Anxiety and Depression Screenings: The Need for Earlier Intervention

On April 12, 2022, the U.S. Preventive Services Task Force shared updated recommendations regarding screening for depression, anxiety, and suicide risk in children and adolescents. According to their press release, “There is not enough evidence to recommend for or against screening for anxiety and depression in younger children and screening for suicide risk for all youth.”

In other words, they have found that the potential benefits of screening for these issues outweigh possible risks, even for children who do not outwardly exhibit symptoms of anxiety or depression.

It can be scary for parents to consider that their child or teen might be struggling with their mental health. What do these screenings look like, and how can they help? What are the risks to early screenings? How does current data about youth mental health in the United States inform these recommendations?

The Importance of Early Intervention

Approximately half of all individuals with diagnosable mental health conditions first experience their symptoms prior to age 14, and many with early symptoms do not have access to appropriate resources and support at the time when their symptoms emerged. However, research shows that early intervention for depression can prevent the frequency and severity of future episodes.

According to a 2019 study by the Journal of Child and Adolescent Psychiatric Nursing, suicide is the “second leading cause of death among teenagers and young adults, [ages] 10–24.” However, providers often do not adequately screen for suicide risk in youth.

Dr. Martha Kubick, PhD, RN, of the U.S. Preventive Services Task Force, states: “To address the critical need for supporting the mental health of children and adolescents in primary care, the Task Force looked at the evidence on screening for anxiety, depression and suicide risks.” She shared their findings: “Screening older children for anxiety is effective in identifying these conditions so children and teens can be connected to the support they need.”

The Mental Health Crisis for Children And Teens

Research conducted between 2019 and 2020 revealed that 29% of children and teens experienced depression, and 26% experienced anxiety. A statement from the Surgeon General of the United States from 2021 indicates that stressors related to issues including the COVID-19 pandemic, racist violence, and gun violence have caused an increase in mental health issues and caused a mental health crisis for youth in America.

Jaynay Johnson, LMFT and author, shared that adults create an environment that contributes to youth anxiety and depression. She stated, “The real crisis is with adults not being open to unlearning the negative ways they engage with youth.” Early screenings can be the first step in opening up a healthy conversation to both support those youth struggling with these symptoms and address the environmental factors that contribute.

Early Screenings: Risks And Benefits

According to the U.S. Preventive Services Task Force, it is not harmful to screen youth for mental health symptoms. Parents and providers might feel hesitant to ask about suicide due to fears that this question might put the idea in a child’s head. However, research has shown that screening for suicidal ideation does not cause someone to experience suicidal ideation.

Provider intent in conducting screenings is important. Jaynay Johnson shared: “Complications of early screenings are minimal if the screening intentions are meant to be helpful versus to label youth.” If the provider uses this information to alienate or stigmatize those with mental health symptoms, this can prevent the youth from being open to support if and when they are offered.

At the same time, used appropriately, screenings can open the door for earlier access to services and improved prognosis and quality of life. According to Jaynay Johnson, “The benefits [of early screenings] include validating the youth’s feelings, suicide prevention, and creating a sustainable quality of life.”

When to Screen

According to the draft, the U.S. Preventive Service Task Force officially recommends screening for some mental health conditions starting at age 8. Jaynay Johnson shared, “For me, it is never too early to screen for anxiety or depression.”

Because of the prevalence and availability of information, today’s youth have access to information about mental health from an early age but might lack the understanding and communication skills to express their experiences to adults without help. Additionally, the information presented might not meet the individual’s experience or cultural norms. Screening in a primary care setting can open the door for these conversations and help youth build this insight.

Jaynay Johnson also points out, “Screening early can help youth know that you are interested in their lives and are concerned about their well-being. This can open the door in the future if there is a struggle. This is preventative care.” In other words, even if a child is not experiencing mental health symptoms, knowing that the adults in their lives care enough to check on them is beneficial on its own.

Tips for Parents

The providers in a child’s life are there to help parents and caregivers navigate difficult conversations and situations. You can ask your child’s doctor about these screenings and for support in monitoring your child or teen’s symptoms between appointments.

Jaynay Johnson advises that parents be aware of and recognize patterns in their child’s behavior. She said, “It is important to know their child’s baseline to notice something is different. After seeing something different, assess what is happening in the family, environment, or child’s life that can disrupt their functioning. From there, a parent can decide that screening is needed.” She points out that the screening itself is an intervention, as it opens the door for conversation about the child’s well-being and needs.

If your child has these symptoms, they might benefit from therapy services. Resources are available to help them with their symptoms and help you support them.