Universal Anxiety, Depression Screening Recommended for Many U.S. Kids

The U.S. Preventive Services Task Force, an influential medical panel, stopped short of urging that all kids get screened for suicide risk.

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American children and teens are in the midst of a worsening mental health crisis.Getty Images

Children 8 and older should get anxiety screenings even when they don’t have any symptoms of this mood disorder, according to new guidelines from the U.S. Preventative Services Task Force.

The recommendations, published in JAMA, mark the first time the Task Force has urged kids to get screened for anxiety. In separate recommendations published in JAMA, the Task Force reaffirmed its previous advice, published in Annals of Internal Medicine, that children 12 and older get screenings in primary care for depression, but not for suicide risk.

“The Task Force reviewed the evidence on screening for anxiety, depression, and suicide risk to provide primary care professionals with guidance on how they can help support the mental health of children and adolescents,” said Task Force member Martha Kubik, PhD, RN, a nursing professor at George Mason University, in a statement (PDF). “Fortunately, screening older children for anxiety and depression can identify these conditions so children and teens can receive the care that they need.”

When it comes to suicide risk, however, it’s not yet clear whether universal screening in pediatric primary care can benefit children and teens enough to outweigh any potential harms, the Task Force concluded. And it’s also not clear whether screening for anxiety or depression in little kids would be a net benefit, according to the Task Force.

What is clear, however, is that American children and teens are in the midst of a worsening mental health crisis.

RELATED: Anxiety Screening Is About to Become Way More Common in Adults — Here's What Your Doctors Want You to Know

Before the COVID-19 pandemic, there were already many signs of trouble. From 2009 to 2019, the proportion of U.S. high school students experiencing persistent feelings of sadness and hopelessness surged 40 percent, to more than one-third of teens this age, according to a report from the Centers for Disease Control and Prevention (CDC) (PDF). In 2019, nearly 1 in 5 high school students seriously considered attempting suicide, and almost 9 percent of them attempted suicide.

“Even before the pandemic, an alarming number of young people struggled with feelings of helplessness, depression, and thoughts of suicide — and rates have increased over the past decade,” U.S. Surgeon General Vivek Murthy, MD, said in a December 2021 statement.

“The COVID-19 pandemic further altered their experiences at home, school, and in the community, and the effect on their mental health has been devastating,” Dr. Murthy said at the time.

This March, the CDC offered fresh evidence that this youth mental health is getting worse. In 2021, almost half of high school students felt persistently sad and hopeless, and more than half of them said they experienced emotional abuse by a parent or other adult at home.

Against this backdrop, the American Academy of Pediatrics (AAP) urged the Task Force to recommend suicide screening for children and teens.

“Youths may keep suicidal thoughts to themselves and will not bring up the topic unless directly asked,” May Lau, MD, MPH, an associate professor of pediatrics at the University of Texas Southwestern Medical Center and lead author of the AAP’s Blueprint for Youth Suicide Prevention said in an April statement when the Task Force released its draft screening recommendations.

“By screening all youth for suicide, we can identify those that are at risk and connect them with the services they need,” Dr. Lau said at the time.

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