Highlights The outbreak of COVID-19 significantly affected italy with severe health, social and economic consequences. The strictness and timing of escalating and de-escalating containment and prevention measures played a major role on health and non-health outcomes. Technological interventions are far from having any impact on the outcomes considered due to delayed implementation. The production of evidence-based interventions is relevant for reducing uncertainty around the interventions, thereby maximising the resource and investment allocations. Our findings are relevant not only for italy but for all countries worldwide.

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Introduction Digital technology has the potential to improve health outcomes and health system performance in fragmented and under-funded mental health systems. Despite this potential, the integration of digital technology tools into mental health systems has been relatively poor. This is a protocol for a synthesis of qualitative evidence that will aim to determine the barriers and facilitators to integrating digital technologies in mental health systems and classify them in contextual domains at individual, organisational and system levels. Methods and analysis The methodological framework for systematic review of qualitative evidence described in Lockwood et al. will be applied to this review. A draft search strategy was developed in collaboration with an experienced senior health research librarian. A systematic search of Medline, Embase, Scopus, PsycInfo, Web of Science and Google Scholar, as well as hand searching of reference lists and reviews will identify relevant studies for inclusion. Study selection will be carried out independently by two authors, with discrepancies resolved by consensus. The quality of selected studies will be assessed using JBI Critical Appraisal Checklist for Qualitative Research. Data will be charted using JBI QUARI Data Extraction Tool for Qualitative Research. Findings will be defined and classified both deductively in a priori conceptual framework and inductively by a thematic analysis. Results will be reported based on the Enhancing transparency in reporting the synthesis of qualitative research. The level of confidence of the findings will be assessed using GRADE-CERQual. Ethics and dissemination This study does not require ethics approval. The systematic review will inform policy and practices around improving the integration of digital technologies into mental health care systems.

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