Mental health system funding of cognitive enhancement interventions for schizophrenia: summary and update of the New York Office of Mental Health expert panel and stakeholder meeting

Psychiatr Rehabil J. 2013 Sep;36(3):133-45. doi: 10.1037/prj0000020.

Abstract

Topic: A growing research literature indicates that cognitive enhancement (CE) interventions for people with schizophrenia can improve cognitive functioning and may benefit psychosocial functioning (e.g., competitive employment, quality of social relationships). Debate continues regarding the strength of evidence for CE and related policy implications, such as the appropriateness of funding CE services.

Purpose: This paper summarizes and updates a meeting of experts and stakeholders convened in 2008 by the New York Office of Mental Health to review evidence on the impact of CE for people with schizophrenia and other serious mental illnesses, and addresses whether the evidence base for CE interventions is sufficient to warrant funding.

Sources used: Specific recommendations based on the extant literature are provided regarding the structure and components of CE programs that should be present in order to improve cognitive and psychosocial outcomes and therefore merit consideration of funding.

Conclusions and implications for practice: These recommendations may serve as a starting point in developing standards for CE programs. Establishing evidence-based practice standards for implementing CE interventions for people with serious mental illnesses may facilitate dissemination of programs that have the greatest potential for improving individuals' functional outcomes while minimizing incremental costs associated with providing CE services. Important open questions include how the performance of CE programs should be monitored and which individuals might be expected to benefit from CE as evidenced by improved functioning in their everyday lives.

MeSH terms

  • Brain Injuries / rehabilitation
  • Cognition Disorders / complications
  • Cognition Disorders / therapy*
  • Cognitive Behavioral Therapy / economics*
  • Cognitive Behavioral Therapy / methods
  • Evidence-Based Practice
  • Expert Testimony*
  • Humans
  • Mental Health Services / economics*
  • Meta-Analysis as Topic
  • New York
  • Practice Guidelines as Topic
  • Program Evaluation
  • Remedial Teaching
  • Review Literature as Topic
  • Schizophrenia / complications
  • Schizophrenia / rehabilitation*
  • Schizophrenic Psychology*
  • Treatment Outcome