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
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