Objective Whilst the benefits of shared decision‐making (SDM) have been promoted across different health settings, its implementation is complex, particularly for children and young people with mental health difficulties. The aim of this scoping review was to identify and describe SDM approaches (tools, techniques, and technologies) used in child and youth mental health. Method Electronic databases and grey literature were searched. Papers were included if they satisfied these criteria: English language; described an SDM approach (tool, technique, or technology); included sufficient detail on the SDM approach for quality assessment; did not use only a questionnaire to provide feedback on SDM or related concepts (e.g., therapeutic alliance) without another SDM approach; child or adolescent population (up to 18 years); carers of children or adolescents; and mental health setting. Screening and data extraction were performed by two co‐authors, and each included record was quality assessed against a set of essential ingredients of SDM identified by previous studies. Results Of the 8,153 initial results, 22 were eligible for final inclusion. These could be grouped into six approaches: therapeutic techniques, psychoeducational information, decision aids, action planning or goal setting, discussion prompts, and mobilizing patients to engage. The quality of approaches identified ranged from one to seven of the nine essential elements of SDM. Conclusion Evidence suggests that a range of approaches are being developed to support SDM in child and youth mental health. Rigorous research evaluating the effectiveness of these approaches is urgently needed, particularly from the perspective of children and young people. Key practitioner message This scoping review is the first to categorise and outline different shared decision‐making (SDM) approaches (tools, techniques, and technologies) as suggested by The Health Foundation and has identified six distinct approaches used in child and youth mental health Each of the six extant SDM approaches has been qualitatively assessed using a most comprehensive list of essential elements of SDM available so far in the area Whilst evidence suggests that a range of approaches is being developed to support SDM in child and youth mental health, rigorous research evaluating the effectiveness of these approaches is largely lacking The current review may serve as a useful guideline for those institutions and health service organisations that are keen to implement an SDM approach for children and young people in their care Further research is urgently needed to establish the effect of SDM on clinical outcomes, as well as whether such approaches are cost effective