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The US Preventive Services Task Force has recommended adults under the age of 65 be screened for anxiety disorders. 

This is the first time anxiety screening for this group has been recommended. 

Screening for depression is still recommended for all adults including those who are pregnant or postpartum. 

"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,” Task Force vice chair Michael Silverstein, M.D., M.P.H said in a press 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.” 

More than 14 million Americans live with an anxiety disorder. This may include social anxiety, phobias, generalized anxiety disorder, panic disorder, selective mutism and anxiety that is not otherwise specified. 

Often, anxiety disorders go unrecognized in the primary care setting. 

Physical symptoms may sometimes be mistaken for other medical issues like hyperthyroidism or heart disease. 

But Shane Owens, PhD, a board certified psychologist practicing in New York, says universal screening may not be the right approach.  

“While I believe it's crucial to identify people with anxiety disorders, I am not sure that universal screening is the best way to accomplish that. The assessment of an anxiety disorder and its effects on a person's life is more than a checklist of symptoms, which is what the recommendations appear to recommend,” he told Theravive. 

“That said, a person may benefit from understanding and seeking treatment for abnormal thoughts, feelings, and behaviors. For a psychologist like me, it's less about identifying an issue and more about helping people make healthy decisions about coping with and treating anxiety if warranted.” 

The Task Force argues there is insufficient evidence to recommend screening in adults aged over 65. 

The Task Force also notes that screening is only the first step, and that those who screen positive for an anxiety disorder will need ongoing evaluation.  

Owens says that as it currently stands, the mental health workforce is not equipped to care properly for all of the people who will screen positive. 

“Unless we grow and rethink the mental health workforce, there is no way to treat everyone who will screen positive for anxiety. The best way to handle the overwhelming number of people with undiagnosed anxiety would be to have integrated primary care. In this model, primary care practices have in-house mental health specialists trained to assess and treat common mental health conditions like anxiety and depression,” he said.   

“At this point, what is likely to happen is that primary care office staff will give patients an anxiety screener along with first-visit paperwork as they do with the depression screeners recommended by a similar task force several years ago. In my experience, well-intentioned but overworked primary care physicians often overlook those results while treating the patient's chief complaint. Instead of screening patients for anxiety, yearly physicals should include professional assessments of emotional, cognitive, and behavioral functioning. And treatment of anxiety and depression should be as available and convenient as receiving treatment for high blood pressure or a sinus infection. This all depends on training more mental health professionals and making mental health care a more attractive career option.” 

Behavioral and cognitive therapies are among the most effective treatment options for anxiety. Owens says more needs to be done to ensuring such treatment is available for people who are found to have an anxiety disorder. 

“The bottom line is that we're likely to find many more anxious people than we have the ability to treat. If we prioritize anxiety screening, we should pay equal attention to effective treatments,” he said.