Experts can speak to new guidelines on screening children for anxiety

This month, the U.S. Preventive Services Task Force released new guidelines recommending all children 8 and up be screened for anxiety, in addition to recommending that children 12 and up be screened for depression. The task force is an independent panel of health experts authorized by Congress to provide evidence-based recommendations about preventive health services. 

Research scientists at the Wellesley Centers for Women (WCW) can offer their expertise about these new recommendations. Tracy R.G. Gladstone, Ph.D., serves as the inaugural director of WCW’s Robert S. and Grace W. Stone Primary Prevention Initiatives, which aims to research, develop, and evaluate programs to prevent the onset of depression and other mental health concerns in children and adolescents. Katherine R Buchholz, Ph.D., is a postdoctoral research scientist who works with Dr. Gladstone on Mood Check, a school-based mental health screening program in the Greater Boston area.

Dr. Buchholz: 

“Anxiety and depression are among the most common mental health concerns in kids and adolescents. Even before the pandemic, we were seeing an increase in anxiety and depression diagnoses in this age group. These new guidelines are important because they can help medical and mental health professionals to identify kids and teens who are at risk of or currently struggling with anxiety and depression. We know that anxiety disorders put a kid or teen at risk of future anxiety and depression in addition to contributing to academic, social, and behavioral problems. Screening young people could help to catch these symptoms early, connect kids/teens with intervention and treatments, and potentially prevent future mental health concerns.” 

“The team I work with runs a school depression screening program. Through this program, we identify teens who are struggling with symptoms of depression, anxiety, or suicidal thinking, but haven’t told anyone else in their lives. Some of these kids are really able to hide their struggles and it is helpful to have a formal screening program where clinicians are checking in with teens to see what is going on. We’ve been able to connect these kids with referrals for treatment, and oftentimes we hear that they have improved and are doing well.”

“Some pediatricians or schools screen for anxiety in kids and teens, and these new guidelines provide a consistent recommendation for universal screening for kids 8-18. The recommendation to start screening at 8 years old makes sense with the screening tools/measures that are available. Having said this, if a parent has concerns about anxiety or depression in kids younger than this, it is really important to reach out and discuss concerns with a pediatrician or mental health professional.”

Dr. Gladstone:

“Depression and suicidal thinking/behavior are significant concerns among adolescents, which is why the American Academy of Pediatrics similarly recommends annual depression screening for children ages 12 and up. According to the Institute of Medicine, preventive efforts around youth mental health are best focused a couple years before the age of highest risk for onset, when symptoms begin to emerge. We know that symptoms of depression often emerge around age 12, so targeting that age group for screening can help us identify at-risk kids at a point when preventive efforts can be particularly helpful. Preventive efforts are particularly important given that depression is a chronic, episodic illness, with most impairing cases of adult depression having roots during adolescence. Over time we have developed an evidence base of depression prevention programs that work for at-risk youth. Universal screening provides an opportunity to focus preventive efforts on those teens who are most likely to benefit, with the goal of preventing long-term struggles with depressive illness.”

“I support universal depression screening, even of kids who we believe do not have symptoms, because sometimes we adults just don’t recognize that the teens in our lives are struggling. Sometimes we think our irritable or moody teens are exhibiting developmentally appropriate mood fluctuations when in fact they are struggling with more significant depressive symptoms. And sometimes our teens, even when they feel really close to us, don’t feel comfortable telling us that they are struggling. Universal self-report screening provides teens with an opportunity to let us know they are having a difficult time, so that we can provide them with the support and resources they need to manage their symptoms.”

“Over the past 8 years, my team has worked in local school districts to conduct universal screenings for depression, anxiety and suicidal thinking/behavior, and time and time again we identify teens who are experiencing symptoms of anxiety and depression but have not found a way to let the adults in their lives know they need support. These screenings allow us to flag teens for further evaluation, and to work with teens and their caregivers to connect with mental health services either in school or in the community.”