Health
Anxiety screenings recommended by US task force will cause overdiagnosis, overprescription, psychologist warns
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Pushing main care docs to display screen all sufferers for anxiousness will result in overdiagnosis and overprescribing, in addition to exacerbate current shortages in psychological well being sources, a psychologist mentioned.
“It’s the improper resolution on the improper time,” Dr. Jonathan Shedler, a scientific professor of psychiatry on the College of California, San Francisco, advised Fox Information. “You may’t simply carve the world into issues and assume you’re doing an ample job of figuring out somebody’s psychological well being wants.”
Earlier this month, the US Preventive Providers Process Pressure really useful that each one adults beneath 65 get screened for anxiousness as extra Individuals report signs of psychological well being points following the COVID-19 pandemic. The advisory group, which launched the steering as a draft, mentioned the aim was to assist stop psychological well being issues from going undetected and untreated.
“It’s merely horrible care to offer anyone a seven-question questionnaire within the workplace and write a prescription on that foundation with out addressing the larger image,” Shedler, who has authored over 100 scholarly and scientific papers in psychology, mentioned.
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Greater than 30% of adults reported signs of an anxiousness or depressive dysfunction this summer season, the Nationwide Heart for Well being Statistics estimates. The share of adults who obtained psychological well being therapy elevated to almost 23% in 2021, up from 19% in 2019, in accordance with the Facilities for Illness Management and Prevention.
Shedler worries that mass screening will result in misdiagnosis, inflicting docs to prescribe anxiousness drugs to sufferers who might not want them.
“Major care shouldn’t be the place to get psychological well being care,” Shedler mentioned. “The physicians do not have the time. They do not have the sources. They do not have the coaching.”
The psychologist pointed to an identical suggestion made by the panel in 2002 to standardize despair screenings, which was adopted by an increase in individuals identified with and prescribed anti-depressants. In 1996, roughly 5 million individuals have been on anti-depressants. That quantity steadily rose to 13 million in 2015, in accordance with a research by Frontiers in Psychiatry.
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A member of the federal process drive, American Psychological Affiliation CEO Arthur C. Evans, advised The Wall Avenue Journal that the group’s suggestion “is a extremely essential step ahead” within the nation’s ongoing battle with psychological well being. “Screening for psychological well being situations is vital to our capacity to assist individuals on the earliest attainable second,” he mentioned.
Shedler, who has achieved in depth analysis on most of these standardized screening exams, mentioned they’re ineffective at figuring out psychological well being issues.
“Psychiatric difficulties do not exist in a vacuum,” the psychologist advised Fox Information. “I feel for huge numbers of individuals, the world is feeling more and more unsafe and unpredictable.”
“There is a distinction between anxiousness and worry,” he added. “On the screening questionnaires, there isn’t any distinction.”
Shedler mentioned he is involved that simplified screenings will yield false positives.
“This type of screening goes to diagnose large numbers of individuals with a dysfunction and an excellent variety of them are going to finish up on a lifelong path of 1 remedy and one therapy after one other,” the physician mentioned. “When, in actual fact, they’re responding to lifelike circumstances on the planet.”
“There’s lots of issues occurring in society, in tradition, financially, politically, that depart individuals feeling extraordinarily susceptible,” Shedler advised Fox Information. He mentioned worry typically stems from these exterior risks, whereas anxiousness “is a response to internally arising risks, psychological risks.”
“If it isn’t anxiousness, however worry of one thing on the market, psychological therapy is not going to be the reply,” he mentioned.
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Moreover, as psychological well being points enhance, docs have raised issues over a scarcity of sources for these searching for assist.
“We now have a power scarcity of psychiatrists, and it’s going to continue to grow,” Saul Levin, MD, CEO and medical director of the American Psychiatric Affiliation mentioned throughout a Could briefing. “Individuals can’t get care. It impacts their lives, their capacity to work, to socialize, and even to get away from bed.”
By 2024, the U.S. might be quick between 14,280 and 31,109 psychiatrists, and psychologists, social employees, and others might be overextended as effectively, in accordance to a research printed in Psychiatry On-line.
Shedler mentioned the dearth of correct psychological well being care will solely be made worse if the federal process drive’s suggestion is finalized, because the variety of sufferers searching for therapy will enhance with out proportionately including psychological well being professionals.
He additionally highlighted that well being insurers often don’t cowl psychological well being therapy. After they do, it’s typically solely low-quality care that’s coated, creating one other barrier for these searching for therapy, in accordance with Shedler.
“A reliable, expert psychological well being skilled has the experience to tease aside what’s a psychological issue that we are able to cope with in psychotherapy, the place is remedy an inexpensive a part of a complete therapy and when is not it,” he advised Fox Information.
“That is what we’re within the enterprise of doing. It is not what a main care doctor can do with a seven-question questionnaire,” Shedler mentioned.
The proposed draft steering is open to public remark by means of Oct. 17.
Health
Nurses speak out: 'What I wish I'd known before entering the profession'
FIRST ON FOX: With nearly two-thirds of nurses in the United States experiencing burnout — including 69% of those under 25 years of age, according to the American Nurses Association — many in the industry are calling for change.
A recent survey by AMN Healthcare, a health care workforce solutions company based in Texas, found that most nurses aren’t optimistic about improvements, with 80% saying they think the year 2024 will be either “no better or worse” than last year and 38% of nurses expecting it to be worse.
“The concerns that many nurses have about their profession were not created by COVID-19 and have not gone away now that the crisis has passed,” Robin Johnson, group president of nursing solutions at AMN Healthcare, who administered the survey, told Fox News Digital.
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“Many nurses still feel overworked and undercompensated,” she said.
“What they want to see is a change in their daily working conditions — better hours, fair compensation and more time with their patients.”
Amid the ongoing challenges faced by today’s nurses, six people in the profession shared what they wish they’d known before they decided to enter the field — and what advice they’d give to newcomers.
Lisbeth Votruba: ‘Nurses don’t have enough influence’
Lisbeth Votruba, a third-generation registered nurse in Belmont, Michigan, is also the chief clinical officer of AvaSure, a virtual health care platform.
“When I first entered the profession in the 1990s, I was surprised to learn that although nurses are held to high ethical and legal standards, they do not have the influence to match that level of accountability,” said Votruba.
“I see trends to show this is changing, and I am doing what I can as a member of the senior leadership team of a technology company to make sure the voice of nurses is heard as health care technology is being designed,” she said.
“Nurses must be at the table for every discussion about technology that impacts the patient,” she said.
Mat Wellnitz: ‘Wish I’d known the stress involved’
Mat Wellnitz, a registered nurse in Big Rapids, Michigan, recently retired from a rural hospital after more than 34 years, most of them spent in critical care.
“I wish I’d known the amount of stress that’s involved in nursing,” said Wellnitz.
“I would have taken more time off for myself. It wasn’t until about a week after I retired that I realized how much stress I was blinded to.”
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He added, “I used to lie down and instantly could feel my heart pounding, always thinking about work. But not anymore — and I sleep better.”
Larry Williams: ‘Your work impacts your overall health’
Larry Williams worked as a registered nurse at California’s Stanford Hospital in the intensive care unit before retiring in 2021.
“I went into nursing with my eyes wide open … There were no surprises because I worked in two different hospitals while going to school,” said Williams.
“My advice to anyone considering nursing and health care in general is to find a way to actually work in a hospital prior to graduating. Pay attention to your strengths and weaknesses and choose an area that fits you as a person.”
“It is not the career for everyone, but it was for me.”
He also told Fox News Digital, “While you are working, pay attention to how your work is impacting your overall health. Not everyone is cut out to work in the ICU. I still have occasional work dreams, and I remember the names and faces of people I cared for who did not survive.”
Said Williams, “That is balanced by the happy memories of my peers as well as lives that I have touched … It is not the career for everyone, but it was for me.”
Karie Ryan: ‘Bedside nursing is not the only option’
Karie Ryan, currently the chief nursing officer at health tech firm Artisight, spent 27 years as a nurse in Florida, with a specialty in medical/surgical/orthopedics.
“I wish I had known that bedside nursing is not the only option available in order to make an impact,” she told Fox News Digital.
“There are so many specialty opportunities, including nursing informatics.”
She added, “If nursing schools offered exploration in nursing informatics and other subspecialties, it would open a new world of possibilities not only to those entering the field, but as a consideration for nurses later in their career who may want to transition but remain in the profession.”
Katelynn Blackburn: ‘Constant pressure took a toll’
Katelynn Blackburn, a former nurse who is now an entrepreneur, worked 12-hour night shifts for parent access care in Chico, California, for over two years before leaving the field.
“I wish I would have known more about how my personality would affect my profession in the medical field,” said Katelynn Blackburn.
“I am empathetic and caring; however, the field itself comes with a lot of pain and anxiety for patients and their families,” she said.
“The constant exposure to hardships, on top of the pressure of providing comfort and support to patients and their families, definitely took its toll on me.”
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She added, “I wish I had thought less about the income and salary and more about what the actual job entails. You must find something you are passionate about and ensure that it will secure your family financially.”
Noted Blackburn, “I have always had an entrepreneurial mindset and a personality driven to achieve more — so I decided to leave to pursue something I felt more aligned with.”
Michele Acito: ‘Emotional bond is deep’
Michele Acito is executive vice president and chief nursing officer at Holy Name Medical Center in New Jersey. She joined Holy Name in 1989 as a telemetry nurse, working in the cardiovascular and intensive care units before she was promoted. Earlier in her career, she worked as a staff nurse in orthopedics at St. Joseph’s University Medical Center.
“I wish I’d known about the emotional commitment I was making,” said Acito.
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“We know we will be committed to providing the best care … but the emotional bond and commitment you make to patients and families as they navigate through life-changing events is deep. As a nurse, you quickly learn how to comfort, celebrate, support and educate patients and families through the good and the difficult times.”
She added, “Today, nearly 40 years into my career, I am able to reflect on how my training as a nurse helped me to help patients and families during their most vulnerable moments. It is what makes me proud to be a nurse.”
“Another thing I wish I had known before entering the profession,” said Acito, “was how complex it would be to blend a career, a young family and a household.”
“Nursing was the perfect career for someone striving to manage it all.”
But “what I realized was that nursing was the perfect career for someone striving to manage it all and find fulfillment and purpose on a personal and professional level. It requires thoughtful prioritization, planning and support.”
Other insights: ‘A nurse is a career learner’
Acito also shared the importance of ongoing education to set up nurses for success.
“Having graduated from a BSN program, I thought I was educationally set for my entire career,” she said. “I quickly realized that was not true.”
She noted, “A nurse is a career learner. Obtaining degrees is very important to remain current with theory — but learning through continuing education is paramount to staying current in practice.”
“Technologically, nothing remains the same in health care,” said Acito. “It’s an ever-evolving field. Pursuing a nursing career in hospitals and health systems that are committed to investing in innovation and technological advancements is critically important.”
Acito also pointed out, “What I did not know then, but I know today, is that I made the best career choice when I decided to be a nurse. The hours are difficult, the stress intense, the emotional commitment deep — but the rewards are innumerable.”
For more Health articles, visit www.foxnews.com/health.
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