Depression: Need For Early Screening Of Children

There are strong recommendations that children between the ages of eight and above be screened for anxiety. This is because it provides the opportunity for early detection and intervention since an untreated anxiety disorder is associated with a higher change of anxiety, depression, substance abuse and suicidal ideation later in life.
The recommendation recently came from United States Preventive Services Task Force, an independent panel of health experts set up to screen children who are not showing any signs or symptoms of mental health problem.
The Task Force had mandated paediatricians to screen children as young as 8 for anxiety and children 12 and above for depression during routine checks.
The health panel’s new guidance represented a final set of recommendations for mental health screening for children. This is consistent with the groups draft recommendation that was released in April this year.
According to reports, the screenings are not meant to diagnose a child with either anxiety or depression, they are meant to identify those who may need extra support in mental health care.
“This is the first time that the task force has put forth a recommendation about anxiety screening in young people,” says Dr. Martha Kubik, a member of the task force and a professor in the School of Nursing in the College of Health and Human Services at George Mason University. She said there was strong evidence for anxiety screenings in children even without symptoms.
There was also substantial evidence anxiety can be successfully treated in young people, once it is identified
”We had a really strong, very robust evidence base looking at treatment for anxiety in young people, and specifically psychotherapy and cognitive behavioral therapy.There’s a very well-established evidence base that supports its effectiveness in treating young people with anxiety,”she asserted.
Also, a child and adolescent psychologist at Children’s Hospital Colorado ,Jenna Glover applauded the recommendations as a positive step foward, saying that, “ This is a way where we can get ahead of the ongoing mental health crisis to identify these  children and get them hooked into service. We know that early intervention really is the key to better outcome”.
According to the Centers for Disease Control and Prevention (CDC), between 2016 and 2019, about 9.4% of children between the ages of 3 and 17 experienced anxiety, and 4.4% have been challenged by depression. Those numbers have been rising over the past decade. As Ilan Shapiro, MD, Chief Health Correspondent, and Medical Affairs Officer at AltaMed Health point out that children’s mental health has become an even more pressing issue since the pandemic.
“Sadly, just as parents have experienced toxic stress during the pandemic, children have as well.
“But the difference is that young children don’t have tools to protect themselves from all the feelings and experiences that adults have. This is one of the reasons I  think these new recommendations are important, and why taking a preventative approach to children’s mental health is imperative.
“If we can screen youth for anxiety and depression early on, we can understand what is impacting our patients and help them. This is crucial to the health of future generations.
“It’s so important to understand the gravity of what’s happening among our children and be able to act upon it,” Dr. Shapiro said.
In another vein,Dr. Teresa  Hsu-Walklet, Assistant Director of the Pediatric Behavioral Health Integration program at Montefiore Medical Group emphasized that certain youth are more vulnerable to mental health challenges than others like children from historically marginalised communities ,” she explained.
“Normalising mental health through screening is a great way to increase the likelihood that these families will receive proper treatment.Young children may not always understand their emotions, so doctors have several standardised questionnaires they can use to screen children for anxiety and depression, such as the Screen for Child Anxiety Related Disorders and what’s called the PHQ-9 questionnaire”, she further said.
However, the task force aim to separate children who are having a rough couple of days from those who are experiencing ongoing and excessive mental health issues that disrupt their daily activities, such as going to school or attending birthday parties and other social events.
Anxiety and depression have been growing in young people for years. A study released in February found that 1 in 5 teenagers had experienced an episode of major depression, even before the Covid pandemic hit. A second report found that emergency room visits related to children’s mental health rose dramatically in 2020, compared with 2019.
“Our hope is that by putting these recommendations forward, that they will help to really bring awareness to the need for greater access to evidence-based mental health care for children and adolescents,” Pbert said.
The task force did not find enough scientific evidence to support screening for suicidal thoughts in children of any age, and called for more research in this area. The issue is especially important, as suicide rates are once again rising.
A September report from the National Center for Health Statistics found that young men ages 15 to 24 are at highest risk of suicide compared to any other groups. And though the overall numbers were small, the percentage of girls ages 10 to 14 dying by suicide rose 16% from 2020 to 2021.
According to experts, certain level of anxiety or sadness is common and even normal in children. Having to do a math problem in front of the class, for example, can lead to a fleeting sense of anxiety.
But Pbert said that true mental health problems in children can result in excessive behavior changes.
Some of the ways to identify anxiety or depression in children include, refusal to attend school or social events, ongoing feelings of hopelessness, a concerning uptick in headaches and stomach aches.
Sometimes, however, “children and teens keep their worries to themselves, so symptoms can be missed,” she said. “That’s why it’s so important that we screen children in primary care.”
“We’re not catching these children early. It is getting more severe and it’s getting to the point of crisis,” Glover said. “They’re engaged in aggressive behavior or severe eating disorder behavior, and they’re showing up in the emergency department.
“Had we caught them earlier, we could have been able to treat them on an outpatient basis,” she said.

By: Ibinabo Ogolo with Agency Report