Routine Anxiety Screenings Will Cause Overdiagnosis, Overprescription, Psychologist Warns

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From Fox News: “Pushing primary care doctors to screen all patients for anxiety will lead to overdiagnosis and overprescribing, as well as exacerbate existing shortages in mental health resources, a psychologist said.

‘It’s the wrong solution at the wrong time,’ Dr. Jonathan Shedler, a clinical professor of psychiatry at the University of California, San Francisco, told Fox News. ‘You can’t just carve the world into “disorders” and think you’re doing an adequate job of determining someone’s mental health needs.’

Earlier this month, the United States Preventive Services Task Force recommended that all adults under 65 get screened for anxiety as more Americans report symptoms of mental health issues following the COVID-19 pandemic . . .

‘It’s simply terrible “care” to give somebody a seven-question questionnaire in the office and write a prescription on that basis without addressing the bigger picture,’ Shedler, who has authored over 100 scholarly and scientific papers in psychology, said.

. . . Shedler worries that mass screening will lead to misdiagnosis, causing doctors to prescribe anxiety medications to patients who may not need them.

‘Primary care is not the place to get mental health care,’ Shedler said. ‘The physicians don’t have the time. They don’t have the resources. They don’t have the training.’

. . . American Psychological Association CEO Arthur C. Evans, told The Wall Street Journal that the group’s recommendation ‘is a really important step forward’ in the country’s ongoing battle with mental health. ‘Screening for mental health conditions is critical to our ability to help people at the earliest possible moment,’ he said.

Shedler, who has done extensive research on these types of standardized screening tests, said they are ineffective at identifying ‘mental health disorders.’

‘Psychiatric difficulties don’t exist in a vacuum,’ the psychologist told Fox News. ‘I think for vast numbers of people, the world is feeling increasingly unsafe and unpredictable.’

‘There’s a difference between anxiety and fear,’ he added. ‘On the screening questionnaires, there’s no distinction.’

. . . ‘This kind of screening is going to diagnose huge numbers of people with a disorder and a good number of them are going to end up on a lifelong path of one medication and one treatment after another,’ the doctor said. ‘When, in fact, they’re responding to realistic circumstances in the world.’

‘There’s a lot of things going on in society, in culture, financially, politically, that leave people feeling extremely vulnerable,’ Shedler told Fox News. He said fear often stems from these external dangers, while anxiety ‘is a response to internally arising dangers, psychological dangers.’

‘If it’s not anxiety, but fear of something out there, psychological treatment isn’t going to be the answer,’ he said.”

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5 COMMENTS

  1. Or like, ask them what they’re anxious about. No, that would be too hard and too scary and we don’t have the resources.
    In that case, leave people alone. The government, the health care system, need to stop pretending they care what happens to people.

    • I always found the best “screening” to be: “How are you doing?” Then ask questions depending on the answer and figure out what the person is worried about or frustrated about or angry about or whatever. Then try to help them come up with a plan. It ain’t rocket science, folks.

      Of course, the PURPOSE of “routine anxiety screenings” IS to create “overdiagnosis and overprescription.” That’s the whole idea. That’s also not rocket science. Screenings exist to get new “customers” and sell more product. They are marketing tools, not medical screening processes.

      • ‘Primary care is not the place to get mental health care, ….’ I couldn’t agree more. And making it illegal for PCPs to hand out the psych drugs, and leaving prescribing of the psych drug classes solely to the psychiatrists, may be a place to start the changes needed to help improve our discredited “mental health” system.

        ‘If it’s not anxiety, but fear of something out there, psychological treatment isn’t going to be the answer.’ Oh, so the psychologists no longer believe that distress caused by 9/11/2001 – right after that event – was distress caused by a “chemical imbalance” in my brain alone? You mean my psychologist’s belief system was totally insane?

        I agree, and figured that out decades ago – when she finally confessed her insane belief system to me – as I was picking up her medical records. Glad some of the psychologists are finally waking up to the fraud of the ‘chemical imbalance’ theory.

        “Screenings exist to get new ‘customers’ and sell more product. They are marketing tools, not medical screening processes.” ‘Call a spade, a spade,’ thanks Steve. And given that reality, ‘screenings’ most definitely are a bad idea for humanity, in general.

  2. Nothing more reliable than self report data given to large groups of people attempting to measure vague concepts that ultimately don’t matter because the person being screened is just entering random numbers to get back at the screener for wasting their time.

    If you want to screen for mental illness try something that might work like modifying the hearing test every kid gets anyway.