Should Childhood Anxiety Screening Be a Mandatory Practice?

Mental health has increasingly become a prevalent topic over the last few years; even major sports organizations, like the NFL, have been pushing to support mental wellness. Recently, the U.S. Preventive Services Task Force, a group of disease prevention and medical experts assembled by the U.S. Department of Health and Human Services released a new recommendation for childhood anxiety screening. The recommendation states that “primary care doctors [should] screen all children ages 8 to 18 for anxiety, even if there are no symptoms.” 

With pediatric mental health conditions on the rise, we asked the Figure 1 community for their thoughts on what is causing increased mental health concerns in children and if mandatory anxiety screening is the right choice.

Here’s what more than 1,100 healthcare professionals had to say.

Do HCPs Agree?

We asked Figure 1 members if children aged 8 to 18 should be regularly assessed for anxiety, even when they show no indication. According to 60% of our respondents, the answer is yes. However, when asked if children under the age of 8 should receive the same screening for anxiety, 45% said no, 37% said yes, and the remaining 18% remained unsure. 

So what does this mean? While a majority of respondents agreed with the new recommendation, nearly a third disapproved. Furthermore, the majority disagreed with screening for children under 8. We can see that many healthcare professionals agree that childhood anxiety screening is probably a good idea but opinions are mixed on determining the criteria for which children should be screened.

What’s the Cause?

Diagnosis of mental health conditions in children has been on the rise for many years. In the U.S., children aged 3-17 diagnosed with anxiety increased by 29% from 2016 to 2020, with an increase of depression diagnoses by 27% for the same period. 

With this in mind, we asked Figure 1 members for their thoughts on what might be driving this unfortunate growth, and the responses were quite interesting. While it is difficult to pin down a precise answer, certain themes arose in our respondents’ answers. What was most commonly discussed was a shift in culture as the cause. Increased access to information and bombardment of multimedia can be overwhelming, especially to children. 

One respondent commented that “excess exposure to social media where children are comparing themselves to people they believe have something they lack. Whether that is beauty, slim figure, lavish lifestyle, freedom to do things that society labels as fun, etc.! Children feel inadequate and fear they will never have those things society labels as ‘must haves’ in order to be happy! So the more social media exposure, the more the kid isn’t happy, instead is anxious!”

The Biggest Concern

The debate on if every child should receive anxiety screening is still in a gray area, but what most concerns HCPs are treatment options. Both those who approved and disapproved of the child anxiety screening recommendation seemed to ask the question, if anxiety is diagnosed, who do I refer to? One respondent noted, “In our medical shortage area, even if I ID anxiety, there’s no one to treat.” And another nurse practitioner added, “Not enough appropriate mental health availability. Every problem doesn’t need a pill, but proper counseling/therapy needs to be available. Especially for children.” The general consensus among respondents was questioning, if no resources are available for treatment, why do more work to find a diagnosis?

However, some respondents remained optimistic, offering solutions and even alternatives to mandatory anxiety screening. One respondent offered the advice: “Therapy! Teaching children coping skills! Skills most adults don’t have so turn to cigarettes, alcohol, drugs or promiscuity!! Therapy is needed in the early school years! Just like they are teaching sex ed in lower school, they need to teach anti-anxiety therapeutic skills to prepare them for life!”

One physiotherapist’s response seemed to resonate with many others, saying that “We know it’s endemic … instead of wasting resources in screening we should teach kids about it in primary school and also teach them how to read or sense the anxiety effect on their bodies (somatic stuff) and mind. Solution is to teach practical strategies of coping [like] yoga (connection to their own bodies). These tools and skills practiced in a small way every day would help the kids feel safety in the moment, thus teaching how to cope with the onslaught of stress that modern life dumps on them daily.” A registered nurse follows up stating, “I like the idea of incorporating more coping mechanisms to help them unwind. Slippery slope if we aren’t careful how many kids we start medicating. If they feel nothing, that becomes a problem too!”

Most HCPs can agree that mental health concerns, especially in children, are becoming increasingly more endemic. But, how we go about addressing the issue is not as clear cut. Yes, we should screen for mental health, but exactly who to screen and why is debated. If a diagnosis is made, how do you handle treatment? Even with a new anxiety screening recommendation, there are still a lot of unanswered questions in the eyes of healthcare professionals. 

All and all, mental health conditions can affect us all differently and while governing bodies can provide guidance and recommendations, it is up to you and the child’s guardian to decide the best course of action.

Published February 6, 2022

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