US Health Task Force Calls for Regular Anxiety Screening for Adults
Anxiety disorders are often unrecognized and undetected in primary care. One study cited by the Task Force found a staggering 23 years for the median time to treatment for anxiety.
While the task force’s initial deliberations on anxiety screening predated the coronavirus pandemic, the new guidance came at a critical time, said task force member and clinical psychologist in Worcester, Massachusetts. said Lori Pubert, a professor at the University of Massachusetts Chang School of Medicine.
“Covid has taken a toll on the mental health of Americans,” said Pbert. “Although this is a topic of high public health importance, it is clear that mental health has become more of a concern in the country in recent years.”
In April, the task force made similar recommendations to begin screening for anxiety in children and teens ages 8 to 18. Treatment can improve anxiety symptoms in people under the age of 65.
Somewhat surprisingly, however, this guidance falls short of recommending anxiety screening for people over the age of 65.
One reason is that many of the common symptoms of aging, such as trouble sleeping, pain, and fatigue, can be symptoms of anxiety. The task force said there was not enough evidence to determine the accuracy of screening tools for older adults, and they may not be sensitive enough to distinguish between anxiety symptoms and aging conditions.
The task force advised clinicians to use their judgment when discussing concerns with older patients.task force It also reiterated previous recommendations that adults of all ages undergo regular screening for depression.
The Task Force is an independent panel of experts appointed by the Medical Research and Quality Agency and has a great deal of influence. Although its advice is not compulsory, the committee’s recommendations often change the way physicians practice medicine in the United States.
Some doctors wondered how the recommendations would work in the real world. Mental health providers say they are still unable to meet patients’ demands, and patients are complaining of waiting months for an appointment with a therapist.
“Screening is great, but a serious shortage of workforce is making it difficult for clinicians,” said Eugene Veresin, a psychiatrist at Massachusetts General Hospital and executive director of the Clay Center for Young Healthy Minds. Unless there are plans to increase funding for
The World Health Organization reported earlier this year that the global prevalence of anxiety and depression increased by 25% in the first year of the pandemic. Yet too many people today remain without the care and support they need for both existing and new-onset mental health conditions.”
Anxiety, with its overt fear and physical manifestations such as heart pounding, heart pounding, and palms sweating, is associated with many disorders, including generalized anxiety disorder, social anxiety disorder, and panic disorder. It can present as different diagnoses of
Together, they constitute the most common mental illness in the United States, afflicting 40 million adults each year, according to the Anxiety and Depression Association of America. Treatment includes psychotherapy, especially cognitive-behavioral therapy. Antidepressants or anti-anxiety medications; as well as various relaxation, mindfulness and desensitization therapies, doctors said.
The panel also considered the benefits of screening patients for suicide risk, but concluded that: Although suicide is the leading cause of death among adults, “there is not enough evidence whether screening people without signs or symptoms will ultimately help prevent suicide.”
Nonetheless, the panel called on health care professionals to use independent clinical judgment to determine whether an individual patient should be screened for suicide risk.
For primary care physicians who are already in the “crisis” of burnout, pandemic stress, and their own mental health issues, adding yet another screening test to a long list of clinical tasks can feel overwhelming. maybe.
“If a primary care provider were asked to do one more screening, we would be on hold without further resources,” said a Northern California nurse practitioner. about the problem.
Check off current requirements such as the latest screenings for cervical, colon and breast cancer, food insecurity, domestic violence, alcohol and tobacco use, all in a 15 minute appointment. she said. Treatment of patients with complex and chronic conditions.
“When people are active with depression and anxiety and there’s no mental health support to help them, it just feels wrong,” the practitioner said.
However, additional support for patients suffering from depression and anxiety can help, said Mamuda Qureshi, a physician at Massachusetts General Hospital.
“Post-2020, it’s rare to find a patient who doesn’t feel anxiety.”
Recognizing the challenges of providing mental health care to all in need, the task force added that “less than half of individuals experiencing mental illness have access to mental health care.”
The panel also cited “racism and structural policies” that disproportionately affect people of color. The panel noted that black patients were less likely to receive mental health services than other groups, and misdiagnosis of mental health conditions was more common among blacks and Hispanics. Patience.
Pbert said the latest guidance is just one step in addressing patients’ urgent mental health needs. “Our hope is that this set of recommendations will raise awareness of the need to increase access to mental health care across the country,” she said, adding that “funders are sorely needed in these areas. We highlight gaps in the evidence so that we can support more robust research.” “
The proposed recommendations are open for public comment until October 17, after which the Task Force will consider them for final approval.