The HEEADSSS assessment is a validated tool for assessing wellbeing and identifying psychosocial risk during adolescence. Early identification of concerns enables health professionals to deliver education and implement timely and appropriate interventions. However, there is little research examining clinician familiarity and confidence with taking a psychosocial history using the HEEADSSS assessment tool.
The aims of this study are two-fold (1) Investigate staff familiarity and (2) Evaluate enablers and barriers to psychosocial history taking with the HEEADSSS assessment.
Methods This study employs purposive sampling of multi-disciplinary staff routinely involved in assessment of young people. Participants were asked whether they were familiar with the HEEADSSS tool, and those responding ‘Yes’ were invited to further discuss perceptions, enablers and barriers through a semi-structured interview. A mix of likert-styled numerical scales, and open-ended questions were asked. Answers were transcribed iteratively for analysis. Basic quantitative methods were applied for likert-based responses. Principles of thematic analysis were used to derive common themes from answers to open ended questions.
Results 20 of 40 participants were unfamiliar with the HEADSSS assessment tool, and only 9/20 interviewees identified HEADSSS as a psychosocial interview. Attitudes regarding the importance of psychosocial assessment varies considerably (3.65/5), as does confidence in using HEEADSSS (3.55/5). Service pressures and concerns about appropriateness were the most commonly cited barriers (table 1). Staff awareness and teaching were identified as enablers to encourage use of HEEADSSS.
Conclusion Improving the mental health and wellbeing of young people is identified as a priority for patients and policy-makers. Wider delivery and confidence in taking a psychosocial history using the HEEADSSS assessment tool in secondary care is vital in detecting and addressing needs. This study highlights priorities to promote appropriate practice of psychosocial assessment: (1) training in adolescent health and history-taking; (2) defined management and referral pathways. Trust-wide stakeholder engagement with easily accessible interactive teaching and simulation training are proposed as initial enabling methods.
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