Understanding the experience of diagnostic overshadowing associated with severe mental illness from the consumer and health professional perspective: a qualitative systematic review protocol

OBJECTIVE: The objective of this review is to identify, appraise, and synthesize available qualitative evidence related to diagnostic overshadowing in mental health consumers who present with clinical manifestations of physical illness. INTRODUCTION: A lived experience of mental illness is associated with compromised physical health and decreased life expectancy. Mental health consumers face greater barriers to accessing treatment for physical illnesses and are less likely to receive appropriate physical care than those without mental illness. Physical illnesses may go underdiagnosed and undertreated in mental health consumers because clinicians tend to focus on the mental illness to the exclusion of other health problems, a phenomenon called diagnostic overshadowing. This systematic review will combine the experiences of mental health consumers and health care professionals to gain deeper understanding of diagnostic overshadowing. INCLUSION CRITERIA: This review will consider qualitative studies that include the experiences of diagnostic overshadowing in mental health consumers and/or the health care professionals who treat them. Studies conducted in any health care facility or service offering care for physical illnesses will be considered. METHODS: MEDLINE, CINAHL, PsycINFO, and Scopus will be searched along with sources of gray literature. Studies in English published from 2004 onward will be considered. Retrieval of full-text studies, assessment of methodological quality, and data extraction will be performed independently by two reviewers. Findings will, where possible, be pooled using JBI SUMARI with the meta-aggregation approach. A ConQual Summary of Findings will be presented. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42020186418.