Remote cognitive assessment in severe mental illness: A scoping review

Schizophrenia and related psychoses are arguably the most serious of all mental disorders, imposing enormous burden on individuals, families, and communities. In addition to symptom recurrence or relapse and deterioration in social functioning, most individuals also present with cognitive impairments (difficulties in verbal memory, executive functioning, attention). These impairments represent important psychological intervention targets. Specifically, cognitive remediation therapy(CRT) and meta-cognitive training (MCT) have been shown to improve these cognitive dimensions, in addition to psychotic symptoms, insight, and self-esteem. Brain imaging evidence additionally suggests that CRT and MCT improve brain function. However, the current COVID-19 pandemic has caused a significant barrier to accessing mental health services, which increases risk of relapse, ER visits, and hospitalizations. Hence, we are working to deliver these psychological interventions remotely using digital mental health technology. We plan to conduct a scoping review of the current literature on remote cognitive assessment to determine best practices in this field. To achieve this, we propose to: 1) map the current knowledge on remote cognitive assessment for severe mental illness; 2) identify potential barriers and facilitators; and 3) compare knowledge regarding remote cognitive assessment for severe mental illness with neurological and geriatric populations. Our national collaborative initiative is intended as a rapid response to the COVID-19 situation for populations with serious mental illness. Our scoping review will facilitate the work of researchers, clinicians, and policy makers whose aim is to develop digital health and technology-based interventions for cognitive health. Our findings will be widely available to the Canadian community, as we will establish a knowledge-user and stakeholder consultation group comprised of organizational leaders, patients, and caregiver representatives.