The U.S. Preventive Services Task Force recommended Tuesday that children and teens be screened for anxiety and depression — the first time the advisory panel has issued such a recommendation.
The move follows a push by Congress and the Biden administration to address youth mental health after data has shown an increase in mental health challenges for young people in recent years that was further amplified by the COVID-19 pandemic.
The task force, an independent, volunteer panel of national experts in prevention and evidence-based medicine, advises that children 12 or older be screened for depression and children ages 8 and older be screened for anxiety. Both recommendations received a B grade and are finalized.
Under the 2010 health care law, most private insurance plans must cover recommendations that receive an A or B grade from the task force as a preventative service.
“The Task Force reviewed the evidence on screening for anxiety, depression, and suicide risk to provide primary care professionals with guidance on how they can help support the mental health of children and adolescents,” task force member Martha Kubik said in a written statement. “Fortunately, screening older children for anxiety and depression can identify these conditions so children and teens can receive the care that they need.”
The recommendations are intended for children and teens who do not already exhibit symptoms of depression or anxiety. Adolescents showing signs of either condition should be connected to appropriate care.
Children and teens with a genetic predisposition for these conditions who have experienced trauma, parental troubles, childhood abuse or bullying are also at increased risk, as are adolescents who identify as LGBTQ. Multiple aspects of the COVID-19 pandemic may also contribute to increased mental health symptoms.
Centers for Disease Control and Prevention data from its Feb. 18 Morbidity and Mortality Weekly Report showed that weekly emergency room visits for girls 12 to 17 years old increased for five mental health conditions in January 2022 compared with 2019.
Depression in particular increases the risk of suicide attempts or suicide deaths. Suicide is the second leading cause of death in adolescents aged 10 to 19, but the panel did not issue a definitive statement related to screening for suicide.
The task force gives each recommendation a rating of A, B, C, D or I. A and B statements mean a service should be offered. An I statement, meanwhile, means the panel does not have enough data to recommend or not recommend a guidance.
On Tuesday, the panel issued three related I statements: one on whether to screen children of all ages for suicide risk, one on whether to screen younger children for anxiety and a third on whether to screen younger children for depression. The panel is calling for more research into these to make an evidence-based decision.
Younger children are not immune to showing signs of these conditions. The task force notes that the onset of anxiety disorders can be seen in kids as young as four or five.
The recommendations come as congressional committees have also pushed for an emphasis on expanding care and resources related to youth mental health.
U.S. Surgeon General Vivek Murthy also issued an advisory warning of the youth mental health crisis in December.
The bipartisan 2021 gun safety law expands school-based mental health, increases training for pediatric providers and boosts the number of community mental health services.
Other congressional efforts are ongoing — though it’s not yet clear if they can be finalized this year.
The Senate Finance Committee’s bipartisan draft mental health package includes a number of youth-oriented provisions. A separate bipartisan House-passed grants package would reauthorize mental health grant programs including some focused on youth.
The two recommendations for adolescents follow similar draft guidance issued in September for adults. The task force’s draft calls for adults 64 and younger — including pregnant and postpartum adults — to be screened for anxiety.
The panel is still seeking public comment on this recommendation until Oct. 17 and will issue its final recommendation after that.