Availability of Cognitive Remediation Therapy in United States Mental Health Facilities Serving Older Adults: A Statistical Study.

INTRODUCTION

Older age is a major risk factor for many neurocognitive disorders like Alzheimer's disease. While there are limited treatment options for improving memory in this population, research has shown that special psychotherapeutic modalities like Cognitive Remediation Therapy (CRT), especially when coupled with psychosocial and vocational rehabilitation (PSR and VCR respectively), benefit older adults. This study examines the availability of these services in US mental health (MH) facilities serving older adults and compares the characteristics of the facilities providing these services.

METHODS

Our study includes 1216 MH facilities using the 2022 National Substance Use and Mental Health Services Survey (N-SUMHSS) data from the Substance Abuse and Mental Health Services Administration (SAMHSA). Descriptive statistics were used to determine availabilities, while multivariable logistic regression was used to compare facilities that offer the services compared to those that do not.

RESULTS

Of the total facilities included, 78 (6%), 634 (52%), and 381 (31%) offered CRT, PSR, and VCR respectively. Facilities that provided only MH services compared to those providing substance use and MH services, those that offer special services for veterans, and special Alzheimer's programs compared to those that do not were more likely to have CRT services. MH facilities that provide supplemental employment services, housing services and recovery housing were more likely to offer PSR and VCR compared to those that do not. Compared to facilities in Midwest states, facilities in East South-Central were less likely to offer PSR and VCR.

CONCLUSION

This study highlights the relative unavailability of CRT, indicating a need for more interest in evidence-based nonpharmacological treatment options for cognitive decline in the aging population.