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    Anxiety and Depression screenings now being recommended in primary care offices.

    Anxiety screenings, oh my! This is such exciting news (and it’s about time!). Psychologists and mental health professionals across the globe have been working to de-stigmatize and incorporate mental health struggles into physicians offices for years. We’ve been trying to help communities connect the dots between physical health and its impact on mental health, and to get more people talking about it. Now, for the first time, the US task force has proposed a recommendation for primary care providers to screen for anxiety and depression. YAY!

    No one can deny the spike in mental health issues since the COVID-19 pandemic. It seems like, whatever struggles we were keeping at bay, all bubbled to the surface and became harder to ignore. The things we were managing became less manageable. In our practice specifically, we saw a huge spike in the demand for mental health services. Heightened anxiety, worsened depression, hopelessness, you name it. Times seem tougher now than they did before. 

    One of the unique opportunities we’ve had at our practice is being connected to several OBGYN offices in the Bay Area. We’ve been able to offer immediate support to women struggling with pre and post perinatal and menopausal issues, as well as generalized anxiety and depression. By having this close of a relationship, we have been able to provide support to the nurses and other staff members about how to identify and talk to their patients, not only about their mental health struggles but about how to seek and receive help. The result of this has been that so many more women have been able to open up and get the support they need. 

    But what about all the other health care providers? Primary care clinicians? Oncologists? Or nursing staff in the ICU and emergency rooms. If only we could foster these symbiotic relationships where we provide education and support to physicians and nurses alike! Now, however, we might not have to. 

    We’re hopeful that this new recommendation will bridge the gap between what we could offer and what is needed. Adding a screening will help patients feel that there is a space for them to express their mental health struggles. Now hopefully, “What’s your discomfort and pain level?”, will be followed by, “What’s your anxiety or depression level?”. 

    If done properly, this screening could act not only as an immediate relief to patients, but also as a preventive tool to avoid more severe mental health symptoms down the road, as early intervention can be critical for people prone to anxiety and depression. 

    This is such a necessary addition to medical office screenings, and hopefully just the beginning! If you are a patient experiencing anxiety or depression, we hope this means you can start talking to your physician about it. And if you’re a nurse or physician, and would like some support around having these conversations with your patients, give us a call! We’re here to help. 

    Check out this article to learn more!

    For the first time, US task force proposes recommendation to screen for anxiety in adults

    By Naomi Thomas, CNN

    Updated 11:00 AM ET, Tue September 20, 2022

     

    (CNN)The US Preventive Services Task Force says for the first time that adults under the age of 65 should be screened for anxiety, according to a draft recommendation posted on Tuesday.

    The USPSTF is a group of independent disease prevention and medical experts whose recommendations help guide doctors’ decisions. The draft recommendation is not final, but will now enter a public comment period.

    The panel found “that screening for anxiety in adults younger than 65, and that includes those who are pregnant and postpartum … can help identify anxiety early,” Lori Pbert, a task force member, told CNN. “So it’s truly exciting.”

    The task force defines anxiety disorders as “characterized by greater duration or intensity of a stress response over everyday events.” Recognized types include generalized anxiety disorder, social anxiety disorder and agoraphobia. The USPSTF drafts also recommend screening for major depressive disorder in adults, consistent with recommendations for depression screening published in 2016.

    Pbert, a clinical psychologist and professor at the University of Massachusetts Chan Medical School, said an anxiety recommendation was prioritized “because of its public health importance, especially with the increased focus on mental health in this country that we’ve been having for the past few years.”

    The Covid-19 pandemic led to a surge of new anxiety and depression, although levels have fallen somewhat since. A recent CDC report found adults ages 18 to 44 were least likely to have received treatment for mental health in 2019 but became the most likely in 2021.

    The anxiety recommendation would apply to adults 19 and older who do not have a diagnosed mental health disorder. The depression screening recommendations apply to those 18 and over who do not have a diagnosed mental health disorder and are not showing any recognized signs of depression or suicide risk.

    Nearly 1 in 4 young adults in US treated for mental health during pandemic, CDC survey finds.

    Pbert emphasized that people who are already showing signs or symptoms should be assessed and connected to care.

    Brief screening tools have been developed for both anxiety and depression and are available for use in primary care. The majority of current screening tools include questionnaires and scales.

    Any positive screening result should lead to additional confirmatory assessments, the task force says. It also notes that there is little evidence regarding the optimal timing and interval for screening, and more evidence is needed.

    USPSTF says that in the absence of data, a pragmatic approach could include screening all adults who have not been screened before and using clinical judgment in considering other factors, such as underlying health conditions and life events, to make a decisions about whether additional screening is needed for people who are at high risk.

    How to get help

    Help is there if you or someone you know is struggling with suicidal thoughts or mental health matters.

    In the US: Call or text 988, the Suicide & Crisis Lifeline

    Globally: The International Association for Suicide Prevention and Befrienders Worldwide have contact information for crisis centers around the world.

    The recommendations for anxiety and depression screening are what USPSTF calls “B” classifications, meaning a clinician should offer the service because there is a “moderate net benefit.”

    Also included in the draft recommendations are two “I statements,” which don’t have enough evidence to recommend for or against the screening, Pbert said. The statements are for anxiety screening in adults over the age of 65 and for screening of suicide risk in adults. The task force calls for more research on both of the I statement topics to be able to help older Americans, as well as to understand the role of primary care in suicide prevention.

    “There are missed opportunities within primary care practice, and this is why we need research to understand what is the best way that we can screen individuals who do not have recognized signs or symptoms of suicide risk, that we can identify them and connect them with care,” she said.

    Elevating awareness about mental health care

    Screening for anxiety disorders is important because of the lifetime prevalence in the US, which the draft recommendations put at 26% for men and 40% for women, Pbert noted.

    Calls to suicide prevention lifeline rose 45% after changeover to 988 number

    “This is a very common mental health concern,” she said. “That is why it’s so important for us to be addressing anxiety disorders and screening for anxiety disorders.”

    The draft recommendations for anxiety, depression and suicide risk screening came together because “we really want to help primary care clinicians in addressing the urgent need to address mental health in adults in the United States,” Pbert said. “So we’re really seeing this set of recommendations as an opportunity to be able to provide clinicians who are working with adult patients comprehensive guidance in terms of how to approach screening for anxiety, depression and suicide risk.”

    The task force members also hope the recommendations will elevate awareness about the need for mental health screening and treatment.

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    “That’s an area that we need a lot of work in,” Pbert said. “There’s so many gaps in terms of providing mental health care, and our hope is that this group of recommendations will elevate that.”

    The task force is also very concerned about health equity, Pbert said.

    “Our hope is that by raising awareness of these issues and having recommendations for clinicians, that we’ll be able to help all adults in the United States, including those who experience disparities,” she said.

    The public will be able to comment on the draft recommendations through October 17.

    “We would like people to be honest, to provide their input and perspectives,” Pbert said, adding that the task force will read every comment. “It’s really important because it’s allowing us to hear from the public — and the public includes people who are specialists in these areas. … We really value the input of other specialists who can give us their perspective and their comments.”