On Tuesday, a group of health experts recommended for the first time that doctors screen all adult patients under 65 for anxiety, a guideline that highlights how unusual stress levels are. United States since the beginning of the pandemic.
The advisory group, known as the US Preventive Services Task Force, says the guidance is intended to help prevent mental health disorders from going undetected and untreated for years or even years. decade. It made a similar recommendation for children and teenagers earlier this year.
The panel, appointed by a branch of the federal Department of Health and Human Services, prepared guidance since before the pandemic. Lori Pbert, a clinical psychologist and professor at the University of Massachusetts Chan School of Medicine who serves on the task force, said the recommendations came at a “necessary” time. Americans reported levels of anxiety that exceeded their response to a combination of stressors, including inflation and crime rates, fear of illness and bereavement from Covid-19 .
“It’s a crisis in this country,” said Dr. Pbert. “Our only hope is that our recommendations highlight the need to create greater access to urgent – and mental health care.”
Between August 2020 and February 2021, the proportion of adults with recent symptoms of anxiety or depressive disorder increased to 41.5% from 36.4%, according to a study cited led by special forces.
Guidelines have been issued in draft form. The panel will finalize it in the coming months after considering public comments. Although the panel recommendations are not mandatory, they greatly influence the standard of care for primary care physicians across the country.
In response to the recommendations, mental health providers emphasized that screening programs are only useful if they lead patients to effective solutions. Jeffrey Staab, a psychiatrist and chair of psychiatry and psychology at the Mayo Clinic, said at a time when the country “lack of mental health resources at all levels – psychiatrists, therapists psychologists and therapists – that’s a real concern. in Rochester, Minn.
“We can screen a lot of people, but that alone is a waste of time,” said Dr. Staab, who was not on the task force.
Psychiatrists, while pleased with the mental health attention, also stress that standard screening is only the first step to a diagnosis and providers will need to be wary of assuming that the results A positive screening indicates a clinical disorder.
For many Americans, screening can simply reveal a temporary difficult time and need for extra support.
“When providers say, ‘You have to have a disorder, here, take this,’ we can face the problem of overprescribing,” says Dr. Staab. “But the opposite scenario is that we have a lot of people who suffer from what shouldn’t be. Both outcomes are possible.”
Rising mental health problems are not unique to the United States. Anxiety and depression 25 percent increase globally during the first year of the pandemic, according to the World Health Organization, and has only partially improved since.
According to the task force, about a quarter of men and about 40% of women in the United States face an anxiety disorder in their lifetime, although much of the data is out of date. Studies show that women are nearly twice as likely to become depressed as men, and it is recommended that special attention be paid to screening for pregnant and postpartum patients.
Doctors often use questionnaires and scales to survey mental health disorders. Per the recommendations, a positive screening result should lead to additional evaluations at the provider’s discretion, depending on underlying health and other life events.
Some primary care physicians expressed concern that adding additional responsibility to their extensive checklists for brief patient appointments was unacceptable.
The task force’s Dr. Pbert says those vendors should “do what they already do every day: Juggling and prioritizing.”
She also said the task force’s rigorous review of existing studies shows that people of color are often underrepresented in mental health research, which, if left unaddressed, can contribute to inequality cycle.
Mental health disparities are widespread in the United States, where Black patients are less likely to receive treatment for mental health conditions than white patients, and Black and Hispanic patients Dentistry is more often misdiagnosed. From 2014 to 2019, suicide rates among black Americans get a raise 30%, data shows.
Dr Pbert said standardizing screening for all patients could help combat the effects of racism, implicit bias and other systemic problems in the medical field.
The Task Force did not extend its screening recommendations to patients 65 years of age and older. It said there was no clear evidence of the effectiveness of screening tools in older adults because symptoms of anxiety are similar to normal signs of aging, such as fatigue and generalized pain. The panel also said it lacked evidence on whether screening for depression in adults without obvious signs of the disorder prevents suicides.
The task force will accept public comment on the draft recommendation through October 17.