Table 1 Characteristics of review articles

1: Allan et al.,

(2020). UK

To synthesize the available literature on pathways of care in At Risk Mental States or prodromal psychosis, an investigate the barriers and facilitators to receiving care for ARMS

Included English studies publish between 1985 and 2019, and the study described or related to pathways to care

The CINAHL Complete, EMBASE, Medline Complete, PsycINFO and PubMed databases were searched

Reported data came exclusively from an ARMS population

Mental health professionals, and general practitioners played a key role in help seeking. Family involvement was also found to be an important factor

2: Allen et al., (2009).UK

Identify the effectiveness of care pathways in mental health settings presented in a narrative way

Systematic review of seven randomized controlled trials published 1980–2008. Using flow chart and RCT method

Using Medline, CINAHL, Cochrane. Use three stages strategy and three stages filtering process

Seven studies from different countries with adult and child in mental health. English, Germany, and French translation was available

Care pathways are most effective in patients with predictable managing of mental symptoms to support proactive management and is more uncertain when including patients with more uncertainty in behavior. Pathways of care could also improve documentation, communication, and change professionals´ behavior in desired direction

3: Amaral et al., (2018). Brazil

Explorative systematic review to highlight evidence for each pathway stage

The review synthesized narrative for the 25 studies ranging from 1999 to 2017

LILACS; MEDLINE; SCIELO databases used to searched for paper. 25 studies included

9 quantitative and 14 qualitative and two mixed methods

In all 25 studies were from Brazil. Both patients and health personnel views were included

Complex social networks were involved in the studies and the points of first contact varied. A high proportion of patients is treated in specialized services and there is a stressing lack of integration between emergency, hospital and community

4: Anderson et al., (2010). Canada

Examine the associations between pathways of care and sex, socio economic and ethnical determinants of pathway, and duration of untreated psychosis as well as help-seeking behavior

Systematic review with inclusion of 30 papers from 1985 and 2009 in 16 countries, with both quantitative and qualitative design

Using Medline, HealthStar, EMBASE, PsycINFO databases. Then manual search in 15 journals

In all 30 studies from Australia, Asia, USA, Africa, Europa. Both patients, relatives and health personnel views were included

Found that the first contact for patients was a physician, but the referral source was emergency services. They did not find consistent results across the studies that explored the sex, socio-economic, and ethnic determinants of the pathway. More research needed to understand disparities between pathways of care and which factors that could increase patients help-seeking behavior

5: Chen et al., (2015). Canada

Evidence to improve quality and efficiency of care for patients with schizophrenia

Scoping review methods following PRISMA guidelines. Metanalysis not being done due to differences in methods in the papers

Paper from MEDLINE, PsycINFO, Health Star, EBM Review Cochrane Database. 7 focused on describing process-related data and 6 examined clinical outcomes

In all 13 papers (Hong Kong, Germany, UK) were included from 1998 to 2014. Inclusion criteria narrowed to people suffering from. schizophrenia. Both patients and health personnel views were included

Finings in three areas: Content, development, effectiveness. Pathways of care show promising results in increasing quality and efficiency for patients with a diagnosis of schizophrenia, but more evidence is needed

6: Deneckere et al. (2012). Belgium

Explore the relationship between effectiveness and how care pathways promote teamwork

Systematic review

with inclusion of 26

relevant studies

Systematic literature search strategy in three electronic

databases – MEDLINE, Embase, and CINAHL, combined with Mesh and non-Mesh terms for care pathways and teamwork

In all 26 studies used the result of an international expert panel on team indicators in care processes to identify search terms

That was frequently mentioned the need for a multidisciplinary approach and educational training sessions. Necessary conditions are a context that support teamwork and to achieve these, each care pathways requires a clearly defined team approach customized to the individual teams’needs

7: Doody et al. (2017). Ireland

Identify families’ experiences

of care planning involvement

in adult mental health services

Review was guided by a framework which is a methodological approach allowing for concurrent synthesis of qualitative and quantitative research methods

An integrative literature review where electronic databases and grey literature were searched for papers published between 2005 and 2016 from CINAHL, Scopus, Web Science, PsyInfo, MEDLINE, PsyArticles

In all 15 papers from UK, USA, Sweden, Norway, Italy, Israel met the inclusion criteria

Thematic analysis generated three themes

1: Families’ experiences and collaboration, 2: families’ perceptions of professionals and 3: families’ impressions of the care planning process. Collaborative decision-making was not regularly experienced by families, lack of communication, confidentiality constraints and a claim of ‘insider knowledge’ of service users. Care planning were perceived to be uncoordinated and their lived experiences not always appreciated

8: Durbin et al. (2012). Canada

To get evidence on the quality of information transfer between primary care physician (PCP/GP) and specialist mental health providers for referral requests and after inpatient discharge

A scoping interview of the literature was conducted to generally explore evidence of information exchange between GPs and specialists

Bibliographic academic databases were searched for the period 1995 – 2011 (MEDLINE, Embase, CINAHL, and PSYC INFO Scius and Google Scholar. Org. websides)

In all 32 paper and the librarian also explored the gray literature using sources suggested by the Cochrane Collaboration, were searched

The study showed variation in the quality of communication between GPs and mental health specialist, although care management inevitably requires collaboration among many providers to meet patients need over time. Patient-centered care, such as explaining the purpose of a consultation request to the patient, need attention, being among the least investigated in the review literature

9: Gronholm et al., (2017)

UK/Australia

Examine stigma related influences on pathways of care in each stage of the pathway in first episode psychosis

Review which included quantitative, qualitative and mixed methods studies from 1996 and 2016

CINAHL, EMBASE; Medline, PsycINFO were used. Data synthesis was conducted in three stages. First thematic analyze, was undertaken to synthesize the finding of articles reporting qualitative data. Second narrative synthesis, third stages involved a meta- synthesis

In all 40 studies. Both patients and health personnel views were included. People aged up to and including 40 years

Lack of information could result in increased perceived stigma. Patients also perceived devaluations by service providers. Perceived stigma reduction could decrease if treatment were normalized as sell as working with info to environment

10: Mutschler et al., (2019)

Canada/USA/UK

To capture and consolidate the current understanding of the experiences of individuals post-discharge who are transitioning back into their communities

Systematic review. Both quantitative and qualitative design is included

Systematic literature search, following PRISMA guidelines. Using Medline, PsycINFO, Google Scholar, HealthStar

Included 27 papers from a variety of countries

In all 27 paper were included. 18 quantitative and 9 qualitative papers. Only patient perspectives

All papers lacking patients´ experiences were excluded

Themes identified as necessary for transition were patient safety, supported autonomy, and activities in the community. Barriers were poverty, interpersonal difficulties and stigma. All pointing to the need of targeting the identified challenges

11: Neame et al. (2019). UK

Explore the effects of implementation of health information technologies in care pathways

Systematic review with inclusion of 44 papers

Systematic literature search, following PRISMA

Using Medline, EMBASE, CENTRAL. 94% reported from hospital care and treatment and 6% from community service

44 paper focused on health technology Electronic documentation. 16 were before-and-after studies,14 was noncomparative, 5 were interrupted time series studies, 4 were retrospective cohort studies, 2 were cluster randomized controlled trials, and there were 1 each of controlled before-after, prospective case–control, and prospective cohort studies

Some evidence that health information technology improving objectively measured patient outcome (mortality, patient-reported outcome measures, biochemical markers, and disease activity). More research is needed

12: Rotter et al

(2010)

Cochrane/

Germany

To assess the effect of clinical pathways on professional practice, patient outcomes, length of stay and hospital costs

Randomized controlled trials, controlled clinical trials, controlled before and after studies and interrupted time series studies comparing alone in clinical pathways with usual care as well as clinical pathways as part of a multifaceted intervention with usual care

Searched the Database of Abstracts and Reviews of effectiveness (DARE), The Effective Practice and Organization of Care Register, the Cochrane Central Register of Controlled Trials and bibliographic databases including MEDLINE, EMBASE, CINAHL, NHS EED and Global Health

In all 28 studies included. Two review authors independently screened all titles to assess eligibility and methodological quality. Studies were grouped into those comparing clinical pathways with usual care and those comparing clinical pathways as a part of a multifaceted intervention with usual care

Clinical pathways are associated with reduced in-hospital complications and improved documentation without negatively impacting on length of stay and hospital costs. (Author’s conclusions)

13: Storm et al., (2019)

Norwegian /USA

Examine effective coordination between levels of care, challenges in providing continuity of care and quality of life in the transition process

Scoping review design followed Arkey & O`Malley´s (2005) five-stage framework

CINAHL; Cochrane, Medline, PsycInfo, Google scholar was used. Systematic review with inclusion of 16 papers with qualitative and quantitative design

In all 16 paper. Both patients and health personnel views were included. Paper from USA, Japan, UK. Individual with mental illness > 8 years old

Effective approaches addressed coordination challenges and resulted in better improvements in service utilization, social functioning and quality of life. Shared decision-making support for caregivers and addressing the challenges when patients are need of complicated medication regimes

14: Viggiano et al., (2012). USA

To provide an overview of current care transition intervention frameworks and models, and to identify components suited for more effectively managing transitions among persons with mental illness

A review of intervention models identified multiple models

PubMed, Google scholar, and grouped into two categories. 1.Models that have been put forward and tested in the area of medical care.2. Information about framework, conceptual models or descriptions of care transitions intervention

In all nine papers about transitions from hospital to outpatient care. Managing transitions among persons with SMI

A core set of nine care transitions intervention components can stimulate the development of interventions that address transitions in the mental health population more effectively

15: Vigod et al., (2013). UK

To describe and evaluate interventions applied during the

transition from in-patient to out-patient care in preventing

early psychiatric readmission

Systematic review of 15 paper about transitional interventions among adults admitted to hospital with mental illness where the study. outcome was psychiatric readmission

Medline, CINAHL, EMBASE, PsycINFO and the Cochrane

Library

I all 15 papers about transition

from in-patient to out-patient care in reducing early psychiatric

readmission among adults with mental illness

Effective transitional intervention components are

feasible and likely to be cost-effective

Our results are consistent with the findings of a previous review of pre-discharge interventions in psychiatry

16: Volpe et al., (2015). Romania

Comparison of mental health pathways in 23 different countries around the world

Due to different instruments and gathering of data, the planned comparison could only be performed at a few variables. PRISMA

From MELINE, OVID, EMBASE, PSYCINFO. Reference list from 1986 to 2013 with majority of studies from 2005 and newer

A global perspective of 34 papers on psychiatric pathway. Both patients and health personnel views were included. Studies from different country and continent

Identified referral delay differences between countries with a range from Romania, Cuba, Bangladesh and Albania to 25 weeks before seeing a psychiatrist. Also, the role of a general practitioners could either decrease or increase the referral time. No direct comparison of data concerning the pathway to mental healthcare at the world level, is available yet