HEADSS Assessment

The AIMHI project in Counties Manukau formed the basis for this component of the Health Expo. ( www.beehive.govt.nz/Print/PrintDocument.aspx?DocumentID=10685 )

This meant that hopefully some comparisons could be made with a large multicultural health assessment. Linwood College demographics asked similar questions but went a lot further, and the HEADSS assessment was modelled closely on AIMHI one. HEADSS stands for a number of categories (Home, Education, Activities, Drugs & Alcohol, Sexuality, Suicide) that are monitored for risk and resilience. Dr Sue Bagshaw met with the Linwood College Counselling team and it was decided to conduct the interviews for both year 9 and year 10 students using Linwood staff and others from the Collaborative and 198.

Training sessions were held to ensure consistency amongst interviewers and also filling out the back page for recording purposes.

It was envisaged that interviews would take 15 - 20 minutes. Reality showed that it was closer to two students an hour. This took until the end of term 2 when a halt was called on the process and it was re-evaluated. The staff decided to continue with a concentrated effort and interviewed all they could by the end of term 3. A reasonable number of students opted out of the interviews.

Dr Sue Bagshaw has written up a report (attached) on this component, having consulted to categorize the results and separate the ratings of risk and resilience.

Those who are identified as being at most risk by the HEADSS assessment had already been previously identified by the counselling staff through other behaviour and pastoral issues.

A significant outcome in this process also is in finding students not previously identified in any way for the college counselling team to follow up.

This project has had the effect of building relationships between the counselling team and the students at risk before the risk became a problem and perhaps even prevented the risk becoming a problem.

HEADSS Assessment at Linwood College

Linwood College has undertaken a project in which they have attempted to ascertain medical and psychosocial barriers to learning for young people at Linwood College in year 9 and year 10 in 2006. This project was part of the LANE project, which is a response to the Mayor, Garry Moore calling for all young people under 25 in Christchurch to be in employment or training and to be literate and numerate.

In February 2006 as part of a Health Expo, educational and physical health barriers to learning were examined. As part of this, in a separate project, Lynda Jeffs from the Collaborative undertook to study sight, hearing and oral health as barriers to learning and has reported on those findings.

Background to the Use of HEADSS

Other schools have been establishing health services around the country. These vary from a registered school nurse with a visiting GP, physiotherapist and alcohol and other drug counsellor through to an office worker who gives out paracetamol. A group of schools in South Auckland came together and called themselves the Aim Hi schools. They all have registered nurses providing a health service for students. They undertook to screen the health of all year 9 students as they entered the school. They screened for medical conditions and used a tool called HEADSS which covers issues related to Home, Education, Employment, Eating, Exercise, Activities, Drugs, Sexuality, Suicide, Spirituality and Safety,

HEADSS is a psychosocial screening tool designed by Dr Henry Berman in the USA and further developed by Drs Goldenring and Cohen. (Goldenring) It was designed to be used to discover the context of a presenting complaint to a health professional. It is also useful to engage young people in a therapeutic relationship and to help form a strengths based management plan with the young person. It is not a research tool. The AIMHI schools endeavoured to aggregate their findings using HEADSS as a screening tool for audit purposes and made it appear to be possible to use it for research.

It is well recognised that barriers to learning include mental health issues, including misuse of alcohol and other drugs. (Allen) Recent research has shown that some young people are more vulnerable to harm than others, and more at risk of events such as dropping out of school. The same research has also focused on what might protect young people or provide them with some resilience to harm. (Werner) There have been attempts to derive screening tools, which provide a score for comparing the balance of risk and resiliency factors. HEADSS has not demonstrated that it is a good tool for this score either. No satisfactory tool has been developed as yet.