Pediatricians should screen children annually for mental or developmental issues, the American Academy of Pediatrics (AAP) recommends in a new clinical report.

The recommendation comes in response to a mental, emotional and behavioral health crisis that’s been brewing among America’s youth, the AAP says.

Up to 1 in 5 children in the U.S., including kids as young as 2, are living with a mental or behavioral health problem like depression, anxiety, ADHD or suicidal thoughts and feelings, according to the report published online today in the journal Pediatrics.

And in 2020, suicide became the second-leading cause of death among kids aged 10 to 14 and the third-leading among 15- to 24-year-olds. AAP said the rate increased 41% between 2000 and 2017.

The AAP argues that pediatricians are in the best position to spot early concerns and get children the help they need.

“Just as a pediatrician checks every child’s physical health and development, they need to feel equipped to identify mental, emotional and behavioral health issues during routine exams,” lead guideline author Dr. Carol Weitzman, co-director of the Autism Spectrum Center at Boston Children’s Hospital, said in a news release.

“The pediatrician also takes into context the family’s history and the community environment,” she added. “In fact, screening begins within the first month of life to identify postpartum depression in caregivers.”

The new report provides guidance on screening children beginning in the first year of life and beyond.

It recommends that child-focused screening begin at 6 months old and continue as part of well-child visits at 1, 2 and 3 years old. After 3, screening would continue annually.

The goal is to work with families to address children’s mental health symptoms before they grow worse, the report says.

Earlier studies have shown there’s a two- to four-year window between the initial appearance of mental or emotional symptoms to when they develop into a full-blown disorder, the AAP says.

“Mental health conditions can seriously affect a child’s ability to learn, grow and connect with others — and yet they often go unnoticed or untreated,” co-author Dr. James Guevara, a pediatrician at Children’s Hospital of Philadelphia, said in a news release.

“There are new strategies that can help pediatricians connect families with mental health support right in their offices,” Guevara added. “These include expert consultations, team-based care and training programs that help doctors respond more effectively.”

The report also provides guidance for organizing a pediatric practice for mental health screening, and what to do if a child screens positive with mental, emotional or behavioral symptoms.

As well as identifying concerns, the report emphasizes the need to build on a family’s strengths, resilience and overall health.

“Pediatricians and families can work together to build resilience and promote wellness in children and teens at every encounter,” Weitzman said. “Supporting children’s mental health now helps them grow into healthy, capable adults. It’s one of the most important investments we can make.”

If you or someone you know is struggling or in crisis, confidential, free help is available from the 988 Suicide and Crisis Lifeline. Call or text 988 or chat 988lifeline.org.