Quality Standard Details
Anxiety Disorders: Care in All Settings
- Publication Date
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2020-January-01
- Status
- Published
- Topic Area
- Mental Health and Addictions
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Anxiety disorders are characterized by excessive and persistent feelings of worry or fear. The most common mental health disorders are anxiety disorders. The prevalence of anxiety disorders (including obsessive–compulsive disorder and post-traumatic stress disorder) in Canada was 4.9% in 2015. In Ontario, 2.5% of adults have experienced generalized anxiety disorder.
Anxiety disorders are underdiagnosed and undertreated. The median time between the onset of a person’s symptoms and the person seeking care is 16.1 years; and even among people diagnosed with anxiety and related disorders, about 40% are untreated. Earlier identification and diagnosis are key first steps to accessing appropriate evidence-based treatment.
This quality standard addresses care for people with an anxiety disorder. It applies to care for people in all settings but focuses on primary and community care. This quality standard addresses the following anxiety disorder types: specific phobia, social anxiety disorder, generalized anxiety disorder, panic disorder, and agoraphobia. It focuses on care for adults (age 18 years and older) but includes content that is relevant for children and adolescents (under age 18 years).
For information about obsessive-compulsive disorder, please see Obsessive-Compulsive Disorder: Care in All Settings, which was developed concurrently with this quality standard.
Quality Standard in Brief
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Quality Statement 1: Identification
People suspected to have an anxiety disorder are identified early using (1) a validated screening tool or recognized screening questions and (2) validated severity-rating scales.
Quality Statement 2: Comprehensive Assessment
People suspected to have an anxiety disorder, or who have had a positive screening result for an anxiety disorder, receive a timely comprehensive assessment to determine whether they have a specific anxiety disorder, the severity of their symptoms, whether they have any comorbid conditions, and whether they have any associated functional impairment.
Quality Statement 3: Support for Family
People with an anxiety disorder are encouraged to involve their family during their assessment and treatment, considering individual needs and preferences. Family members are connected to available resources and supports and provided with psychoeducation.
Quality Statement 4: Stepped-Care Approach
People with an anxiety disorder receive treatment that follows a stepped-care approach, providing the least intensive, most effective intervention first, based on symptom severity, level of functional impairment, and individual needs and preferences.
Quality Statement 5: Self-Help
People with an anxiety disorder are informed about and supported in accessing self-help resources, such as self-help books, Internet-based educational resources, and support groups, considering their individual needs and preferences and in alignment with a stepped-care approach.
Quality Statement 6: Cognitive Behavioural Therapy
People with an anxiety disorder have timely access to cognitive behavioural therapy, considering their individual needs and preferences and in alignment with a stepped-care approach. The cognitive behavioural therapy is delivered by a health care professional with expertise in anxiety disorders.
Quality Statement 7: Pharmacological Treatment
People with a moderate to severe anxiety disorder, or people who are not responding to psychological treatment, are offered pharmacological treatment based on their specific anxiety disorder, considering their individual needs and preferences and in alignment with a stepped-care approach.
Quality Statement 8: Monitoring
People with an anxiety disorder have their response to treatment (effectiveness and tolerability) monitored regularly over the course of treatment using validated tools in conjunction with an assessment of their clinical presentation.
Quality Statement 9: Support During Initial Treatment Response
People with an anxiety disorder are informed about what to expect and supported during their initial treatment response. When initial treatment is not working, people with an anxiety disorder are reassessed. They are offered other treatment options, considering their individual needs and preferences and in alignment with a stepped-care approach.
Quality Statement 10: Specialized Expertise in Anxiety Disorders
People with an anxiety disorder who have not responded adequately to treatments are connected to a health care professional with specialized expertise in anxiety disorders.
Quality Statement 11: Relapse Prevention
People with an anxiety disorder who are receiving treatment are provided with information and education about how to prevent relapse and manage symptoms if they re-emerge.
Quality Statement 12: Transitions in Care
People with an anxiety disorder are given appropriate care throughout their lifespan and experience seamless transitions between services and health care professionals, including between care settings and from child and adolescent services to adult services.
Supporting Documents
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Patient guide for this quality standard
Know what to ask for in your care
Placemat for this quality standard
A quick-reference resource for clinicians that summarizes the quality standard and includes links to helpful resources and tools
Quality improvement tools and resources for health care professionals, including an action plan template
Supplementary information to support the data collection and measurement process
Additional Resources
If you would like to receive these resources, please send us a message using our contact form.
- Case for improvement (slide deck)
Share why this standard was created and the data behind it, to get the support you need to put it into practice - Technical specifications
See the technical specifications for the indicators within the quality standard - Tools to support patient care
- Summary of the public feedback we received
- Case for improvement (slide deck)
Last Updated: February 24, 2026
