The Effectiveness of GAD-7 Screening in High School Students

Abstract

Purpose/Background Adolescent mental health is a growing concern, with anxiety disorders being particularly prevalent among high school students. Left untreated, anxiety can significantly impact academic performance, social functioning, and long-term mental health. The COVID-19 pandemic exacerbated these challenges, highlighting the critical need for effective screening and intervention strategies. The Generalized Anxiety Disorder 7-item scale (GAD-7) is a validated tool for identifying anxiety disorders, yet its application in high school settings is limited. This scoping review explores the effectiveness of GAD-7 in increasing mental health referrals and improving anxiety outcomes in high school students. Methods A comprehensive search was conducted across PubMed, CINAHL, PsycINFO, Cochrane, and Scopus databases, focusing on studies published between 2014 and 2024. Inclusion criteria targeted peer-reviewed articles evaluating GAD-7 implementation in adolescents aged 14–19 years, with measurable outcomes such as mental health referral rates and anxiety symptom reduction. Studies not meeting these criteria or published in languages other than English were excluded. Four articles meeting the inclusion criteria were critically appraised and synthesized. Results The review revealed that three of the four studies demonstrated significant increases in mental health referrals following GAD-7 implementation. Two studies reported reductions in anxiety symptoms among students referred to mental health services. The GAD-7 consistently showed reliability in identifying moderate to severe anxiety cases, facilitating earlier intervention and access to mental health resources. Implications for Nursing Practice Integrating the GAD-7 into high school settings can address gaps in adolescent mental health care by promoting early identification and timely referrals. These findings support the development of school-based mental health programs incorporating the GAD-7 to mitigate long- term consequences of untreated anxiety and enhance overall student well-being. Further research is recommended to explore the tool’s long-term impact and cost-effectiveness in diverse educational settings