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

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, attention-deficit/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.