HEADSSS history scenario
candidate brief
You are reviewing a 15yo patient who has presented to ED with abdominal pain. Take a social history. You have asked her mother to leave the room.
actor brief
You are a 15yo who has come in with abdominal pain today.
- Live with mother and 13yo sister - no contact with father - good relationships with family, feel safe at home
- In year 12, usually good grades
- Very physically active - dance, cheerleading - good friendships
- Stress over exams lately
- If asked specifically, is careful to have healthy diet, coach has talked about eating disorders
- No boyfriend or girlfriend
- Not sexually active
- If asked specifically, has been feeling low last few months and have had suicidal ideation
- no plan - just the feeling of wanting to die
- protective factors - worries that her death will upset sister
- if candidate is appropriately reassuring, consent to disclose to parents and signposting advice/help
- Else, becomes withdrawn and tearful
examiner brief
- Wash hands, Introduce self
- Confirm patient identity
- Explain reason for social history
- Ensure confidentiality
- Structured social history
- Home
- Education
- Activities
- Asks about alcohol, illicit drug use
- Asks about sexual activity and any coercion
- Asks about MH, suicidal ideation, self-harm ideation
- Age-appropriate suicide risk assessment
- Disclose to parents
- Signposts to further support - e.g. MH liaison, GP
- Closes conversation well
- Empathetic manner
- Invites questions
- Thanks patient