosion, and displacement, alongside entrenched stigma and service exclusion, placing them at high risk of climate-related mental distress. We conducted a hermeneutic phenomenological study to examine how environmental hazards, social exclusion, and access barriers affect mental health and coping among Bede communities living along the Jamuna River in Sirajganj district. Seven in-depth interviews and one focus group discussion were carried out with adult community members. Data were analysed using reflexive thematic analysis, informed by Conservation of Resources (COR) theory, structural stigma theory, and a patient-centred access framework. Four interconnected domains were identified. First, environmental shocks and resource loss : hydro-climatic events (flooding, erosion, forced moves) triggered cumulative losses of shelter, assets, income, and schooling (hydro-climatic shocks → resource loss → demoralisation; COR loss spiral). Second, sleep disruption and persistent arousal : unsafe, damp sleeping spaces and anticipatory fear of future floods generated chronic insomnia, fatigue, and irritability (resource loss → unsafe sleep → persistent arousal). Third, gatekeeping and structural exclusion : stigmatising labels, lack of fixed address and documentation led to denial of water, exclusion from relief and social protection, and humiliating encounters in services (structural gatekeeping → disrupted ability to seek, reach and engage with care). Fourth, coping repertoires and collective strategies : prayer, quiet reflection, family pooling of resources, community solidarity, and pluralistic help-seeking from biomedical and traditional healers provided important but fragile buffers. Mental distress among Bede communities arises from the interaction of cumulative resource loss, sleep disruption and structural exclusion. Disaster-risk-reduction and health policies for mobile, climate-vulnerable populations should secure safe dry sleeping spaces, lighting, food and small assets; introduce portable ID and flexible registration; implement low-threshold, co-designed mental health and psychosocial support through outreach-based primary care; and reduce stigma at initial point of contact.

access to mental health care · Bank erosion · Conservation of resources theory · coping strategies · Disaster risk reduction · displacement · Floods · Gatekeeping · Insomnia · Jamuna River · mobile populations · Psychosocial support · resource loss · Sirajganj · sleep disruption · Social exclusion · structural stigma · Climate Change, Adaptation, Migration · Mental Health Treatment and Access · Migration, Health and Trauma

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