After-Visit Summary (AVS) and Discharge Summary (DS) are essential tools for patient-centered care, aiming to improve communication, enhance engagement, an

Background/Objectives: Open Notes—defined as patients’ electronic, portal-based access to clinicians’ narrative documentation within electronic health records (EHRs)—has become routine through policy and portal initiatives. In mental health (MH), transparency intersects with sensitive formulation and risk language, making outcomes contingent on documentation practices, release timing, and reader support. This scoping review mapped empirical evidence on experiences, perceived impacts, and implementation of Open Notes in MH across stakeholders and settings, deriving implications for practice, training, and policy. Methods: A PRISMA-ScR-guided review was conducted with a preregistered protocol on OSF. Eligible studies examined Open Notes in MH settings and reported stakeholder perspectives. Two reviewers independently screened and extracted data, analyzed through inductive narrative thematic synthesis. Results: Twenty-two studies (2012–2025) from the USA, Sweden, Germany, Canada, and international settings included surveys, qualitative interviews, mixed-methods designs, pilot and quasi-experimental implementations, and a Delphi consensus. Patients consistently reported improved comprehension, recall, empowerment, and—in some cases—greater trust. Large surveys identified error detection and patient-initiated corrections as safety mechanisms, while a minority reported worry or feeling judged by wording. Clinicians adapted documentation—modifying tone, wording, or candor—to minimize misinterpretation. Workload effects were generally modest, limited to occasional clarifications. Implementation and expert studies emphasize organizational readiness, training, patient preparation, and privacy-aware portal design as key enablers of safe transparency. Conclusions: In MH, Open Notes function as a communication and engagement tool that strengthens partnership, comprehension, and safety when implemented with attention to risk-sensitive documentation and privacy safeguards.

Background: Palliative care—while overlapping with but distinct from end-of-life care—involves multidisciplinary teams providing medical, psychosocial, and existential support to patients and families facing serious illness. While prior research has examined professional identity in palliative care, the existential dimensions of identity formation—what it means to be a palliative care professional—remain largely underexplored. Aim: To explore the lived experiences of palliative care professionals, focussing on how their professional identity is constructed through the existential notion of “being,” and to identify implications for advancing international education and workforce policy. Design: Semi-structured interviews were analysed using Interpretative Phenomenological Analysis (IPA). Reflexivity, peer debriefing, thick description, and an audit trail were applied to ensure rigour and transparency. Setting/participants: Fourteen Italian palliative care professionals from diverse disciplines (nursing, medicine, allied health) working primarily in community-based services. Results: One Group Existential Theme emerged: Being, encompassing four subthemes—Meaning of Being, Ways of Being, Being Present for Others, and Reasons for Being Present. Across these, participants framed their identity not only around technical competence but also around emotional presence, relational depth, and ethical commitment to dignity in dying. Conclusions: This study advances existing literature by integrating the existential dimensions of “being” into professional identity theory. Findings highlight the need for international education and workforce strategies that embed reflective practice, emotional competence training, and peer-support structures alongside technical instruction, to sustain professionals in death-related work.