Aim Unaccompanied asylum seeking children (UASC) experience psychological traumas, denying them age related cultural and developmental norms. They are at risk of significant psychosocial health problems. Identifying these health issues aids targeted interventions. This study tests feasibility of the HEEADSSS tool to identify psychosocial issues presenting at the Initial Health Assessment (IHA) for UASC.

Method 3 years of IHA reports of UASC were analysed using the HEEADSSS tool (Home & relationships/Education/Eating/Activities/Drugs/Sex/Self -image/harm & depression/Safety), to identify psychosocial risks. Each UASC report was matched by age and sex with one from a non UASC young person in care.

Results IHA reports of 64 UASC and 64 matched non UASC were used. Ethnicities: UASC 48% Afghan Pashtun, 46% Iranian Kurd. Non UASC 60% White British, 35% mixed Black/White British. Ages 11-18 years. Home: UASC 93% no family contact, 62% one deceased parent. Non UASC 95% family contact, 8% one deceased parent. Education: UASC 93% no previous formal education, 90% in UK Education with 95% >90% attendance, 94% indicated a future career. Non UASC 100% previous formal education, 72% in UK education with 65% <80% attendance, 48% indicated a future career. Eating: UASC 6% showed disordered eating, Non UASC 32% showed disordered eating. Activities: UASC 59% gym, 81% music, 37% football, 83% mosque. Non UASC 35% gym, 54% music, 64% football. Drugs: UASC 42% cigarettes, 3% drugs, 12% alcohol. Non UASC 27% cigarettes, 45% drugs, 59% alcohol. Sex: UASC 2% sexually active, 0% previous sex education, 24% history of sexual abuse. Non UASC 38% sexually active, 100% previous sex education, 15% history of sexual abuse. Self-image/harm: UASC 2% self harm, 61% low self esteem, 43% depression, 82% trauma history. Non UASC 45% self harm, 68% low self esteem, 38% depression, 68% trauma history. Safety: UASC 82% felt safe, Non UASC 56% felt safe. Overall: 87% UASC and 76% Non UASC required intervention.

Conclusion It is feasible to apply the HEEADSSS tool to the IHA report to collate specific psychosocial health risks for UASC, therefore enabling targeted interventions.