Cognitive health treatment priorities and preferences among young people with mental illness: The your mind, your choice survey

Abstract

AimCognitive impairments negatively impact the everyday functioning of young people with mental illness. However, no previous study has asked young people (1) how much of a priority cognitive functioning is within mental health treatment, and (2) what types of cognition‐focused treatments are most appealing. The current study aimed to address these questions.MethodsYour Mind, Your Choice was a survey‐based study involving an Australian sample of young people who were receiving mental health treatment. The survey asked participants to (1) provide demographic and mental health history, (2) rate the importance of 20 recovery domains, including cognition, when receiving mental health treatment, (3) share their experiences of cognitive functioning, and (4) rate their likelihood of trying 14 different behavioural, biochemical, and physical treatments that may address cognitive functioning.ResultsTwo‐hundred and forty‐three participants (Mage = 20.07, SD = 3.25, range = 15–25, 74% female) completed the survey. Participants reported that addressing cognitive functioning in mental health care was very important (M = 76.33, SD = 20.7, rated on a scale from 0 = not important to 100 = extremely important), ranking cognition among their top six treatment needs. Seventy percent of participants reported experiencing cognitive difficulties, but less than one‐third had received treatment for these difficulties. Compensatory training, sleep interventions and psychoeducation were ranked as treatments that participants were most likely to try to support their cognitive functioning.ConclusionsYoung people with mental ill‐health commonly experience cognitive difficulties and would like this to be a focus of treatment; however, this need is often unmet and should be a focus of research and implementation.

Tailoring cognitive interventions to individuals' cognitive profiles: commentary on ‘Prevalence of cognitive impairments and strengths in the early course of psychosis and depression’ by Stainton et al

“…Qualitative research has shown that current approaches in treating cognition in mental health services typically default to a ‘deficit-based’ approach to make up for a ‘loss’ (e.g. focuses on remediation of deficits), even though clinicians and young people with mental illness view strengths-based approaches favourably (Bryce et al, 2023; Steele et al, 2021). Considering the impact of being identified as ‘cognitively impaired’ is important too, with this label having been described as a ‘self-fulfilling prophecy’ which is taken on as an ‘identity in a very profound way’ (Jones, 2023).…”

“…Research supports this discrepancy between objective and subjective cognitive impairment. In young people with mental illness, very high rates (70%) of subjective cognitive difficulties have been reported, but a much lower rate (31%) have reported receiving treatment targeting cognition (Bryce et al, 2023). While this may reflect other systemic factors in mental health provision, this low rate of cognitive intervention for individuals reporting significant cognitive difficulties may relate to clinicians typically only delivering interventions targeting cognition when objective cognitive impairment is present.…”

Reply to ‘Tailoring Cognitive Interventions to Individuals’ Cognitive Profiles: Commentary on “Prevalence of Cognitive Impairments and Strengths in the Early Course of Psychosis and Depression” by Stainton et al.’

“…Our recent work also shows that such early intervention for cognition is also aligned with the preferences of young people. Cognition is a high treatment priority for young people with mental illness, alongside the treatment of mental health symptoms (Bryce et al, 2023).…”

“…In our 'Your Mind, Your Choice' survey (Bryce et al, 2023), we asked young people who had recently received mental health treatment to rate the importance of 20 different recovery domains. Respondents were 243 young people (mean age = 20.07, S.D.…”

“…Therefore, greater focus on cognition as a priority to enable recovery is required as part of standard care. Indeed, 70% of survey respondents reported experiencing cognitive difficulties, but only 31% indicated receiving treatment for the same, highlighting that less than half of those who felt that they were struggling with their cognition had received a targeted, evidence-based treatment to assist them with these important skills (Bryce et al, 2023). Douglas et al highlight the importance of incorporating a strengths-based approach into cognitive intervention.…”