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Using Neuropsychological Profiling to Tailor Mental Health Care for Children and Youth: a Quality Improvement Project
Angelica Blais1, Anne-Lise Holahan2, Amanda Helleman1
1Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
Insights
Integrating neuropsychology data into pediatric mental healthcare is feasible and highly valued by patients, caregivers, and practitioners. This innovative approach shows promise for improving child and youth mental health services.
Area of Science:
- Child and Adolescent Psychiatry
- Neuropsychology
- Healthcare Innovation
Background:
- Precision child and youth mental healthcare aims to improve treatment success through tailored interventions.
- An innovative care pathway was developed to integrate neuropsychology data into psychotherapeutic care within a pediatric mental health outpatient clinic.
- This study assesses the feasibility, implementation, and acceptability of this novel care pathway.
Purpose of the Study:
- To describe the feasibility of integrating neuropsychology data into pediatric mental healthcare.
- To evaluate implementation outcomes and acceptability of the new care pathway.
- To explore the potential for future integration of neuropsychological insights into routine clinical practice.
Main Methods:
- A co-developed care pathway involving neuropsychologists and mental health practitioners was implemented in a tertiary outpatient mental health clinic.
- A stepped assessment protocol was used, with neuropsychological function reports shared with patients, caregivers, and providers.
- Evaluation utilized phone surveys, questionnaires, focus groups, and administrative records.
Main Results:
- High patient (93%) and practitioner (91%) acceptance of the neuropsychology-informed care pathway.
- Significant patient (83%) and caregiver (94%) value for neuropsychology-informed care, with some reporting transformative experiences.
- No adverse effects on participants or patient flow, indicating safe implementation.
Conclusions:
- Neuropsychology-informed pediatric outpatient mental health care is feasible and well-received.
- The pathway demonstrates potential for enhancing the quality and personalization of mental healthcare for children and youth.
- Further research in an experimental trial is recommended to establish clinical effectiveness.
Objective:
Precision child and youth mental healthcare has great potential to improve treatment success by tailoring interventions to individual needs. An innovative care pathway in a pediatric mental health outpatient clinic was designed to allow for neuropsychology data to be integrated in psychotherapeutic care. This paper describes the feasibility of this new pathway, including implementation outcomes, acceptability, and potential for future integration.
Method:
The target population was outpatients 6-17 years old referred for individual treatment to a tertiary outpatient mental health (OPMH) clinic. The new care pathway was co-developed by neuropsychologists and mental health practitioners. A logic model was created to guide the evaluation, which was informed by the Reach Effectiveness Adoption Implementation Maintenance framework. As part of the logic model, a stepped assessment protocol was implemented, and reports on neuropsychological function were shared with patients, caregivers, and care providers. Evaluation data were collected from phone surveys, questionnaires, a focus group, and administrative records.
Results:
Forty-two patients scheduled to receive therapy over a 6-month period were offered the opportunity to participate in the new care pathway and 39 (93%) agreed. Self-reported outcome data showed that 83% of patients and 94% of caregivers valued neuropsychology-informed care, with some describing it as transformative. Almost all practitioners (91%) reported that the project added value to their clinical care. There were no adverse effects on participants nor the flow of patients through the system.
Conclusions:
Neuropsychology-informed pediatric OPMH care was feasible and well-received. Clinical effectiveness should be studied in an experimental trial.
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