Introduction

Mental health is a neglected but crucial aspect of overall well-being, but its importance in healthcare has been increasingly recognised in recent years. Votruba and Thornicroft (2016) [1] highlight the growing importance of mental health in healthcare. In September 2015, mental health was included in the United Nations (UN) Sustainable Development Goals (SDGs). The UN, therefore, acknowledged that for the next 15 years, the burden of disease of mental illness is a growing priority for global development. Nevertheless, mental health orders remain at an all-time high, and access to effective mental health services continues to be a significant challenge globally for the population [2]. Furthermore, it is recognised that many healthcare systems across the world continue to provide fragmented care, but that healthcare professionals need to be able to work together collaboratively, if this is to be addressed.

In 2010, the World Health Organisation (WHO) launched its framework for action on interprofessional education (IPE) and collaborative practice (CP), emphasising the importance of pre-registration health care professionals being ‘collaborative practice ready’ at the point of registration [2]. Its importance is recognised in enhancing communication across professions, whilst increasing the likelihood of shared decision-making, providing a safe environment for advice seeking and admitting mistakes. The definition of CP, however, lacks universal clarity [3] but is often described as both a system and person-level approach to working together to address the complexity of fragmented care [4] to enhance the quality and safety of the care provided [5–9].

IPE is a global, pedagogical approach considered to be best practice for equipping students with the knowledge, skills, behaviours and attitudes for CP and to develop a shared understanding of their roles and responsibilities in providing patient-centred care [2]. It is defined as: ‘occasions when members or students of two or more professions learn with, from and about each other to improve collaboration and the quality of care’ [10]. For this reason, IPE and CP are inextricably linked and frequently referred to as IPECP. In relation to mental health, it is identified as a key action for improving the quality and efficiency of mental health services [4].

However, just as there is no globally shared agreement as to the meaning of CP, there is also no shared agreement as to the precise knowledge, skills, attitudes and behaviours that students should develop through IPE, to effectively equip them to become ‘collaborative practice ready’ [2]. The United States and Canada, for example, both have their own sets of competencies they identify as necessary in individual students [4]. Australia published a capability framework in 2011, which highlighted three core elements: client-centred service, client safety, and collaborative practice. These core elements are underpinned by five collaborative practice capabilities [11]. Others, such as the United Kingdom, are attempting to create a set of standards for the delivery of effective IPE that align with competencies identified by different regulatory bodies [10]. Nonetheless, whilst there is no global agreement on its precise definition, there remains universal recognition of its importance.

According to Reinders et al. [9], identity can be best described as the sense of oneself, shaped by one’s own personality, experiences, and social interactions. Social identity, however, refers to the association of oneself with a specific group. Extended identity theory builds on these theories and forms the basis for the concept of ‘interprofessional identity’, arguing that an interprofessional identity needs to be built alongside the professional identity, without impacting on it [9].

Whilst no definitive definition of ‘interprofessional identity’ exists, it is helpfully described by Khalili et al. [12] as a ‘sense of belonging to your own profession and interprofessional community’. It is made up of three elements: a sense of belonging, commitment and shared beliefs [13]. It is also described as a set of shared beliefs, values, and attitudes that enable healthcare students or professionals to work together effectively, making it an essential part of CP [12]. Discussions are continuing regarding how best to facilitate the development of an interprofessional identity, with challenges such as power dynamics as a factor that can impede it [6].

However, pre-registration students face particular challenges in finding a mental health field identity due to the generic nature of most professional programmes. Globally, for example, nursing students will complete a generic programme of study and then specialise in a field of practice after registration. In South Africa, it is common practice for pre-registration students to be placed at facilities that focus on mental health challenges, to allow students to gain practical experience as part of their workplace learning. However, in the UK, nursing students choose their field of practice at the point of application, meaning the professional identity for mental health field students could be formed early in their professional careers.

Yet, a significant challenge they face is the genericism of the nursing programmes within the UK. The Professional Standards for Nursing [14] require students from all fields of nursing to be competent in the same proficiencies, with some arguing that there is great emphasis and value placed on the acquisition of physical skills over those more closely aligned to mental health, which can lead to a sense of hierarchy between fields of nursing, with mental health nursing seen as being of lower status than that of the adult field nurse [15].

It is generally recognised that pre-registration students have a strong desire to ‘belong’ to their own profession before and in the early stages of their professional journey [5,16]. However, this can lead to resentment of others [17]. And could, therefore, be of particular concern for those in the field of mental health. Nevertheless, having a strong professional identity is considered an essential prerequisite to developing a strong interprofessional identity [9,12]. However, it can conversely create a barrier to it if the uni-professional identity feels threatened [17]. It is, therefore, important to understand and identify the processes that have been used to develop an interprofessional identity before evaluating the best or most effective approach in this context.

To establish a foundational understanding of the literature on the subject, it is essential first to identify the literature that has been published in this field and map the available evidence to identify any key gaps in our knowledge. Therefore, a scoping review, which enables us to explore the breadth of the available evidence, is a necessary first step. Although there appears to be a lack of literature identifying, specifically, what an interprofessional mental health identity would look like, the particular challenges faced by students working in this field make this review timely.

Materials and methods

A scoping review will be conducted to address the breadth of the research question and map the available literature on the subject. This scoping review will follow the five stages of Arksey and O’Malley’s (2005) Framework [18] and be reported in line with the PRISMA-ScR reporting guidelines [19]. The protocol has been registered prospectively on Open Science Framework Registries (DOI: https://doi.org/10.17605/OSF.IO/TJ9E7) prior to screening records. At the time of writing this protocol, data extraction has not yet started.

Discussion

Through reviewing the literature, this scoping review will highlight those aspects that are essential to help achieve an interprofessional mental health identity in pre-registration students. To date, research on interprofessional identity has focused on an identity across professions, rather than an identity across the mental health field, and particularly at the pre-registration level. Through undertaking this review, it is anticipated that a theoretical model to help facilitate an interprofessional mental health identity can be proposed.

Supporting information