Need for clinical neuropsychological assessment in headspace youth mental health services: A national survey of providers

Abstract

Objective: To determine the perceived met and unmet need for clinical neuropsychological assessment (CNA) in headspace youth mental health services Australia wide. Method: Brief online survey of headspace service providers exploring the number and types of clients seen, confidence in identifying neurocognitive impairments, and need, availability and usefulness of CNA. A total of 532 salaried, private, and in-kind service providers working across 103 primary headspace and headspace Youth Early Psychosis Programs completed the survey from May to December 2017. Results: Survey respondents were 76% female with a mean age of 38 (range 22-74 years). The majority had psychology (42%) or social work (21%) backgrounds. CNA was believed to be beneficial for 35% of headspace clients on average, but 86% of service providers reported that CNA was unavailable. Only 12% of clients were estimated to have received CNA when it was needed. On average, 36% of headspace clients were estimated to present with neurocognitive impairment and 38% were described as diagnostically complex (e.g., comorbid medical, developmental, substance use, trauma presentations). A mean of 27% were described as having a suspected or diagnosed developmental condition (e.g., intellectual disability, learning disorder, autism spectrum disorder, attentiondeficit/hyperactivity disorder). Respondents rated their confidence in identifying cognitive impairment as moderate. Conclusions: There is marked unmet need for CNA to provide diagnostic clarification and inform treatment approaches in youth mental health care. Funding for CNA under the Medicare Benefits Schedule, headspace workforce development in neurocognitive screening and cognitive interventions, and tele-neuropsychological services should be explored.

Thematic analysis of youth mental health providers' perceptions of neuropsychological assessment services

“…Current study responders also identified a limited availability of neuropsychologists to conduct evaluations. This parallels findings from quantitative investigations of neuropsychology utilization (Allott et al, ; Fisher et al, ). Overall, many of these discrete clinician‐endorsed barriers appear interrelated.…”

“…There also appears to be a need to promote greater awareness of neuropsychology to clinicians, clients and their families within mental health settings as well as the broader community. This may help reduce potential stigma associated with neuropsychological assessments, with greater knowledge facilitating implementation in youth settings (Allott et al, ; Corrigan, ; Temple et al, ). Increasing site‐specific information regarding streamlined methods of accessing neuropsychology resources and when referrals are appropriate is encouraged.…”

“…Qualitative data obtained as part of a larger project investigating the perceived need of neuropsychological assessments among clinicians working in headspace youth mental health centres in Australia (Allott et al, ) was analysed in the current study. Eligible participants were clinicians assessing or treating youth (aged 12‐25 years inclusive) that were attending headspace centres (N = 101) operational at the time of the study.…”

“…Participation was supported by headspace managers. Recruitment methodology is described further in Allott et al ().…”

“…Such evaluations consist of assessing cognition, behaviours and emotions using observations, clinical interviews and standardized neuropsychological tests, results of which are interpreted in relation to the individual's personal history, their clinical presentation and functioning, and normative data (Board of Directors, ). However, studies have demonstrated that neuropsychological assessment is a significant area of unmet need for youth receiving mental health care (Allott et al, ; Fisher, Hetrick, Merrett, Parrish, & Allott, ; Proffitt et al, ).…”