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As Youth Mental Illness Soars, Task Force Calls for Screening Earlier to Identify Those At Risk

An influential panel of experts says all kids ages eight to 18 should be screened regularly for anxiety. This recommendation by the United States Preventive Services Task Force comes at a time when mental health problems among kids nationally and locally have escalated – prompting more emergency visits and hospital admissions.

In making the recommendation, the task force noted kids with anxiety disorders are at higher risk of anxiety disorders and depression as adults, along with related risks like substance abuse.

The task force also recommends that kids 12 and older continue to be screened for depression, a recommendation that has been in place since 2016.

The goal of the screenings, said Michelle Morris-Deal, LCPC, a social worker in the behavioral health unit at CalvertHealth Medical Center, is to help doctors and other providers identify at-risk kids early on in their illness so they can be treated before symptoms worsen.

These screenings are usually done by primary care physicians or pediatricians using standardized questionnaires that parents and/or kids answer, depending on their age.

Morris-Deal said, “The screenings help gauge where a patient is concerning their mental health and if there is a higher level of care or services needed.” In that instance, she explained, the provider can make referrals to a therapist or psychiatrist in the area or to the emergency department for further assessment and connection to appropriate community resources.

She went on to add, “It’s vital we identify at-risk kids early so they can have the opportunity to address things sooner with appropriate resources such as outpatient therapy and medication management to avoid the need for a higher level of care.”

Numbers Jump During Pandemic

Morris-Deal said, “There was definitely an increase in ED (emergency department) visits, inpatient and PHP (partial hospital program) admissions during the pandemic here at CalvertHealth Medical Center.

“Some of the contributing factors I have seen are related to the toll isolation (during the pandemic) had on their social/emotional skills as well as their academic needs,” said Morris-Deal.

According to Lisa Hartwell, RN, who coordinates the partial hospitalization program, there were two occasions during the past year in which the adult program was temporarily closed in order to manage the high number of adolescents on the waitlist.

“At one point in February, there were 17 adolescents requesting admission,” said Hartwell. “Luckily, the adult volumes remained low so no adult patients were displaced.”

She went on to add, “Adults have more options available to them. They can travel to other facilities, which gives them more flexibility for treatment. Adolescents rely on parents and other adults in their lives for help with transportation, coordination and follow through. There is concern the adolescents on the waitlist run the risk of deteriorating further while waiting for treatment, which can lead to a higher level of care.”

Hartwell said the mental health issues adolescents are dealing with go beyond just feeling anxious. “The issues include but are not limited to depression, stress management, self-harm, suicidal thoughts, self-esteem, perceptual and distorted thoughts, anger management, impulsivity and self-care, which includes hygiene, sleep and daily maintenance.”

How Parents Can Help

“Anxiety can go undetected in children because of a lack of understanding of what anxiety is and the signs to look for,” said Morris-Deal.

Signs of stress and anxiety in children often show up as physical or behavioral changes. According to Morris-Deal, some signs parents should be concerned about are: when their adolescent isolates (more often than not), they’re irritable, when they notice signs of scratching/picking or other forms of self-harm, lack of appetite or eating more than usual and/or sleeping too much or not enough.

“It’s important for parents to recognize the signs and to look for possible causes,” she said. Children may not recognize their own anxiety and may lack the maturity to explain what is causing them stress.

Morris-Deal said the best thing parents can do is be available. “Be there to talk, listen and guide, as needed. Provide them with the opportunities to have conversations.”

Hartwell said it’s important to validate their emotions. She advises to “avoid such comments as: ‘You have everything, why should you be sad/unhappy/anxious? You’ll be okay. You’re fine.’ ”

Morris-Deal said it is time seek the advice of a healthcare practitioner, counselor or therapist when parents notice their symptoms are persistent and it affects their ability to function.

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