Next of kin involvement in mental health care services – a systematic participatory overview of evidence syntheses

BACKGROUND: The importance of the involvement of next of kin (NOK) in mental health treatment settings is widely recognized. Yet, interventions to involve NOK are not sufficiently implemented in clinical practice - a situation that the German-based collaborative-participatory research project "Involvement of Next of Kin in Psychiatric Care" (PazAng) aims to change. This overview intends to systematically collect and evaluate the existing evidence syntheses (=ES) on interventions, programs, and approaches for the involvement of NOK in the field of mental health care to create a foundation for their improved implementation in future. METHODS: The study follows a collaborative-participatory approach to ensure the grounding of the results in diverse and experiential perspectives throughout the research process. An overview of ES is conducted, focusing on the types of interventions and mental disorder for which NOK involvement has been evaluated, the types of outcomes assessed, and the inferences to be drawn on the effectiveness. RESULTS: The search identified 1340 publications of which 50 ES were included after full text screening. Interventions were heterogenous in relation to their theoretical underpinnings, components, setting, delivery format, the delivering staff, duration, and frequency. The component most assessed was psychoeducation. Outcomes varied widely, especially for the NOK involved. Overall, positive effects on both NOK and PIT were reported. CONCLUSION: The heterogeneity of NOK interventions relate to fundamental contingencies: first, to individuum-centrism of the mental health care system with a strong bias towards individualized over social-relational explanation models. Second, to a lack of research on multi-person setting interventions that also pay attention on how to renumerate and institutionally implement them in sustainable ways. PROSPERO ID: CRD42024595639.