Community Health Workers and Mental Health Among Indigenous Communities in Amazonia: A Scoping Review

Indigenous peoples in Amazonia face major mental health inequities, including high rates of suicidal behaviour among adolescents and young adults in some settings. We conducted a scoping review of the peer-reviewed literature on community health workers (CHWs) and equivalent cadres involved in Indigenous and remote contexts, with a focus on their roles in relation to mental health, psychosocial support, and suicide prevention among Indigenous populations in Amazonia and the Guiana Shield. We reported this review in line with PRISMA-ScR. Searches (September–November 2025) were conducted in PubMed/MEDLINE, Scopus, Web of Science and SciELO, complemented by targeted searches in major publisher platforms and JSTOR. We included English, French, Spanish and Portuguese publications that (i) described CHWs or functionally equivalent cadres in Indigenous/remote contexts and/or (ii) reported CHW-related roles, models, or experiences relevant to mental health, psychosocial support or suicide prevention in Amazonian settings. Global documentation of CHW designations used in Indigenous/remote contexts was compiled; we compiled evidence from Amazonia and the Guiana Shield on CHW roles, programme models, implementation conditions and reported outcomes. Data were charted into a structured template (cadre designation, setting, population, study type, functions, programme features and reported mental health/suicide-related outcomes) and synthesised descriptively and thematically. CHWs commonly function as cultural and linguistic brokers between Indigenous communities and biomedical systems, supporting early detection of distress, psychosocial accompaniment, referral navigation and dialogue with local healing practices. Reported programme models differ markedly: Brazil’s institutionalised Indigenous Health Agents (AIS) offer stability and formal recognition, whereas French Guiana relies more heavily on project-based mediation with innovative practices but greater funding fragility. The available literature remains heterogeneous and uneven across countries, with limited evaluative designs and substantial reliance on descriptive reports. Future work should prioritise stronger implementation and impact evaluation, alongside Indigenous-led governance and sustainable support for CHW cadres.