Mapping autonomy in mental health care: a scoping review protocol

Abstract

Autonomy is regarded as a fundamental principle in the global reform of mental health care, as promoted by the Convention on the Rights of Persons with Disabilities (CRPD) and reflected in various international initiatives aimed at eliminating coercive practices and fostering rights-based recovery approaches. However, its meaning and application remain contested, with interpretations varying widely across cultural, theoretical, and institutional contexts. This scoping review aims to identify and characterize the various conceptualizations and implementations of autonomy for users and ex-users of mental health services, with the goal of clarifying its scope and informing future policies and practices. The review will follow the Arksey and O’Malley framework, supplemented by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Searches will be conducted in Web of Science, Scopus, PubMed, PsycInfo, and Dialnet, as well as Google Scholar and gray literature databases. Reference lists of relevant studies will be reviewed. Eligible documents include peer-reviewed articles, conference abstracts, dissertations, and unpublished research addressing conceptualizations or implementations of autonomy related to mental health service users and ex-users. Data will be analyzed using descriptive and thematic analysis, based on the Braun and Clarke approach. The review will be conducted from May to December 2025. This scoping review will map international definitions and practices of autonomy in mental health, contributing to policy development and aligning with human rights standards, particularly the CRPD. The findings will be relevant to policymakers, practitioners, and organizations aiming to promote autonomy-based initiatives. Registration with Open Science Framework can be found under registration number https://doi.org/10.17605/OSF.IO/DKFBR .