Ethics and presymptomatic screening: Focus group study

Title	Presymptomatic Screening for Risks to Children’s Mental Health: Ethical Considerations from a European Focus Group Study with Mental Health Professionals
Source	Sammie N. G. Jansen; Bob C. Mulder; Sandra Boekhold (2025). Bioethical Inquiry https://doi.org/10.1007/s11673-025-10473-0
Level of evidence	Direct/qualitative research evidence
What	Six focus group discussions on potential risks and benefits of presymptomatic screening, involving 34 and adolescent mental health professionals (clinical, educational, or policy settings) based in North Macedonia, Slovenia, Italy, Germany, the Netherlands, Sweden.
Findings	We identified three main themes: 1) Promises and concerns about early screening. These include potential stigmatization and discrimination, ability to act on screening results, and the reliability and potential individual side-effects of screening tools. 2) Additional considerations. For example, biomarker screenings should include social and environmental factors to provide a holistic understanding of the child’s risk profile. Communication with children and parents should highlight screening results as predictive rather than diagnostic. 3) Implications for healthcare systems and society, including healthcare systems’ capacity to implement screening activities and follow-up procedures, and the need to balance individual side-effects of screening tools against expected population benefits. Our findings show the importance of considering risks associated with the development and implementation of presymptomatic screening to children’s mental health, and of balancing benefits and harms for individuals and society.
Recommendations	For researchers: Conduct further ethical and societal studies into presymptomatic screening, focusing on assessing and balancing risks and benefits for children’s well-being and societal development. For policymakers: When considering policy options for promoting children’s mental health: ·      Weigh the potential benefits of early screening against alternative interventions such as improving living environments and expanding social welfare policies. ·      Aim to balance long-term public health benefits of prevention programs against short-term demands and pressures on healthcare systems.
Target audience	Child and adolescent mental health professionals in clinical, educational, or policy settings, excluding prenatal phases.