Integrating mental health in oncology a scoping review of barriers, facilitators, and innovative strategies

Introduction: Psychological distress in cancer is common and linked to poorer adherence, higher utilization, and worse outcomes, making mental health integration a core component of effective oncology care. Methods: We completed a PRISMA-ScR/JBI-guided scoping review (OSF preregistered) of peer-reviewed studies (2011–2025; English/Scandinavian) searched in PubMed, CINAHL, MEDLINE, PsycINFO, and Web of Science. PCC eligibility included adults with cancer/survivors, caregivers, and oncology professionals; data were synthesized using inductive thematic synthesis supported by Covidence and NVivo. Results: Twenty-eight studies were included. Five themes emerged: persistent distress across survivorship; structural, cultural and attitudinal barriers to service use; impacts on guideline-concordant care, adherence, utilization and survival; caregiver burden; and digital/innovative interventions. Discussion: Integrated models should embed routine screening, clinician-initiated pathways, culturally tailored supports, and hybrid digital services, alongside sustainable implementation outputs to reduce inequities and improve outcomes in practice.