Examining the role of neuropsychology in community-based pediatric mental health care.

Numerous investigations have demonstrated a link between neuropsychological functioning and mental health. Children with a history of neurological compromise are more vulnerable to mental illness and there is a growing literature indicating that neurocognitive functioning predicts psychosocial outcomes in adulthood. However, not much is known about how neuropsychological information is utilized in community-based mental health care. Thus, we examined what neuropsychological information is available to pediatric centers and how neuropsychological functioning relates to treatment outcomes in these settings. Two content analyses were conducted to identify mental health indicators across different intake sources and these results were compared to a structured intake. Further, a series of standardized neurocognitive and neuroemotional measures were completed and these indices were correlated with treatment outcomes. Qualitative results confirmed that neuropsychological factors are often overlooked when utilizing current approaches and that observable symptoms are a primary focus of treatment. Additionally, neurocognitive deficits were associated with self-reported interpersonal difficulties and caregivers' reports of externalizing; however, only caregiver-reported externalizing challenges correlated with treatment outcomes. Importantly, neurocognitive challenges were associated with long-term treatment responses, suggesting that these factors may be an important therapeutic target. Collectively, these findings indicate a need to incorporate neuropsychological factors in pediatric mental health treatment.