The U.S. Preventive Services Task Force (USPSTF) has released its “13th Annual Report to Congress on High-Priority Evidence Gaps for Clinical Preventive Services.
In 2023, the USPSTF continued to fulfill its mission of improving the health of people nationwide by making evidence-based recommendations about clinical preventive services such as screening tests, counseling about healthy behaviors, and preventive medications. These recommendations help healthcare professionals, and their patients make informed healthcare decisions.
In this annual report, the USPSTF calls attention to high-priority research gaps related to promoting mental health and wellness for people of all ages. The report reinforces the Task Force’s commitment to improving health equity by highlighting research gaps that are reflective of populations that are most affected by mental health conditions.
Read the executive summary below or access the full report here (PDF File, 1.4 KB).
The U.S. Preventive Services Task Force (USPSTF or Task Force) is an independent, volunteer panel of national experts in prevention, primary care, and evidence-based medicine. The Task Force makes evidence-based recommendations about clinical preventive services that can be delivered or referred from a primary care setting to improve the health of people nationwide. The Task Force assesses the strength of the evidence and the balance of benefits and harms of a preventive service in people without signs or symptoms, including screening tests, behavioral counseling, and preventive medications.
Each year, Congress charges the USPSTF to provide a report that identifies gaps in the scientific evidence base and recommends areas for future research. In some cases, clinical preventive services have been well studied, but there are important evidence gaps that prevent the Task Force from making recommendations for specific populations. The USPSTF recognizes that disparities persist in healthcare delivery and health outcomes based on age, race and ethnicity, sexual orientation, gender identity, and social determinants of health, such as economic and social conditions. Addressing these historical inequities through research can help the Task Force issue recommendations to overcome economic, social, and other barriers to health, supporting the reduction of preventable health disparities.
In this 13th Annual Report to Congress, the USPSTF calls for more research on three key topics related to mental health and wellness—anxiety disorders, depression, and suicide risk prevention—to improve health across the lifespan. These issues are especially important to study in underserved populations and high-risk groups.
Where More Research Is Needed Related to Promoting Mental Health and Wellness for All Ages and Specific High-Risk Populations
In this report, the USPSTF calls attention to high-priority research gaps from its recent recommendations related to anxiety disorders, depression, and suicide risk for people of all ages and particularly for groups of people at increased risk. The Task Force has a long-standing commitment to, and specific methods for, evaluating the evidence for clinical preventive services and making recommendations that promote health and prevent chronic conditions, including interventions focused on mental health and wellness. Anxiety disorders and depression are common mental health conditions that can have a substantial impact on an individual’s life and their family members, and suicide is tragically a leading cause of death in the United States. Also, the impact of the COVID-19 pandemic has exacerbated already widespread morbidity relating to mental health and wellness.
Although mental health conditions can affect anyone, some groups of people are at higher risk because of their sex, gender, age, race, ethnicity, socioeconomic status, or other factors. The USPSTF is committed to mitigating the health inequities that prevent many people from fully benefiting from preventive services. Racism of all kinds affects the health of individuals and results in policies and practices, including healthcare access and delivery, that can lead to inequities in health on a population level. The USPSTF recognizes that race, ethnicity, and gender are essentially social rather than biological constructs. However, they are also often important predictors of health risk. The USPSTF is committed to helping reverse the negative impacts of racism, gender-based discrimination, bias, and other sources of health inequities, and their effects on health and wellness, throughout its work. As part of this effort, the Task Force works to improve health equity by highlighting research gaps that are reflective of the populations who are most affected by these conditions.
The Task Force recognizes that to achieve the benefit of screening for mental health disorders and reduce disparities and associated morbidity, it is important that persons who screen positive are evaluated further for diagnosis and, if appropriate, are provided or referred for evidence-based care. By highlighting the research gaps regarding screening tools for use in the primary care setting, collaborative care approaches, barriers to establishing adequate systems of care, and solutions to these barriers, the Task Force hopes that future research can fill these gaps and lead to improvements in mental health outcomes.
Future research in asymptomatic persons in the primary care setting in the following areas may help fill gaps and may result in new recommendations that will help improve the mental health and wellness of people nationwide.
Screening for Anxiety, Depression, and Suicide Risk in Children and Adolescents
- The Task Force is calling for more research on the benefits and harms of screening for suicide risk in all children and adolescents and of screening for anxiety disorders and depression in younger children.
- For anxiety disorders, more research is needed on the benefits of screening tests that look for a specific anxiety disorder vs. tests that look for several anxiety disorders.
- For depression, more research is needed to better understand the effects of screening for depression on long-term health outcomes.
- For suicide risk, more research is needed on the effectiveness of screening tests and treatments.
- For all conditions, evidence is lacking on screening and treatment based on specific demographics such as sex, race, ethnicity, sexual orientation, and gender identity.
Screening for Anxiety Disorders, Depression, and Suicide Risk in Adults
- The Task Force is calling for more research on the benefits and harms of screening for anxiety disorders in adults age 65 years or older and screening for suicide risk in all adults.
- For anxiety disorders, more research is needed on the accuracy of screening tools used in the primary care setting, especially in older adults and pregnant and postpartum people; barriers to systems of care; and the prevalence of anxiety disorders.
- For depression, more research is needed on the barriers to followup care and on implementation programs that report on how many patients are screened, referred, and treated.
- For suicide risk, more research is needed on what screening tools should be used, the accuracy of including one question on suicide risk within a depression screening, treatments for individuals identified through screening, and whether individuals identified through screening can be helped before they act.
- For all conditions, evidence is lacking on the most effective tools and treatments for screening high-risk populations, including Hispanic/Latino and Native American/Alaska Native populations.