From innovation to adoption: barriers and facilitators to implementing digital risk assessment tools in severe mental illness - A scoping review protocol

Background Digital risk assessment tools are increasingly being developed in psychiatry to support early detection and person-centred prevention of severe mental illness (SMI). Although validation studies show promising predictive accuracy, their uptake in routine care remains limited. Evidence of implementation in real-world contexts, and the practical, ethical, and organisational factors shaping their use, is still fragmented. Objective This study aims to map and characterise existing digital risk assessment tools and models, describe their external validation and implementation-related evidence, synthesise reported barriers and facilitators to adoption, including stakeholder perspectives, review available evidence on efficiency and cost-effectiveness, and identify gaps in the literature to guide future research and implementation initiatives. Methods Following the PRISMA-ScR framework, a scoping review will be conducted, including evidence published in eight databases (PubMed, Cochrane, Scopus, SciELO, Web of Science, Lens.org/OpenAlex, PsycINFO, CINAHL). Eligible studies will include digital prognostic risk assessment tools for SMI or associated somatic comorbidities. Data extraction will cover study design, population, model type, validation strategy, and with a specific focus on implementation-related aspects (e.g. real-world testing or implementation-related evaluations, acceptability, barriers and facilitators). Results will be summarised narratively and visually to identify reported methods, key implementation findings, and evidence gaps. Ethics and Dissemination As the review uses publicly available data, ethical approval is not required. Findings will be disseminated via a peer-reviewed publication, a preprint, and scientific conferences.