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Preventive intervention type
Who is at risk?
What should be done?
Level/ strength of evidence
All young people aged 12–24 years
Conduct a Social Emotional Wellbeing (SEW) assessment using a strengths-based approach, to obtain a holistic assessment of health and to determine risk factors affecting wellbeing
Useful tools include a table of adolescent development stages (Appendix 1); the HEEADSSS assessment tool (Appendix 2); and the Aboriginal and Torres Strait Islander Youth SEW assessment (modified HEEADSSS; Appendix 3a) with its question guide (Appendix 3b)
Opportunistic and as part of an annual health check
Note: A strengths-based approach focuses on the strengths and capabilities of an individual and the community; advocates for a positive sense of cultural identity; and acknowledges that there is potential for change, growth and success.
The aetiology of most illness in young people is psychosocial, as their ‘health and behaviour patterns emerge from a complex interplay between the individual and more “upstream” forces that shape social contexts’.19 A comprehensive psychosocial assessment that provides information about multiple psychosocial areas of a young person’s life is considered essential for the provision of primary healthcare to young people. Although there is limited evidence on the effectiveness of such assessments in improving health outcomes, expert consensus recommends that such assessments be conducted. Numerous US organisations, including the US Preventive Services Task Force and the American Academy of Paediatrics,17,20,21 have produced guidelines recommending screening of young people for high-risk behaviours.
The HEEADSSS (Home, Education/Employment, Eating/Exercise, Activities, Drugs and alcohol, Sexuality, Suicide and depression, Safety) assessment is the most widely recommended psychosocial assessment tool both nationally and internationally.1,8,17,22,23 It is a systematic, structured and graded approach and designed such that topics perceived to be non-threatening are broached first before moving to more sensitive issues. HEEADSSS has been endorsed by the University of Melbourne Centre for Adolescent Health, the New South Wales Ministry of Health, Queensland Health and The Royal Australian College of General Practitioners.1,16,24
In 2012–13, the ‘Y Health – Staying Deadly’ research project, funded by the Australian Primary Health Care Research Institute, developed a culturally valid and culturally specific version of the HEEADSSS assessment – the Youth Social Emotional Wellbeing (SEW) assessment. Consistent with Aboriginal and Torres Strait Islander holistic perspectives on health, it takes a strengths-based approach. Such an approach focuses on the strengths and capabilities of an individual and the community; advocates for a positive sense of cultural identity; and acknowledges that there is potential for change, growth, and success.25,26 Appendix 1 provides a table showing adolescent development stages. Appendix 2 provides the original HEEADSSS assessment questions. Appendix 3a provides the Aboriginal and Torres Strait Islander Youth SEW assessment (modified HEEADSSS), and Appendix 3b provides a question guide to support the latter.
The Youth SEW assessment is recommended to be conducted as part of an annual health check. In Australia, the Medicare health assessment items for Aboriginal and Torres Strait Islander peoples provide an opportunity to conduct funded annual health checks. The ‘Y Health – Staying Deadly’ project also developed a template for an Aboriginal and Torres Strait Islander Youth Health Check, which can be adapted for use by individual services (refer to ‘Resources’).27 The Adolescent Health GP Resource Kit produced by the NSW Centre for the Advancement of Adolescent Health and Transcultural Mental Health Centre also provides templates for a health check for young people.1
National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (PDF 9.8 MB)
Evidence base to a preventive health assessment in Aboriginal and Torres Strait Islander people (PDF 9.4 MB)
National Guide Lifecycle chart (child) (PDF 555 KB)
National Guide Lifecycle chart (young) (PDF 1 MB)
National Guide Lifecycle chart (adult) (PDF 1 MB)