Assessing Adherence to Preventive Behaviors Among Patients with Mental Illness in the Context of the COVID-19 Pandemic: A Scoping Review

Background: The COVID-19 pandemic has become a global public health emergency, causing substantial disruptions in societal norms and behaviors. Among the affected population, individuals with mental health disorders are particularly vulnerable, facing heightened infection rates and worse outcomes. These challenges can be linked to factors such as insufficient adherence to vaccination and other preventive measures. Objective: This study aims to investigate the literature on the adherence of individuals with mental disorders to vaccination and other preventive behaviors such as social distancing, use of face masks, and hygiene practices during the COVID-19 pandemic. Methods: This scoping review was performed following the methodological guidelines outlined by the Joanna Briggs Institute and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. A comprehensive search for published research containing original data was conducted in four databases (Embase, Medline, PsycINFO, and Web of Science). Results: The search yielded 2778 records, and 10 additional relevant papers were identified through handsearching, resulting in a total of 50 studies meeting all inclusion criteria. Most of them focused on vaccination adherence, with approximately half reporting lower adherence in the patient group, particularly among individuals with severe mental illnesses (SMIs), compared to the general population or to other control groups. However, some studies reported comparable—or, in specific psychiatric populations, even higher—levels of adherence to preventive behaviors. Out of the fifty selected studies, only four employed an interventional approach aimed at increasing preventative behaviors, but they were effective in most of the studies. Conclusions: This review underscores a noticeable lack of intervention studies employing psychoeducational strategies to mitigate risky behaviors among individuals with mental disorders. This gap emphasizes the urgent need for increased research focus in this area, as it holds promise for reshaping future approaches and strategies to address other crises within this vulnerable population.