Implementation strategies to improve primary care patients’ initiation of specialty outpatient mental health treatment: A scoping review protocol (Preprint)

Abstract

Background: Primary care settings are the most common point of contact with health professionals before suicide death. Primary care clinicians often refer individuals at risk for suicide to outpatient mental health care, but many individuals fail to connect with care following referral. The range and characteristics of implementation strategies used in primary care settings to improve the initiation of outpatient mental health treatment for adults with a history of suicidal thoughts and/or behaviors are unknown.

Objective: This scoping review aims to identify and operationalize implementation strategies used in primary care settings for adults with a history of suicidal thoughts and/or behaviors that target initiation of outpatient specialty mental health treatment.

Methods: We will follow the JBI methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). MEDLINE, CINAHL, Embase, PsycInfo, and Google Scholar will be searched for any past peer-reviewed articles published in the English language in the summer of 2024. Articles will be imported into Covidence for title and abstract screening, full-text review, and data extraction by at least two independent reviewers. Data will be analyzed and synthesized using narratives, descriptive statistics, and figures and tables. We will review studies of adults with a history of suicidal thoughts and/or behaviors presenting to primary care settings and extract implementation strategies used to improve the initiation of outpatient mental health treatment. Studies will be excluded if they were abstracts, editorials, commentaries, unpublished, or grey literature, and if they include intensive outpatient or partial hospitalization treatment.

Results: A limited search of databases occurred in the spring of 2024, the protocol was registered in the early summer of 2024, and a comprehensive search of databases occurred in June of 2024. The search produced 590 de-duplicated citations. Screening, full-text review, and data extraction will occur throughout the summer of 2024. We anticipate the scoping review will be completed in the Fall of 2025.

Conclusions: These findings will be used to improve the adoption, deployment, and sustainability of primary care practices that aim to provider greater access to mental health treatment for individuals with suicidality.

Trial Registration: Open Science Framework, https://doi.org/10.17605/OSF.IO/PXY79