Using HEADSSS assessment by Dr Emma Parish

In the UK we often discuss our ageing population but sometimes fail to see the significant proportion of those in adolescence, between 12 – 19% of the total UK population in 2017¹.

Engaging this age group can be daunting for health professionals. HEADSSS is an interview prompt or psychosocial tool to use with young people. Still growing in the consciousness of health professionals (and in the letters making up its acronym) HEADS(SS) was first presented in publication in 1988². It has a reported yield of 1 in 3 for identifying concerns that warrant further investigation.

It follows a simple structure remembered by the acronym:

Home

Education & Employment

Activities

Drugs/Drinking

Sex

Self-harm, depression & suicide

Safety (including social media/online)

The great news is that many studies have shown that self-assessment with HEADSSS tools before discussion (completed at home or in waiting rooms) yields equal, and in some cases more, information than conducting the assessment in person. Helpful for time-strapped clinicians and better utilisation of time for young people attending appointments.

Key tips for using HEADSSS

• Greet young person first, let them introduce others
• Practice discussing issues that embarrass you
• Be clear in what you mean by confidentiality relating to discussion
• See young people on their own routinely (whenever clinically appropriate)
• Use linking phrases and questions that don’t presume:
  • Do you have a boyfriend/girlfriend?

Vs

• Do you have someone important in your life?
• Have you been in a relationship before? Tell me more…

For more details see the RCPCH Young People’s Health Special Interest Group (YPSIG) app – free to download here: https://app.appinstitute.com/heeadsss

Or this short HEADS-ED assessment tool: http://www.heads-ed.com/en/headsed/HEADSED_Tool_p3751.html

1. Association of Young People’s Health – Key Statistics Document 2017 download here: http://www.ayph.org.uk/keydata2017/FullVersion2017.pdf
2. Cohen, E, MacKenzie, R.G., Yates, G.L. (1991). HEADSS, a psychosocial risk assessment instrument: Implications for designing effective intervention programs for runaway youth. Journal of Adolescent Health 12 (7): 539-544.