Prof Kate Steinbeck: HEEADSSS is a way of getting a
comprehensive picture of a young
person's world.
Graham Lane: It's a psychosocial screen tool, so
you're talking about the things that
influence people's lives. Andre Zeballos: More often than
not, the young person are coming with one
issue, but as you're having that
conversation, you'll realize that there's
a whole number of contributing factors
that maybe even the young person isn't
quite aware of. Voice over: When HEEADSSS conversations
with young people are crucial. Dr Melissa Kang: I was
quite a junior doctor working in an
emergency department, and there was a
fourteen-year-old girl in a bed with an
oxygen mask on
with the diagnosis of asthma. I started
talking to her, started to take a HEEADSSS
history, and I think that engaged her in
a conversation. By the time we got to
talking about sex, she actually admitted
to me that she thought she was pregnant
or she just found out she was pregnant.
She was having a panic attack and
hyperventilating, and that's the reason
she'd come into hospital. So we were able
to actually change tack and, you know,
give her the treatment and management
that she needed. Prof Kate Steinbeck: Often I'm going to be
the only person who's going to directly
ask those questions of that young person.
And then if I get answers, I have the
capacity to act and act in a timely way.
Graham Lane: The thing about working with young
people is that it's important to engage
them in a conversation. Kate Tolley: Sometimes a young
person might not have the the tools to
communicate what's really going on for
them. Dr Melissa Kang: I always find it important to build
trust and to have engagement. I think
that actually should be the first
goal when you're seeing an adolescent
patient. Doctor: Are you feeling OK?
Young person: Yeah, I am a bit anxious. Doctor: Yeah? Feeling a bit
nervous. That's understandable. You don't
know me. First time we've met, yeah. That's
all right.
So you are happy if I ask you a few
questions? Young person: Yeah. Dr Melissa Kang: Of course HEEADSSS is actually
more than that. It's about assessing risk
and protective factors because the
health problems of young people are
often around health risk behaviors. Andre Zeballos: So,
by having that conversation, you're
kind of able to bring that out while
building the relationship at the same
time. Dr Jane Ho: I think there are barriers at
different levels. Andre Zeballos: A lot of workers feel
stressed, pressed for time. You know, how
can I have a conversation when there's
10 million things in the back of
my mind that I need to do?
Dr Jane Ho: Often for general practitioners, they have long
lists of people who are waiting to see
them. Everybody's urgent. Dr Melissa Kang: But you don't
have to do it all at once. You can start,
move around in it, come back to it at
another time. Andre Zeballos: Just taking five minutes to
finish two of the questions, you know,
knowing that it can be a work in
progress. Dr Melissa Kang: Clinicians often worry that, by
the time they get to some of the more
sensitive parts of HEEADSSS, that they're
going to open a can of worms, that they
might not be equipped to actually deal
with what the young person is going to
reveal. And it can create a lot of
anxiety on the part of the clinician. And
there's often a concern to get to the
presenting problem, to deal with the
presenting symptoms and get to a
diagnosis rather than taking a step back
and saying, "Well let's broaden the line
of inquiry here". Dr Jane Ho: "But I think the
important thing to remember is that, I
think, the biggest barrier is in our own
heads. And that's not a pun...that was a pun.
Dr Melissa Kang: If you're getting ready to start
having a HEEADSSS conversation with a
young person, it's really important for
clinicians to be aware of how they're
feeling. Kate Tolley: So make sure I'm in the right
frame of mind, acknowledging what you're
not comfortable with. So, it might be that,
before you even ask the questions, that
you might need to go away and do a
little bit of research or discussion
with your peers first. Prof Kate Steinbeck: I think it's
always important as the clinician to
remember truly what adolescence was like.
Not knowing what you wanted to say, being
worried what you might sound like, all
that self-consciousness, and
embarrassment of being an adolescent. And
the sensitivity and the need for privacy.
I think it just reminds us to not push
too hard. Graham Lane: You need to take into
consideration what is actually happening
around you and what's happening around
the young person in whatever setting you're
in. And to make sure that people are
comfortable, it's best if you can make it
private. Dr Melissa Kang: Create a warm and welcoming and
trusting place for the young person and
for yourself as well. Because once you've
done it once or twice, it actually can
become absolute second nature when
you're talking to a young person.
Voice over: The next video is What a young person
may bring to the conversation.
It covers: Stages of adolescent
development; If trauma is disclosed, what
to do; Identifying protective factors; and
approaches for different stages of
development.
[Music]