Psychosocial screening in adolescents

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Screen used in psychosocial screening of adolescent: HEADSS

H: Home:

● Who lives with the young person? Where?

● Do they have their own room?

● What are relationships like at home?

● What do parents and relatives do for a living?

● Ever institutionalized? Incarcerated?

● Recent moves? Running away?

● New people in home environment?

E: Education & Employment:

● School/grade performance--any recent changes? Any dramatic past changes?

● Favorite subjects--worst subjects? (include grades)

● Any years repeated/classes failed

● Suspension, termination, dropping out?

● Future education/employment plans?

● Any current or past employment?

● Relations with teachers, employers--school, work attendance?

A: Activities:

● On own, with peers (what do you do for fun?, where? when?)

● With family?

● Sports--regular exercise?

● Church attendance, clubs, projects?

● Hobbies--other activities?

● Reading for fun--what?

● TV--how much weekly--favorite shows?

● Favorite music?

● Does young person have car, use seat belts?

● History of arrests--acting out--crime?

D: Drugs:

● Use by peers? Use by young person? (include tobacco, alcohol)

● Use by family members? (include tobacco, alcohol)

● Amounts, frequency, patterns of use/abuse, and car use while intoxicated?

● Source--how paid for?

S: Sexuality:

● Orientation?

● Degree and types of sexual experience and acts?

● Number of partners?

● Masturbation? (normalize)

● History of pregnancy/abortion?

● Sexually transmitted diseases--knowledge and prevention? Contraception?

Frequency of use?

● Comfort with sexual activity, enjoyment/pleasure obtained? History of

sexual/physical abuse?

S: Suicidal safety:

● Sleep disorders (usually induction problems, also early/frequent waking or greatly

increased sleep and complaints of increasing fatigue)

● Appetite/eating behavior changes

● Feelings of 'boredom'

● Emotional outbursts and highly impulsive behavior

● History of withdrawal/isolation

● Hopeless/helpless feelings

● History of past suicide attempts, depression, psychological counseling

● History of suicide attempts in family or peers

● History of recurrent serious 'accidents'

● Psychosomatic symptomology

● Suicidal ideation (including significant current and past losses)

● Decreased affect on interview, avoidance of eye contact--depression posturing

● Preoccupation with death (clothing, media, music, art).

H: Home:

0. Supportive

1. Conflict

2. Chaotic

E: Education & Employment:

0. On track

1. Grades dropping

2. Failing/not attending

A: Activities:

0. No change

1. Reduced

2. Withdrawal

D: Drugs:

0. No / infrequent

1. Occasional

2. Frequent

E: Emotion:

0. Mild anxious

1. Moderately anxious

2. Depressed

D: Discharge resources:

0. Well

1. Some

2. None

0: No action

1: Action needed but not immediate

2: Need immediate action