Neuropsychology Referrals and Outcomes in an Adult Mental Health Service in India

Clinical neuropsychological services, traditionally developed for brain damage or injury, are increasingly focused on psychiatric referrals. Although neurocognition is implicated in, and significantly impacts outcomes for, many psychiatric disorders, neuropsychological assessments are still not part of routine clinical care in many psychiatric settings in India. The current study aimed to assess the reasons for referral and outcomes of neuropsychological assessment in clinical psychiatric settings. An audit of neuropsychology referrals received by a clinical psychology team in an adult mental health unit of a large tertiary referral centre in India was conducted over a year. Findings resulted approximately 51% of individuals were referred due to observed or reported cognitive decline. The most common diagnoses in the current sample were bipolar disorder, psychosis and ‘not yet diagnosed’ (17.9%), followed by schizophrenia and depression among others (10.7%). Over 77% of referred individuals received psychoeducation/feedback following assessment; approximately 51% were referred for further (neuro) psychological intervention. Limitations in resources hamper access to neuropsychological services in India, particularly in psychiatric settings. Nevertheless, cognitive difficulties are a key concern for many individuals with psychiatric disorders, and hence neuropsychological assessments with a consultative focus and emphasis on feedback/psychoeducation are important for improving outcomes in routine clinical psychiatric settings, consistent with the shifts in focus in clinical neuropsychology across the world.