title: Communication of a mental health diagnosis: a systematic synthesis and narrative review.
abstract: BACKGROUND
  There is limited understanding of the mechanisms used to effectively communicate with service-users about their mental health diagnoses.
  
  
  OBJECTIVE
  To conduct a systematic synthesis of studies that present data on the communication of a psychiatric diagnosis.
  
  
  METHODS
  Comprehensive database and manual searches were conducted resulting in the inclusion of 30 quantitative and qualitative papers.
  
  
  RESULTS
  The majority of studies were descriptive. The rate of service-users being informed of their diagnosis has increased over the past decade. Consumer communication preferences were not always satisfactorily addressed in practice. Individual characteristics of service-users and clinicians influenced whether a diagnostic discussion took place. RESULTS from intervention studies aimed at facilitating diagnostic communication reported significant improvements in service-user satisfaction and mood and clinician communication skills.
  
  
  CONCLUSIONS
  This review highlights a gap in the system of communication between clinicians and service-users. To assist clinicians to talk effectively with individuals about their mental health, communication protocols and training need to be further developed and assessed. Such developments would benefit from well-designed randomised controlled trial protocols, should incorporate service-users' preferences and address stigma-related concerns.
authors.affiliation: School of Psychology, The University of Sydney , Sydney , Australia and.
authors.forename: Alyssa C
authors.initials: AC
authors.lastname: Milton
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Mullan
mesh_terms: D058015:Health Communication; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis*; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D010817:Physician-Patient Relations
keywords: Breaking bad news; communication models; diagnosis; mental health