New research recommends anxiety screenings for youth

Children ages 8 to 18 should undergo screenings for anxiety, the U.S. Preventive Services Task Force recommended in an October statement published in the Journal of the American Medical Association.

Anxiety disorder was common among youth prior to pandemic, which recent data suggests exacerbated the issue. The 2018–19 National Survey of Children’s Health (NSCH) found 7.8 percent of children and adolescents aged 3 to 17 years had an anxiety disorder. By 2020, 9.2 percent of youth had been diagnosed with anxiety problems, according to research from the Health Resources and Services Administration.

Though there is no specific recommendation for the number of screenings children should go through nor at what intervals, the health panel said repeated screenings “may be most productive in adolescents with risk factors for anxiety.”

“Risk factors for anxiety disorders include genetic, personality, and environmental factors, such as attachment difficulties, interparental conflict, parental overprotection, early parental separation, and child maltreatment,” according to the report. “Demographic factors such as poverty and low socioeconomic status are also associated with higher rates of anxiety disorders.”

Policymakers should take note of more recent findings surrounding risk factors.

While prior studies suggested that Black youth may have lower rates of mental health disorders compared to their peers, “recent cohorts of Black children or adolescents have reported a higher prevalence of anxiety disorders than in the past,” researchers wrote. “Multiple factors, ranging from socioeconomic status, childhood adversity, family structure, and neighborhood effects, may influence patterns of prevalence by race or ethnicity.”

The study notes that adverse childhood experiences, also known as ACEs, can increase the likelihood of one experiencing mental health conditions such as anxiety, which may result from a complex interaction of familial, peer or societal factors, including racial discrimination. Combined with lower engagement with mental health services, ACEs can result in high levels of unmet mental health needs in Black youth. Similar patterns of historic trauma, ACEs and substance abuse may also explain higher rates of mental health disorders in Native American/Alaska Native youth, according to the report.

The National Survey on LGBTQ Youth Mental Health reported that 72 percent of lesbian, gay, bisexual, transgender and queer youth and 77 percent of transgender and nonbinary youth described experiencing symptoms of generalized anxiety disorder. Anxiety conditions were most common in older children and adolescents (aged 12 to 17 years) compared with younger children (11 years or younger), according to the 2016 NSCH.

California’s ACEs Aware initiative, led by the Office of the California Surgeon General and the Department of Health Care Services, aims to help leaders bridge the gap between health, human services, education and non-profit sectors to prevent and address the impact of ACEs and toxic stress.

In August, Gov. Gavin Newsom announced California’s Master Plan for Kids’ Mental Health to ensure all California kids, parents and communities have increased access to mental health and substance use services. The plan includes investments such as $4.1 billion to connect kids and families to essential services including health screenings, meals and more through community schools strategies; $5 billion on a Medi-Cal initiative, CalAIM, to better integrate health and behavioral health services for low-income kids; and $1.4 billion to build a larger, more diverse healthcare workforce.