Anxiety screenings recommended amid mental health crisis

Adults under 65 should be screened for anxiety disorders, an influential group of national experts recommended Tuesday, a move Long Island experts said is needed and overdue amid a mental health crisis.

Symptoms of anxiety are relatively common among adults, the U.S. Preventive Services Task Force said in its recommendation, and can impact a person’s quality of life by causing restlessness, fatigue and irritability as well as problems concentrating and sleeping.

This is the first time the task force has recommended anxiety screening for adults between the ages of 19 and 64, including people who are pregnant and postpartum. It has previously recommended anxiety screening for children 8 and older.

It also reaffirmed on Tuesday an earlier recommendation that adults, including people 65 and over, be screened for depression.

"Amid the mental health crisis in the United States, the Task Force worked to provide primary care professionals and their patients with recommendations on evidence-based screening,” Dr. Michael Silverstein, vice-chair of the task force, said in a statement. “Fortunately, screening all adults for depression, including those who are pregnant and postpartum, and screening adults younger than 65 for anxiety disorders is effective in identifying these conditions so adults can receive the care they need.”

Colleen Merlo, CEO of the nonprofit Association of Mental Health and Wellness based in Ronkonkoma and Riverhead, which has been advocating for anxiety screening in primary care settings, said the recommendation was "long overdue."

“We know that a lot of folks who need mental health treatment never make it through our doors or make it through the doors after they have suffered needlessly for years,” she said.

Diagnosing and treating mental health issues was pushed into the spotlight during the first years of the COVID-19 pandemic when people grappled with stress and isolation.

More than 35% of adult New Yorkers surveyed in May 2020 reported symptoms of anxiety and/or depression in the prior week, according to the New York Health Foundation. 

Experts said people are still struggling three years later.

“Prior to the pandemic, more than 10% of the general population already met criteria for an anxiety disorder and some people suggest during the pandemic that it more than doubled,” said Dr. Victor Fornari, director of child and adolescent psychiatry at Northwell Health. “Assessing for anxiety is important because if you find it, the treatment of anxiety can really … help minimize addiction, help minimize suicidal thoughts for people who are highly anxious.”

Fornari said a certain amount of anxiety is normal and healthy, such as knowing to look both ways before crossing the street.

“You don’t want to worry so much that it interferes with your ability to function,” he said. “People need to take anxiety seriously because it can have a negative impact on their social life, professional attainment, educational functioning and cause significant distress.”

Dr. Ronald Brenner, chief of Behavioral Health Services at Catholic Health said the recommendations bring attention to an important problem, noting that high blood pressure and gastrointestinal issues in a patient could be a sign of anxiety.

But how and when to screen for anxiety should be up to the clinician and the patient, he said.

“There should be some common sense of when to apply a screening and when not to,” he said. “We don’t want everybody to get tested for anxiety without them saying 'Ok, I’d like to have that done.’“

The recommendation is not binding and the task force did not specify what kind of screening tools should be used or how often screening should take place, saying more research is needed.

Some doctors use questionnaires to help measure anxiety by asking patients how often they have trouble stopping or controlling their worrying, if they have trouble relaxing, easily become irritated and other scenarios.

Jeffrey Reynolds, president and CEO of Family & Children’s Association, a nonprofit counseling center in Garden City, said anxiety screenings are “critical,” partly because people rarely go for mental health care on their own.

“I think it’s always been important, but post-COVID it’s even more important, just because the prevalence of anxiety appears to be increasing,” he said. “It’s just as important as questions about the monitoring of your blood pressure, your height, your weight, or anything else.”

Doctors can screen for anxiety with a simple assessment, he said. “I don’t think it is a huge lift on their part.”

“Typically people don’t go get mental health care until things are really bad,” Reynolds added. A screening “can bring you to a level of awareness before it turns into a full-blown crisis in which you are showing up at a hospital emergency room.”