(PS7-B48) Characterizing the Racial, Ethnic, and Gender Diversity of Patients Screened for and Adults Receiving Neuropsychological Assessment Services at an Urban Outpatient Mental Health Clinic from 2015-2021

Neuropsychological services represent 3% of the total adult outpatient services provided by the Center for Anxiety and Related Disorders (CARD) at Boston University from 2015-2021. This includes neuropsychological assessments (NPA) conducted by pre-doctoral clinicians, licensed neuropsychologists, and clinical psychologists. During COVID-19, in-person NPAs were halted from March-August 2020, before a hybrid testing model was implemented in September 2021. In response to the pandemic, online screening forms were created to streamline patient contact. We are interested in examining if there were differences in rates of reporting diverse gender identities since implementing an updated form, whether there were significant differences in rates of reporting diverse racial identities between 2015-20 and 2021, and whether there were differences in appointment scheduling and attendance data across 2015-2021 for adult NPA services.

Of NPA phone screens completed in 2021 (including children; N=185), patients represented one or more of the following gender identities: 63.8% cisgender women; 17.3% cisgender men, 1.6% transgender women, 2.7% transgender men, 12.4% as gender non-binary or non-conforming, 1.6% questioning, 3.8% gender queer or gender fluid, 0.5% as agender, and 2.2% other (5.4% no response). NPA phone screens from 2015-2020 (N=104), which included fewer specifiers for gender identity, revealed that 59.6% identified as women and 36.5% identified as men (3.8% no response).

Of all NPA phone screens completed in 2021, 12.4% of patients identified as Hispanic/Latino (76.2% identified as non-Hispanic/Latino; 12.4% another or no response). Racial identity breakdowns included: 58.9% Caucasian, 22.7% Asian, 10.8% Black, 4.9% Middle Eastern, and 2.7% American Indian. Comparatively, patients screened from 2015-2020 identified as: 6.7% Hispanic/Latino, 70.2% Caucasian, 9.6% Asian, 9.6% Black, 3.8% Middle Eastern, 1.9% American Indian, 1.9% Native Hawaiian/Pacific Islander, and 7.7% multiracial. Chi-square results comparing racial identity data from 2015-20 to 2021 indicated a significant difference in racial identity (χ² (1,289) = 4.25, p = 0.04), with more individuals in 2021 representing racial identities other than Caucasian than previously.

Of adult NPA appointment data from 2015-2021, 688 appointments were scheduled (M: 98, SD: 54 per year). 87% of these NPAs were attended, and 96.9% of appointments were completed by doctoral clinicians in-training. Scheduled adult NPAs in 2021 increased by 169% from the 2015-2019 average. Despite increases in scheduled NPAs, there were no significant differences in attendance versus non-attendance by year (χ² (6,688) = 10.12, p =0.12).

Use of the online screening form in 2021 appears to have increased the number of screening forms and captured increased aspects of gender diversity. Significantly more patients screened for NPAs in 2021 than in 2015-20 identified as racial identities other than Caucasian. There were no significant differences in adult NPA attendance, despite more appointments scheduled in 2021. Use of online screening forms with inclusive language is important for increasing access to care and collecting meaningful information on identities.