Implementation of cognitive health interventions for schizophrenia: a survey of mental health clinicians’ perceived challenges and enablers

Introduction: Cognitive impairment associated with schizophrenia is persistent and can lead to functional disability and a reduced quality of life. Although cognitive remediation is recommended in clinical guidelines, access in Australia remains inconsistent, and implementation and participation barriers limit its effectiveness. Cognitively stimulating activities, particularly music therapy, could offer an alternative approach, although limited research has examined its feasibility within Australian mental health services. This exploratory mixed-methods survey aimed to understand mental health clinicians’ perspectives on: (1) the cognitive health interventions available within their services, (2) the challenges and facilitators involved in implementing these interventions, and (3) the potential for using music therapy as a cognitively stimulating activity for adults with schizophrenia. Methods: A mixed methods purpose-designed online survey was conducted across six months with qualified mental health clinicians in Australia. Snowball sampling was utilised for recruitment. Quantitative data were analysed with descriptive statistics, and qualitative responses underwent a five-stage reflexive thematic analysis. Both types of data were analysed simultaneously using an integrated approach. Results: A total of 37 clinicians completed the survey. More than half of respondents (56.7 %) reported that cognitive remediation programs were available at their mental health service, while 89.3 % noted the availability of cognitively stimulating activities. The main implementation challenges reported were discharge timing, lack of training, staffing issues, insufficient resources, and difficulties engaging consumers. Enablers included applying evidence-based practice, personalising interventions, and prioritising recovery goals. Participants viewed music therapy as helpful for improving attention, memory, and communication. Conclusion: The findings of this study show that clinicians value cognitive health interventions for schizophrenia but face significant implementation challenges, particularly a lack of training, insufficient resources, and staffing constraints. Music therapy is seen as a promising cognitively stimulating activity that may help overcome accessibility, engagement, and resource barriers. Further research is necessary to assess the feasibility of using music therapy to support adults with schizophrenia in improving their cognitive skills.