Referrers' Perceived Utility and Outcomes of Clinical Neuropsychological Assessment in an Adolescent and Young Adult Public Mental Health Service

Abstract

Despite frequent informal or anecdotal acknowledgement of the usefulness of neuropsychological services within various settings, including mental health settings, few studies have formally investigated the satisfaction, perceived utility, or outcomes associated with such a service. This survey-based study evaluated referring clinicians' (n = 35) perceptions of the usefulness and outcomes associated with the provision of clinical neuropsychological assessment and feedback within an adolescent and young adult public mental health service in Melbourne, Australia. The results suggest that referrers perceive the neuropsychological service, including formal neuropsychological assessment report and verbal and written feedbacks, as a highly useful adjunct to their clinical practice. In addition, referrers frequently reported clinically meaningful outcomes in association with the neuropsychological service, including diagnostic changes or additions (11% of clients referred), changes to approaches in treatment (52% of clients referred), and increased or appropriate access to services, education, or work (33% of clients referred). Referrers also reported that almost 60% of neuropsychological assessment reports were forwarded to other services or clinicians involved in the client's care. The findings suggest that mental health settings are likely to benefit from routine inclusion of specialist neuropsychology services. However, future research should also examine client and family perceptions regarding the satisfaction and usefulness of neuropsychological services.

Hospital Service Utilization is Reduced Following Neuropsychological Evaluation in a Sample of U.S. Veterans

“…Neuropsychologists are particularly well-positioned to accurately diagnose, treat, and refer individuals with neuropsychiatric symptoms, thereby improving efficiency of healthcare delivery (Allott et al, 2011;Vanderploeg, 1998). While theoretically sound and clinically intuitive, there is very little data supporting this assertion.…”

“…In addition, another survey of providers' perceptions of neuropsychological services found that referrers reported clinically meaningful outcomes associated with neuropsychological assessments (Allott et al, 2011). As such, neuropsychological services are routinely sought out by providers in medical settings because of the perceived value of their unique contribution to patient care (Johnstone, Coppel, & Townes, 1997).…”

“…Neuropsychological assessments provide critical assistance in the diagnosis and treatment of conditions associated with cognitive dysfunction (Allott, Brewer, McGorry, & Proffitt, 2011;Prigatano, Zigler, & Rosenstein, 2003). Correct diagnosis is a beneficial and ultimately cost-effective goal because correct diagnosis: (1) guides treatment and interventions; (2) enables more accurate predictions about the prognosis, nature, and course of illness; and (3) in the long term, may reduce the overall cost of medical care by eliminating unnecessary use of medical resources.…”

Neuropsychology and Youth Mental Health in Victoria: The Results of a Clinical Service Audit

“…Thus, assessing for cognitive difficulties in young people with mental health conditions and using this to inform management strategies and assist with school/tertiary liaison and employment options, is of high importance. Clinical neuropsychological assessment has been shown to lead to enhanced diagnostic clarification and more personalised and appropriate treatment/service use in young people with mental illness (Allott, Brewer, McGorry, & Proffitt, 2011). This involves the assessment of cognition (e.g., intelligence, attention, learning, memory, language, problem solving, and academic skills), emotion and behaviour through clinical interview, observation, and the administration of objective neuropsychological tests (Lezak, Howieson, Bigler, & Tranel, 2012).…”

Early intervention in psychosis: clinical aspects of treatment

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