Pathways to inclusion: A scoping review exploring equity, diversity, and inclusion in mental health and addictions patient navigation programs

Mental health and addictions (MHA) patient navigation programs have gained traction in recent years, helping clients overcome barriers and access suitable resources. Equity-deserving communities (EDCs) continue to experience significant disparities in MHA outcomes, due to additional systemic barriers to care. This scoping review explores the approaches and practices utilized by MHA patient navigation programs to support the unique needs of EDCs. A search was conducted in four electronic databases. Articles were required to be focused on MHA patient navigation services and EDCs (including low-income individuals, racial and ethnic minorities, members of 2SLGBTQI+ communities, people with disabilities, Indigenous Peoples, and newcomers), peer-reviewed studies, written in English, and available as full-text. Three members of the research team conducted title, abstract, and full-text screening. Extracted data underwent descriptive synthesis and thematic analysis. The database search identified 1382 unique studies, 40 of which remained for full-text review after title and abstract screening. A total of 16 studies were extracted. Four themes emerged surrounding considerations and approaches needed to appropriately support EDCs in MHA patient navigation: barriers to equitable access to MHA services, influences on equitable service utilization, supports provided by MHA navigation to address complex needs, and design and delivery of inclusive MHA navigation programs. These themes encompass important considerations for MHA navigation programs when supporting EDCs to improve reach, engagement, and outcomes. This review provides crucial information regarding equitable navigation approaches when supporting EDCs with MHA concerns, including addressing specific barriers, leveraging facilitators, and practicing cultural competence. The findings enhance the current understanding of how known benefits of MHA patient navigation services can be maximized for marginalized populations, thereby supporting advancements toward health equity.