A Systematic Review of Nudging in the Mental Health Contexts - Progress, Findings, and Ways Forward

Many barriers could impede mental health behaviors including practicing self-care, seeking professional help, and engaging in interventions. Nudges, as characterized by decisional context designs such as information presentation and structure, are increasingly utilized to address these barriers and steer various health behaviors. In the realm of mental health, given a surge in nudging studies aimed at encouraging mental health behaviors has yielded some promising but inconsistent results, a systematic review is warranted to summarize these findings and understand the current state of knowledge. We reviewed the literature on mental health nudging, with inclusion of 25 studies predominantly employing between-subject framing experiments, involving mainly adult participants from Western regions, and focusing primarily on help-seeking and self-care. Findings on norm nudging and framing (self-other and positive-negative) have been mixed with some evidence of positive-framing advantage in encouraging help-seeking. Limited studies on default nudge, decoy nudge, and reminder nudge found mostly beneficial effects. We provided suggestions to advance mental health nudging research, including a call for more theory-driven research with potential mediating and moderating measures, sampling of diverse populations in mental health conditions, age, cultural backgrounds. More research on tailored nudges and comparison between different nudges are also encouraged. Finally, studies with more consequential outcome variables (e.g. mental health, behaviors over longer term), and monitoring and addressing risks of adverse effects, will be worthwhile.