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November 2, 2022

Screening for Anxiety: Improving Health Outcomes With Early Detection and Treatment

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Twenty five percent. That’s how much the prevalence of anxiety and depression increased worldwide in the first year of the COVID-19 pandemic. 

In the U.S. in particular, stressors caused by the COVID-19 pandemic, along with other crises, have led to a rise in anxiety disorders among adults and adolescents. 

To combat this growing issue, the U.S. Preventive Services Task Force (USPSTF) has recommended that adults under 65 be screened for anxiety by their doctors. This is in addition to their recommendation that all children aged 8 to 18 get screened for anxiety at their regular primary care appointments.The goal of these recommendations is to help keep anxiety disorders and other mental health disorders from going undetected and untreated for a long period of time, thus preventing worsening mental health symptoms and potential physical health issues. 

Here, we’ll share the potential benefits of screening, how it can be implemented in your practice, and how you can connect your patients to professional mental health care.

Anxiety poses risks to whole health 

Data shows that one in five adults in the U.S. has an anxiety disorder, yet many go undiagnosed and untreated. This growing issue poses a risk to not just American adults’ mental well-being, but their whole health. 

“Anxiety has been associated with a higher likelihood of getting sick because it affects our immune system,” says SonderMind Chief Medical Officer, Doug Newton, MD, MPH. It can also cause a racing heart, shortness of breath, stomach discomfort, and poor sleep. 

Moreover, anxiety can worsen existing physical and mental health conditions. “Studies have shown it can impact diabetes and our sugar intake…and heart disease,” says Dr. Newton.  

Improving clinical outcomes through anxiety screening

These recent anxiety screening recommendations follow a 2016 recommendation by the USPSTF to screen adults under 65 for depression — a recommendation that has proven to improve clinical outcomes. 

Evidence shows that:

  • Screening for depression improves the accurate identification of adult patients with depression in primary care settings
  • Combining depression screening with adequate support systems in place improves clinical outcomes
  • Treating adults and older adults with depression who were identified through screening in primary care settings with antidepressants, psychotherapy, or both decreases clinical morbidity

With the new anxiety screening recommendations, the USPSTF hopes to see a similar improvement in clinical outcomes for anxiety disorders. 

Reducing stigma

The potential to improve clinical outcomes is especially meaningful for those who experience higher rates of anxiety and other mental health disorders. Women are twice as likely to be diagnosed with an anxiety disorder, and it’s still not fully understood in the medical community why this is. Moreover, “LGBTQ+ and Black, Indigenous, and People of Color (BIPOC) populations have been differentially impacted by anxiety disorders,” says Dr. Newton. 

Between 30 - 60% of people who identify as lesbian, gay, bisexual, or transgender experience anxiety and depression at some point — a rate that is 1.5 to 2.5 times higher than what heterosexual or gender-conforming populations experience. This is, in part, because members of the LGBTQ+ community often face discrimination, harassment, rejection from their family, and fear of violence. 

BIPOC populations experience disparities that may contribute to persistent symptoms of emotional distress and worse mental health outcomes. These include, but are not limited to, discrimination and racism, and racial inequalities in mental health care, such as socioeconomic disparities, stigma, provider bias, and inequality of care. 

Increasing access to care 

To improve clinical outcomes, it’s imperative that U.S. adults have better access to the mental health care they need. The new adult screening recommendation has the potential to do just that. 

Anxiety screenings for adults can be done by any medical professional — not just a mental health professional or PCP. This allows people to have more choice in where or who they go to to get screened, and may enable a more convenient and comfortable experience. 

“This recommendation allows people to have a more evidence-based opportunity to get screened,” says. Dr. Newton.

It also paves the way for more education and discussion around anxiety. 

“It’s going to increase access to mental health care in many ways — perhaps getting people screened who may not have known about it or had the ability to talk about it previously,” says Dr. Newton. 

The recommendation has the potential to normalize anxiety and other mental health screenings. “Doing this screening, just as you would a blood pressure screening or a cholesterol screening, really does decrease stigma and therefore increases access to care,” he says. 

With millions of Americans with mental illness struggling to find mental health care each year, your practice can play a big role in helping U.S. adults get access to the professional help they need. 

What the screening recommendations mean for your practice 

You may be wondering if these new screening recommendations come with new guidance for how you screen your patients. There’s good news —  to screen your adult patients under 65, popular screening tools such as the Generalized Anxiety Disorder 2 (GAD-2) and Generalized Anxiety Disorder 7 (GAD-7) can be used. 

The USPSTF notes that anxiety screening tools alone are not sufficient to diagnose anxiety. If the screening test is positive for anxiety, a confirming diagnostic assessment and follow up are needed. 

You may also be wondering — and feel concerned — that screening all of your adult patients under 65 for anxiety may lead to false positives or to over-index anxiety disorders. This is a valid concern, but not something to be worried about, according to Dr. Newton. The key, he says, is to not overpathologize. 

“You may have some people screening in and having false positives, but that’s not a bad thing. This allows a mental health professional to come in and evaluate if there is something going on,” he says. “I’d rather over-index and allow more people to get help if needed. But it’s also important to make sure that we don’t overpathologize.”

Screening is key to identifying symptoms of anxiety disorders, but is only the first step in preventing mental health disorders and improving health outcomes. The critical second step is having the ability to refer patients to the mental health care they need to address their symptoms. 

Support for your practice and patients 

Having the appropriate processes in place to establish an efficient referral system is vital to connecting your patients to the mental health care they need. 

“SonderMind can be that valued partner when you need a quick referral. We’re there to help not only the patient, but the provider who may also be overwhelmed with their professional and personal needs,” says Dr. Newton.

SonderMind seeks to understand what your patients are looking for in a therapist and uses that information to quickly connect them — typically within 48 hours — with quality, licensed behavioral health specialists. Patients can schedule a session in-person or virtually, and use their insurance. 

“Knowing that you can get quick access to care and be able to use insurance is really important in getting people to the provider who is right for them,” says Dr. Newton. 

Moreover, SonderMind providers use an evidence-based approach to care and focus on high-quality clinical outcomes. They use outcome measurement tools and integrate data and research-driven insights that lead to improved outcomes. Together with SonderMind's secure telehealth capabilities and direct messaging and scheduling features, providers can quickly and easily reach patients in need.  

“The data we have at SonderMind shows that people often within six weeks can start to feel better,” says Dr. Newton. 

You can make a difference

Medical professionals and practices will play a big role in the effectiveness of these new anxiety screening recommendations. Implementing this new screening may feel like a huge undertaking, but you don’t have to do it on your own. If you need a partner to help ensure your patients have access to mental health care, SonderMind’s evidence-based, personalized approach can give your patients the comprehensive care they need.

Sources: 

Barile, J., Blumberg, J., Guerin, R., Jia, H., McKnight-Eily, L., Njai, R., Okun, A., Thompson, W. (2021, October 8). National and state trends in anxiety and depression severity scores among adults during the COVID-19 pandemic — United States, 2020–2021. Centers for Disease Control and Prevention.  https://www.cdc.gov/mmwr/volumes/70/wr/mm7040e3.htm#:~:text=The%20frequency%20of%20anxiety%20and%20depression%20symptoms%20experienced%20among%20U.S.,estimates%20from%20the%202019%20NHIS

Baumgaertner, E. (2022, September 20). Health panel recommends anxiety screening for all adults under 65. The New York Times. https://www.nytimes.com/2022/09/20/health/anxiety-screening-recommendation.html

Bentley, L. (2021, July 7). Why does the LGBTQIA+ community suffer from poor mental health at higher rates? University of Utah Health. https://healthcare.utah.edu/healthfeed/postings/2021/07/lgbtqia_mental_health.php

Brenner, B. (2016, May 18). Understanding anxiety and depression for LGBTQ people. Anxiety and Depression Association of America. https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/understanding-anxiety-and-depression-lgbtq

Caron, C. (2022, January 19). The upside of anxiety. The New York Times. https://www.nytimes.com/2022/01/19/well/mind/anxiety-benefits.html

Dentato, M. (2012, April). The minority stress perspective. American Psychological Association. https://www.apa.org/pi/aids/resources/exchange/2012/04/minority-stress

Harrington Hospital. (n.d.). What anxiety does to your body: 7 common physical symptoms. UMass Memorial Health. https://www.harringtonhospital.org/women_blog/what-anxiety-does-to-your-body-7-common-physical-symptoms/

Levey, D. (n.d.) High anxiety. Anxiety and Depression Association of America. https://adaa.org/sites/default/files/Anxiety.pdf

Mayo Clinic Staff. (n.d.) Anxiety disorders. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961

National Alliance on Mental Illness (n.d.). Black/African American. https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/Black-African-American 

National Alliance on Mental Illness. (n.d.) The doctor is out. https://www.nami.org/Support-Education/Publications-Reports/Public-Policy-Reports/The-Doctor-is-Out 

Perzichilli, T. (2020, May 7). The historical roots of racial disparities in the mental health system. Counseling Today. https://ct.counseling.org/2020/05/the-historical-roots-of-racial-disparities-in-the-mental-health-system/

Texas Health Resources. (n.d.) How anxiety affects men and women differently.  https://www.texashealth.org/Health-and-Wellness/Behavioral-Health/How-Anxiety-Affects-Men-and-Women-Differently 

World Health Organization. (2022, March 2). COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide 

**Disclaimer: This document is intended for educational purposes only. Please check with your legal counsel or state licensing board for specific requirements.

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