All children 8 and up should be screened for anxiety even if they are not showing signs or symptoms, a panel of health experts in the United States recommends. This guidance comes after the U.S. Surgeon General Vivek Murthy warned last year that children are experiencing a mental health crisis, which the pandemic has worsened.
The group, called the U.S. Preventive Services Task Force, released draft recommendation statements for anxiety, depression and suicide risk in kids earlier this week. The task force upholds previous guidance that kids 12 and older should be routinely screened for depression.
“It’s critical to be able to intervene before a life is disrupted,” Martha Kubik, a member of the task force and a professor in the School of Nursing at George Mason University, tells New York Times’ Christina Caron. She tells the publication that a variety surveys and questionnaires to screen for anxiety exist for primary care providers.
"What our review found is that these screening tools are effective in picking up anxiety in young people before they can present with overt signs and symptoms,” she tells the Times.
The CDC reports that 7.1 percent, or 4.4 million children, aged 3 to 17 have diagnosed anxiety. About 3.2 percent have diagnosed depression.
However, many kids go undiagnosed, and symptoms of these conditions seem to have increased during the Covid-19 pandemic. During the pandemic, 25 percent of kids under 18 are experiencing clinically elevated depression symptoms and about 21 percent are experiencing elevated anxiety symptoms, according to a meta-analysis published last year in JAMA Pediatrics.
The task force acknowledges in the draft that screening is just the first step; kids would need further evaluation if they have a positive screening. If diagnosed with anxiety or depression, they would then need to work with their parents and healthcare professionals to determine an appropriate treatment. And they would need continual monitoring to make sure the treatment or treatments are effective.
Julie Cerel, a psychologist and director of the Suicide Prevention and Exposure Lab at the University of Kentucky who is not on the task force, cautions that just because a teen has a negative screening doesn’t mean they cannot be at risk for these conditions in the future, writes NBC News’ Erika Edwards.
“People feel like it rules out the possibility of future issues,” she tells the publication. “You've screened negative, so we don't have to worry about it."
She tells NBC symptoms can change quickly, and adults should be on the lookout for “extreme changes in mood or behavior.”
The draft is open for public review and comment until May. The task force did not find enough evidence to recommend for or against screening for younger kids or screening for suicide.
“The challenge is that, for children and adolescents without signs or symptoms, we do not have the evidence to tell us whether or not it’s beneficial to screen younger children for depression and anxiety and all youth for suicide risk,” says task force member Lori Pbert, a clinical psychologist at the University of Massachusetts, in a statement. “More research on these important conditions is critical. In the meantime, healthcare professionals should use their clinical judgment based on individual patient circumstances when deciding whether or not to screen.”