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Dr. Smith is Assistant Professor, and Dr. McGuinness is Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama.
The authors have disclosed no potential conflicts of interest, financial or otherwise.
Addressing psychiatric and psychosocial issues related to children and adolescents
Brandy is a 14-year-old girl who has been in the foster care system for the past 5 years due to her mother's relapsing substance use disorder. In that time, she has received care from four pediatricians. Her most recent placement involves moving into kinship care with her 72-year-old great grandmother who brings Brandy to a children's medical center outpatient clinic with integrated psychiatric care. Brandy is referred to the psychiatric-mental health nurse practitioner (PMHNP) who has developed expertise in understanding the frequent moves associated with residing in the child welfare system as well as the potential for risky behaviors of adolescents. Due to the lack of documentation regarding any health history, the PMHNP decides to conduct a psychosocial assessment during the first visit using the HEEADSSS review of systems.
The purpose of the current article is to highlight HEEADSSS, a guide to assessing the context of a teen's life and how psychosocial issues relate to individual health. HEEADSSS is an acronym of pertinent factors associated with adolescent health: home, education/employment, eating, activities, drugs and alcohol, sexuality, suicidality, and safety ( Goldenring & Rosen, 2004 ; Klein, Goldenring, & Adelman, 2014 ).
Risky Behaviors in Adolescents
Adolescence is one of the most vulnerable periods in human development due to body changes, peer pressure, and the establishment of self-identity ( Sawyer et al., 2012 ). Neuroscience research shows that a crucial part of the brain undergoes extensive changes during puberty, which may account for some of the risk-taking behaviors seen in this age group ( Shonkoff & Phillips, 2000 ). Unintentional injury remains the leading cause of death, with motor vehicle accidents accounting for 70% of those deaths ( Park, Scott, Adams, Brindis, & Irwin, 2014 ). Suicide rates have risen for adolescents, and suicide is now the second leading cause of death, accounting for 13% of all adolescent deaths ( Shain & Committee on Adolescence, 2016 ; Sullivan, Annest, Simon, Luo, & Dahlberg, 2015 ). For lesbian, gay, bisexual, transgender, and questioning youth, the...