Justice, Decolonisation, and Planetary Well-Being

Epistemic injustice refers to the systematic discrediting, silencing, and/or total erasure of marginalised groups’ knowledge systems, particularly within mental health systems or frameworks shaped by colonial ideologies (Côté 2024, 456). Western-centric models, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) typically prioritise Euro-American interpretations of distress or symptoms while erasing culturally specific expressions of trauma, hope and resilience (Côté 2024, 460; Hosny 2024; Redvers et al. 2024). For instance, somatic symptom distress caused by climate disasters may be misdiagnosed as ‘generalised anxiety disorder (GAD)’ rather than being contextualised within systemic oppression, climate change, or ecological collapse (Pitron et al. 2024). 

This reflects a broader pattern, tied to the rise of Western scientific paradigms, of separating culture from biology in our understanding of knowledge (epistemology) and life (biology) (Chakravarty 2015, 200).

These injustices can vary in many forms, and may include: 

1. Testimonial Injustice 
2. Hermeneutical Injustice 
3. Epistemicide 

Testimonial injustice happens when someone isn’t believed or taken seriously because of stereotypes about their identity like race or gender, and this can occur in two ways: (1) intentionally (e.g., gaslighting, where someone deliberately manipulates others to doubt you) or (2) unintentionally (e.g., unconscious bias, where someone misjudges you without realizing it) (Abramson 2014, 5; Langton 2010, 462). The problem with unintentional cases is that they’re invisible, and since the person causing harm isn’t aware of their bias, it’s hard to prove or address, leaving victims struggling to be heard (Arcila-Valenzuela 2024, 587). 

When 18th-century society dismissed women’s mental anguish as “inherent frailty” instead of recognising it as a consequence of systemic male oppression, it perpetrated testimonial injustice. Women’s accounts of suffering were discredited, while being attributed to biological weakness or sentimental tropes (like the “love-mad maid”), rather than seen as valid critiques of patriarchal harm. This silenced their voices and shielded male accountability (Weiss 2024).  

Hermeneutical injustice, as defined by Fricker (2017), occurs when systemic inequalities prevent marginalized groups from accessing the shared language or concepts needed to fully understand and communicate their experiences. For example, survivors of abuse may have lacked the term “gaslighting” to describe manipulative tactics before it entered mainstream discourse—leaving their suffering misunderstood or ignored due to a gap in collective understanding shaped by power imbalances. Similarly, the absence of DSM-5 codes for ecological grief, such as anguish over environmental loss, leaves disadvantaged and underserved populations displaced by rising sea levels without access to culturally relevant care (Ágoston et al. 2022). 

Epistemicide refers to the intentional suppression and erasure of Indigenous and colonised knowledge systems, driven by colonial ideologies that prioritise Euro-Western perspectives as the only valid form of knowledge. This process entrenches power in dominant groups (often white, male, and patriarchal), devalues other ways of knowing, and perpetuates systemic inequities like racism and health disparities. It dismisses marginalised worldviews, deepens oppression, and obstructs meaningful solutions to justice and well-being in the affected communities (Redvers et al. 2024). A critical example of epistemicide is the destruction of Indigenous knowledge through colonisation, which broke the deep bond between health and nature by replacing holistic, land-connected healing with systems that ignore this relationship—ultimately harming well-being (Deranger 2022).  

These examples illustrate how epistemic injustice fuels a feedback loop where environmental degradation harms mental health, and the exclusion of marginalised groups and Indigenous knowledge prevents sustainable solutions. 

Looking Beyond the Western Gaze

Decolonising mental health requires dismantling colonial legacies in research, education, and care delivery. This process must centre on Indigenous cosmologies that view individual and Planetary Health as interdependent. 

Centring Indigenous and Local Knowledge

Indigenous healing practices offer sustainable alternatives to Western models. The Māori whānau ora framework in Aotearoa/New Zealand prioritises collective well-being and land-based rituals (Reweti 2023). This approach aligns with the Inuit concept of Inuit Qaujimajatuqangit, which integrates environmental stewardship into mental health care (Akearok 2023). 

Current suicide prevention approaches often overlook how colonialism and cultural loss contribute to Indigenous suffering, reducing complex struggles to individual mental health issues. We must centre Indigenous knowledge, which means shifting from clinical, isolated interventions to community-led healing that honours cultural practices, addresses collective trauma, and empowers families and traditions as the foundation of care. This transforms prevention into a process of reclaiming cultural strength and shared healing, not just treating symptoms (Wexler 2012).

Cultural humility is a commitment to being open and willing to learn from people who come from different backgrounds. It’s about recognising that we don’t know everything, especially about other cultures, and being humble enough to listen and reflect. Instead of assuming or judging, we stay curious, check our own biases, and respect others’ experiences. This approach helps build trust, foster equal relationships, and provide better care or support for everyone. It’s not something we do once; it’s a lifelong habit of learning and growing (Foronda et al. 2016). 

In Australia, Aboriginal and Torres Strait Islander Health Workers and Liason Officers show how cultural humility can be put into action. They support patients not only medically but also emotionally and culturally by listening deeply, advocating for their needs and helping hospital teams understand what respectful care looks like. Methods like Dadirri, a form of deep listening that is rooted in Aboriginal knowledge, are central to this. These approaches can help improve health outcomes and build trust between communities and health care providers (Wilson et al. 2022). Another example is Native American healers in the United States Southwest who collaborate with psychiatrists to treat “historical trauma” through ceremonies that reconnect individuals to sacred landscapes (Parker 2013).  

Redefining Research Priorities

The Shared Decision-Making (SDM) model demonstrates that involving patients in study design increases intervention efficacy, particularly for underserved and marginalised groups (Durand et al. 2014). 

Decolonised methodologies have identified climate anxiety as a leading mental health concern among Indigenous youths, a finding absent in Western-led studies. However, only a small fraction of global mental health funding supports community-led research, therefore further perpetuating epistemic hierarchies.

Colonial epidemic has brought about the annihilation of Indigenous knowledge, which has severed humanity’s relationship with the Earth, and worsened both ecological and mental health crises.  

80-90% of the world’s biodiversity is stewarded by Indigenous Peoples, yet their exclusion from climate policymaking has accelerated ecosystem collapse (Mulrennan and Bussueres 2020). Despite contributing significantly less to global carbon emissions (Brasche 2023), the Global South bears a disproportionate share of climate-related mental health burdens, from drought-induced displacement in Somalia to pollution-related trauma in the Sahel. 

The Land as Healer

Land dispossession is a mental health emergency. It profoundly undermines mental health across Indigenous contexts. In Canada, First Nations people face suicide rates three times higher than non‑Indigenous Canadians, with systematic reviews linking industrial land loss, including mining, to negative mental health outcomes. In Kenya, forced evictions of the Sengwer from the Embobut Forest have precipitated widespread psychological distress, although robust epidemiological data on the exact changes in prevalence remain lacking (Ninomiya et al. 2023; Forest Peoples Programme 2024). 

The loss of ancestral lands, such as the forced relocation of the Ogoni people in Nigeria due to oil extraction, has also been linked to a rise in post-traumatic stress disorder (PTSD) rates (Agbonifo 2009). 

Climate Justice in Mental Health Justice

Mental health advocacy must align with climate justice movements, addressing root causes like fossil fuel extraction; deforestation and land-use change; livestock enteric fermentation; fertiliser application in rice paddies; and industrial processes and waste.  

The #StopLine3 movement, led by the Anishinaabe people in Minnesota, USA, helps bring to light the deep interconnection between Indigenous land rights, environmental justice, and community mental health. This also highlights how threats to ancestral lands and water bodies can cause psychological distress and cultural trauma. Similarly, the Singida Nutrition and Agroecology Project (SNAP-Tz) in Tanzania, which integrated sustainable agriculture, nutrition education, and gender equity, led to a reduction in maternal depression among participants (Cetrone et al. 2021). This improvement was attributed to enhanced food security, peer support, and increased community engagement. Another example is Nepal’s Mental Health initiative, which integrates livelihood support, such as farming and animal husbandry, into mental health programs for survivors of torture in western Nepal. This led to significant improvements in mental health outcomes, including reductions in depression, anxiety, and PTSD symptoms. Participants reported improved social relationships, economic status, and autonomy, demonstrating the positive impact of combining psychosocial support with agroecological practices (Khanal et al. 2024).  

These examples emphasise the need to frame climate action as a mental health intervention.

Way Forward Towards Democratizing Power and Knowledge

True health equity demands that we confront colonial histories and embrace anti‑oppressive practices in every aspect of care. This can be achieved through initiatives like the Two‑Eyed Seeing program, where medical students learn directly from Indigenous healers and clinicians discover the value of listening as much as prescribing, or by integrating scientific cosmologies into therapist training. 

We also need to shift policy to direct resources into community‑led programs and include patients in governance, which will help rebuild trust and ensure services reach those who have long been sidelined.  

On the ground, the peer‑run crisis centres model proves that recovery flourishes when support is rooted in empathy and shared experience, and online movements such as #DecoloniseMentalHealth show how amplifying Indigenous voices can reshape national conversations around well‑being. Together, these efforts remind us that genuine healing springs from partnerships grounded in respect, cultural understanding, and the stories people carry.

To create an equitable mental health system, we must first open our ears and hearts to the people we aim to serve, inviting their experiences and ideas to shape every decision we make. We have to invest time and resources into building genuine partnerships, showing up in communities, learning their languages and traditions, and standing by them long after the funding ends. We must question the rules and routines that leave so many behind, rewriting policies so that everyone, no matter their background or ZIP code, can find care that feels safe and makes sense. And if we hold the keys to power, it’s our responsibility to hand them over, trusting that lived experience can guide the path forward. Only by walking beside each other, sharing authority, and honouring each person’s story can we incorporate a mental health system that truly belongs to us all. 

This also means redefining what health means by extending care beyond individual minds and bodies to include the planet that sustains us. If we are to build an inclusive system, we must address the root drivers of ecological degradation alongside mental health inequality. That includes ending extractive economies, protecting Indigenous stewardship of ecosystems, and ensuring that climate justice is incorporated into every conversation about well-being. 

Conclusion

Healing epistemic injustices will require much more than reforming systems; it demands a gaze shift. We need to centre Indigenous wisdom, democratise knowledge, and reconnect health to planetary well–being. We can develop more robust mental health systems that honour all voices.  

This is a call not only to decolonise our minds and methods, but also to re-indigenise our relationship with the Earth, understanding that planetary well-being is inseparable from mental health justice—a justice that honours the interdependence of all life and sees mental health not as separate from the Earth, but as one of its most urgent expressions.

About the Author 

Dr. Adewunmi Oluwaseun Adebayo (Seun /Shay-oon/) is a medical doctor, public health expert, and advocate for integrating health policy with innovative healthcare solutions and technology. Currently pursuing a Doctor of Public Health (DrPH) degree at the Interfaculty Initiative in Planetary Health, Nagasaki University, Japan, they have over five years of experience in healthcare delivery and global health innovation.

Their work centers on addressing the intersections of climate change, mental health, emergency preparedness, and the well-being of vulnerable populations. Driven by a passion for equitable and sustainable health systems, they are dedicated to bridging the gap between policy and practice to promote resilience and inclusivity in global health.

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