Decision-Making Support for Physical Treatment and Care of Individuals with Severe Mental Illness and Physical Comorbidities: A Scoping Review Protocol

This scoping review aims to identify and map the characteristics of decision-making support provided to individuals with severe mental illness (SMI), such as schizophrenia, bipolar disorder, or major depressive disorder, who also have physical comorbidities. Despite the increasing emphasis on shared decision-making (SDM) and supported decision-making (SDM-S) in healthcare, individuals with SMI are often excluded from treatment decisions, especially those related to physical care. These decisions are frequently complicated by psychiatric symptoms, cognitive impairments, social and family dynamics, and systemic barriers. Using the Joanna Briggs Institute’s PCC (Population, Concept, Context) framework and following the PRISMA-ScR checklist, we will conduct a comprehensive literature search in MEDLINE, CINAHL, PsycINFO, and Ichushi-Web without date restrictions. Eligible studies will include original empirical research (qualitative, quantitative, or mixed-methods) that describes decision-making support interventions related to physical treatment and care in individuals with SMI and comorbid physical illnesses (e.g., cancer, diabetes, cardiovascular diseases, COPD, pneumonia, renal failure). The review will chart the types of interventions, the supporters involved (e.g., healthcare providers, family members), the theories or conceptual frameworks used, and any reported barriers and facilitators. The findings will contribute to the understanding and future implementation of decision-making support for this vulnerable population.