Healthcare professionals’ perspectives on barriers and enablers to delivering chronic disease preventive care in mental health settings: a scoping review

Individuals with mental health difficulties face a higher risk of chronic disease than the general population, partly due to greater prevalence of health risk behaviours such as smoking, alcohol and drug use, physical inactivity, and poor diet. Preventive care aims to reduce this burden by addressing these modifiable behaviours. However, implementing preventive care in mental health settings is challenging due to numerous barriers. This scoping review explored healthcare professionals' perspectives on barriers and enablers to delivering preventive care, using the Theoretical Domains Framework (TDF). Four databases (Medline All, PsycINFO, CINAHL, EMBASE) and reference lists were searched. Eligible studies included qualitative, quantitative, and mixed-methods articles in English reporting healthcare professionals' perspectives on delivering preventive care for these modifiable behaviours. Forty-one studies were included. Barriers were identified across all fourteen TDF domains, 24 studies identified barriers relating to 'Social Influences' and 16 studies identified barriers relating to 'Beliefs about Consequences'. Enablers mapped to eleven domains, with four studies reporting enablers relating to 'Social Influences' and four studies reporting enablers relating to 'Knowledge.' Findings highlight the need for tailored, multilevel strategies to address barriers, strengthen implementation, and improve health outcomes for people with mental health difficulties.