Graphic by Jieru Ye ’23.
By Shira Sadeh ’25
Science and Environment Editor
Content warning: This article discusses mental illness and eating disorders.
In a historic first, the U.S. Preventive Services Task Force — a panel of health experts — recommended routine anxiety screenings for all adults under the age of 65, according to The New York Times. The task force explained that their declaration is in an effort to detect and treat mental health disorders earlier, and follows a similar advisory released earlier this year for children and young adults, reported The New York Times.
Associated Press News reported that this is the first time the U.S. Preventive Services Task Force has issued advice on screening for anxiety before a patient displays symptoms. The proposal, which was made public by the task force on Sept. 20, 2022, will be open for public commentary until Oct. 17.
According to AP News, this recommendation follows studies that found that the potential benefits of widespread screening outweigh the costs. Lori Pbert, task force member and psychologist-researcher at the University of Massachusetts’ Chan Medical School, called this recommendation “very timely,” especially after increased reports of declining mental health resulting from isolation during the pandemic.
Pbert told The Washington Post that “[COVID-19] has taken a tremendous toll on the mental health of Americans.” She added that COVID-19 is “a topic prioritized for its public health importance, but clearly there’s an increased focus on mental health in this country over the past few years.”
In the AP News article, Pbert explained that anxiety disorders account for some of the most common mental health complaints from patients. They affect 40 percent of women in the United States at some stage of their lives, one in 10 people during antepartum and postpartum stages and one in every four men, according to the article.
Those facing discrimination, living in poverty or experiencing deep personal losses are more susceptible to developing an anxiety disorder, which can manifest in the form of frequent or infrequent panic attacks, phobias or feeling “on edge,” the article reported.
According to the New York University Langone Health website, anxiety screenings include a physical examination and a blood test recommendation, which the doctor will use to first determine if the symptoms originate from a physical condition, such as hypothyroidism, which has similar symptoms. Then, the doctor will ask a series of questions regarding any medications the patient is taking, some of which may cause anxiety as a side effect, such as levodopa for Parkinson’s disease or Cyclosporine, an immunosuppressant used to manage rheumatoid arthritis and psoriasis. If it is determined that the patient’s symptoms do not originate from physical conditions or medication side effects, the doctor will conduct a psychological evaluation, according to the article.
The psychological evaluation starts with an investigation into family history of anxiety disorders or depression. Then, the specialist will ask for a more in-depth description of symptoms and how they affect the patient’s life which may or may not include a self-completed questionnaire.
This more detailed explanation of symptoms helps determine if there are additional disorders accompanying the anxiety, a frequent occurrence, at times existing alongside eating disorders or post-traumatic stress disorder. Following these assessments, the doctor will facilitate a feedback session, during which they will describe appropriate treatment options, Langone Health said.
According to The Washington Post, while the task force’s recommendation may be a big step forward in addressing rising mental health statistics, some worry that it will not achieve practical results. The Washington Post article explains that some doctors, such as Massachusetts General Hospital psychiatrist and executive director of the Clay Center for Young Healthy Minds Eugene Beresin, are worried that this recommendation is unrealistic when it comes to their everyday practice.
Many health providers are struggling to keep up with patient demand, and many therapists have waitlists of over a month, the article said. “Screening is great, but with a dire shortage in the workforce, it’s perplexing unless there are plans for increased funding of clinicians,” Beresin said in an interview with The Washington Post.
The article went on to explain that the task force expects doctors to use their own clinical judgment when implementing this recommendation, stating that this is not a mandate, but will no doubt influence common medical practice across the country.