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Clinical guidelines

National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people Second edition

Psychosocial

Author Dr Annapurna Nori
Expert reviewer Professor Sherry Saggers

Background

Since the aetiology of most illness in young people is psychosocial, a comprehensive psychosocial assessment is considered one of the cornerstones of primary healthcare for young people. There is, however, limited evidence on its effectiveness in improving health outcomes and current recommendations rely on expert opinion. The HEEADSSS assessment is the most widely recommended psychosocial assessment tool both nationally and internationally.1,7,11,13–16 It is a systematic, structured and graded approach and designed so that topics perceived to be non-threatening are broached before moving to more sensitive issues. Appendix 3.1 provides a table showing adolescent development stages. Appendix 3.2 provides the assessment questions. HEEADSSS has been endorsed by the University of Melbourne Centre for Adolescent Health, the NSW Centre for the Advancement of Adolescent Health, the RACGP and state funded family planning organisations such as Family Planning Queensland.1,17

The HEEADSSS assessment is recommended to be conducted as part of an annual health assessment. Numerous organisations including the US Preventive Services Task Force, the American Academy of Paediatrics and the American Medical Association11,18 have produced guidelines recommending annual screening of young people for high risk behaviours. In Australia, the Medicare health assessment items for Aboriginal and Torres Strait Islander people provide an opportunity to conduct funded annual health assessments. 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 assessment for young people.19

Recommendations: Psychosocial assessment
Preventive intervention typeWho is at risk?What should be done?How often?Level/strength of evidence
Screening All young people aged 12–24 years Conduct a psychosocial assessment to obtain a holistic assessment of health and to determine risk factors affecting wellbeing
Useful tools include the HEEADSSS assessment (see Appendix 3.2)
Opportunistic and as part of an annual health assessment GPP1,7,11,13–18

References

  1. Chown P, Kang M, Sanci L, Newnham V, Bennett DL. Adolescent health: enhancing the skills of general practitioners in caring for young people from culturally diverse backgrounds. GP resource kit, 2nd edn. Sydney: NSW Centre for the Advancement of Adolescent Health and Transcultural Mental Health Centre, 2008.
  2. Carr-Gregg M, Enderby K, Grover S. Risk-taking behaviour of young women in Australia: screening for health-risk behaviours. Med J Aust 2003;178:601–4.
  3. American Medical Association. Guidelines for adolescent preventive services (GAPS) recommendations monograph. Chicago: American Medical Association, 1997. Cited October 2011. Available at www.ama-assn.org/ ama1/pub/upload/mm/ 39/gapsmono.pdf.
  4. Goldenring J, Cohen E. Getting into adolescent heads. Contemporary Pediatrics 1988;75–90.
  5. Goldenring J, Rosen D. Getting into adolescent heads: an essential update. Contemporary Pediatrics 2004;21:64.
  6. Christie D, Viner R. ABC of adolescence: adolescent development. BMJ 2005;330:301–4.
  7. Queensland Health. Queensland sexual health clinical management guidelines. Brisbane: Queensland Government, 2010. Cited October 2011. Available at www.health.qld.gov.au/ sexhealth/documents/cm_guidelines.pdf.
  8. Family Planning Queensland. Working with young people. Family Planning Queensland. Cited October 2011. Available at www.fpq.com.au/ youthproject/traininginfo-SexAlcohol DrugsNotes2.html.
  9. Beall S. Talking with teens: successfully screening for high-risk behavior. J Soc Pediatr Nurs 2000;5(3):139–41.
  10. Chown P, Kang M, Sanci L, Newnham V, Bennett DL. Appendix one: Adolescent health check template. Adolescent health: enhancing the skills of general practitioners in caring for young people from culturally diverse backgrounds, 2nd edn. Sydney: NSW Centre for the Advancement of Adolescent Health and Transcultural Mental Health Centre, 2008.
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