The U.S. Preventive Services Task Force (USPSTF) has released new draft guidance recommending for the first time that doctors screen all adults age 19-65 for anxiety. This includes people who don’t currently have a diagnosed mental health disorder or signs or symptoms of anxiety.

The Task Force said the guidance is intended to help identify mental health disorders earlier. Currently, many mental health disorders such as anxiety and depression go undetected and untreated for years. Studies show the average person waits 11 years to seek treatment for a mental health disorder.

These recommendations come at a time when more and more people are becoming aware of how everyday work and life stressors affect their mental health. It’s estimated that the pandemic caused cases of anxiety and depression to rise by 25 percent and that almost one third of adults will experience an anxiety disorder at some point in their lives.

“It’s a crisis in this country,” said Dr. Lori Pbert, a clinical psychologist and member of the USPSTF. “Our only hope is that our recommendations throw a spotlight on the need to create greater access to mental health care – and urgently.”

Screening Recommendations for Children and Adolescents

The draft recommendations for adults follow similar screening recommendations made by the USPSTF earlier this year for children and adolescents. The Task Force recommended screening children and adolescents age 8 to 18 for anxiety and screening adolescents age 12 to 18 for major depressive disorder.

Like the recommendations for adults, the recommended screenings for kids aren’t meant to be a diagnosis. The goal is to identify kids who may need extra support around their mental health.

“This is a way where we can get ahead of the ongoing mental health crisis to identify these kids and get them hooked into services,” said Jenna Glover, a child and adolescent psychologist at Children’s Hospital Colorado. “We know that early intervention really is the key to better outcomes.”

When Would Screening Happen?

The USPSTF recommends incorporating these screenings into routine visits to a person’s primary care doctor or, in the case of children, their pediatrician. Screening would take the form of a questionnaire about mental health symptoms. The results and follow-up conversation will determine next steps around mental health needs, which could include medication or referring the patient to a licensed mental health professional for more specialized care.

Potential Impact and Current Obstacles to Task Force Recommendations

Doctors and pediatricians aren’t required to follow the Task Force’s guidelines. However, USPSTF recommendations tend to strongly influence patient care. The Affordable Care Act requires most private insurance plans to cover recommendations that receive an A or B grade from the Task Force. In this case, both screening recommendations received a B grade because evidence showed these preventive services were beneficial.

The real question isn’t whether additional screenings will occur; it’s whether there are enough resources and providers to help those who get screened. There’s already a severe shortage of mental health care workers – including psychiatrists, psychologists and therapists – across the country. People seeking treatment from a licensed mental health professional can face long wait times that present another obstacle to care.

“We can screen lots of people, but if that’s all that happens, it’s a waste of time,” said Dr. Jeffrey Staab, a psychiatrist and chair of the Department of Psychiatry and Psychology at the Mayo Clinic in Minnesota.

These USPSTF recommendations will likely result in millions more adults and children being screened each year. As we get better at identifying people who need help and moving them towards care, we also have to ensure they get the treatment and resources they need.

For more information, LIUNA signatory contractors and other LIUNA affiliates can register on our website and order any of the Fund’s mental and emotional health publications free of charge, including:

• Understanding Mental Health: Supporting Members and Stopping Stigma
• Stress Management Toolbox Talk
• What Is Depression? Health Alert
• Stress Management: Handle Stress the Healthy Way Health Alert

[Nick Fox]