Mental health and substance use screenings by age
These screenings are short questionnaires, usually at a checkup, not blood tests. The USPSTF recommends four for adults: depression, anxiety up to 64, unhealthy alcohol use and unhealthy drug use. Children and teens have their own ages. A screen is not a diagnosis; a positive result leads to a fuller conversation with your clinician.
If you are struggling or thinking about suicide: in the US, call or text 988, or chat at 988lifeline.org, any time. (988 Lifeline)
What applies at each age
| Age | What applies | Source |
|---|---|---|
| 8 to 11 | Anxiety screening from 8. Depression screening: evidence insufficient under 12. | USPSTF, 2022 USPSTF, 2022 |
| 12 to 17 | Depression and anxiety screening. Alcohol and drug use screening: evidence insufficient for adolescents. | USPSTF, 2022 USPSTF, 2022 USPSTF, 2018 USPSTF, 2020 |
| 18 to 64 | Depression, anxiety, unhealthy alcohol use, unhealthy drug use; including during pregnancy and after birth for depression and anxiety | USPSTF, 2023 USPSTF, 2023 USPSTF, 2018 USPSTF, 2020 |
| 65 and older | Depression, unhealthy alcohol use, unhealthy drug use. Anxiety: evidence insufficient at 65 and older. | USPSTF, 2023 USPSTF, 2023 USPSTF, 2018 USPSTF, 2020 |
Your screening plan lists the adult screenings for your age. It never asks how you feel; the questionnaires belong in a visit.
Depression
The USPSTF recommends depression screening for all adults, including pregnant and postpartum people and older adults (grade B, 2023). (USPSTF, 2023) For young people it recommends screening for major depression at 12 to 18 and finds the evidence insufficient for children 11 and younger (2022). (USPSTF, 2022) More on depression screening.
Anxiety
For adults, the USPSTF recommends anxiety screening at 64 and younger, including during pregnancy and after birth, regardless of risk factors (grade B, 2023). At 65 and older the evidence is insufficient. (USPSTF, 2023) For young people it recommends screening at 8 to 18 (2022). (USPSTF, 2022) More on anxiety screening.
Suicide risk: evidence insufficient
The USPSTF found the evidence insufficient to weigh the benefits and harms of screening for suicide risk, in adults (2023) and in children and teens (2022). (USPSTF, 2023)(USPSTF, 2022) It notes that some depression questionnaires, such as the PHQ-9, include a question about thoughts of suicide. (USPSTF, 2023) Help does not depend on screening: the 988 Lifeline takes calls, texts and chats. (988 Lifeline)
Alcohol and drug use
The USPSTF recommends screening adults 18 and older for unhealthy alcohol use, with brief counseling for people who drink at risky levels (grade B, 2018). For ages 12 to 17 the evidence is insufficient. (USPSTF, 2018) It also recommends asking adults 18 and older about unhealthy drug use, where diagnosis and care can be offered or referred (grade B, 2020); for adolescents the evidence is insufficient. (USPSTF, 2020) For free, confidential treatment referral in the US, SAMHSA's National Helpline is 1-800-662-4357, open around the clock. (SAMHSA)
What the questionnaires look like
We name the common tools so you recognize them; we do not reproduce them, and they are meant to be used with a clinician.
- Depression: the Patient Health Questionnaire in its forms, such as the 2-question PHQ-2 and the 9-question PHQ-9, plus others such as the Geriatric Depression Scale for older adults and the Edinburgh scale after birth. (USPSTF, 2023) For teens, the PHQ-9 is the most used in practice, and a teen version (PHQ-A) was studied. (USPSTF, 2022) What happens at the visit and how PHQ scores are read: depression screening: what to expect.
- Anxiety: the GAD-2 and GAD-7, the most studied tools. (USPSTF, 2023) What the GAD-7 asks and how scores are read: GAD-7 anxiety screening.
- Alcohol: the AUDIT-C, with 3 questions on how often, how much, and heavy drinking occasions, or a single alcohol screening question (SASQ). (USPSTF, 2018) How the scores are read: AUDIT-C alcohol screening.
- Drugs: brief tools such as the NIDA Quick Screen, which asks 4 questions about alcohol, tobacco, nonmedical use of prescription drugs and illegal drugs in the past year. (USPSTF, 2020)
A positive result on any of these is a starting point, not a diagnosis: the USPSTF says it should lead to further assessment. (USPSTF, 2023)(USPSTF, 2018) This page is educational only, not medical advice; talk to your doctor about how you have been feeling.
Questions people ask
How often should I be screened for depression?
The USPSTF does not set an interval. It recommends screening all adults, including during pregnancy and after birth and in older age, and says a positive screen should lead to a fuller assessment to confirm the diagnosis. (USPSTF, 2023)
Why is anxiety screening only up to 64?
The USPSTF found too little evidence to weigh benefits and harms of anxiety screening at 65 and older, so it gives that age an I statement rather than a recommendation against. Depression screening continues at any adult age. (USPSTF, 2023) (USPSTF, 2023)
Does the USPSTF recommend screening for suicide risk?
It found the evidence insufficient for adults (2023) and for children and teens (2022). That is not advice to ignore it: if you are struggling or thinking about suicide, call or text 988 in the US, any time. (USPSTF, 2023) (USPSTF, 2022) (988 Lifeline)
What is the AUDIT-C?
A 3-question alcohol screen about how often you drink, how much on a typical day, and how often you drink heavily. It takes 1 to 2 minutes. The USPSTF names it, along with a single-question screen, as accurate brief tools for adults. (USPSTF, 2018)