Adolescent Health

Question 1

What are most common causes of death in adolescents?

Answer 1

Most common causes (mostly to do with behaviours):

• Non-intentional injuries and poisoning
• Suicide
• Road traffic accidents

Question 2

When is adolescence?

Answer 2

Specific unique developmental stage:

• Occurs between 11-25 years

Question 3

What changes does the brain undergo in adolescence?

Answer 3

• Many changes in pre-frontal cortex
  
  • Social
    
    • Development of self-identify and increased self-consciousness
    • Growing independence from patents and increased focus on peer relationships
    • Questioning of different views
    • Development of romantic relationships
    • Seeking new experiences and increased risk taking
  • Emotional
  • Behavioural

Question 4

How can you support adolescent brain changes?

Answer 4

• Normalise challenges
• Supporting problem solving/goal setting
• Exploring and negotiating support – school/home
• Reminders (such as on hone)
• Finding opportunities to recognise successes

Question 5

During what phase of development do most mental health problems establish?

Answer 5

Data shows most mental health conditions established in this phase of development

Question 6

How can the consultation be adapted to suit adolescents?

Answer 6

• Setting it up
  
  • Offer to see adolescent patients on their own
  • Introductions – first name or Dr
  • Agenda setting – what do they want to discuss
• How we talk to young person (communication style)
  
  • Aim for conversation rather than interrogation
  • Avoid medical jargon
  • Judge when to use open and closed questions
  • Explore ICE, tailor management to their priorities
    
    • Can use decisional matrix (good/bads about how things are and how things could be)
  • Discuss adherence to treatment
  • Explore their understanding of their disease and treatments
  • Assess motivation

Question 7

Described the consultation model for adolescent health?

Answer 7

• Home
  
  • Where do you live, who stays with you
  • How do you get on with them
  • Who would you talk to if you had a problem
• Education (or employment)
  
  • What school, what year
  • What subjects enjoy, what are you good at
  • Who do you spend time with at school
• Activities
  
  • What do you do outside school
  • Are you in any clubs or teams
  • Who do you meet up with on weekends
• Drugs/alcohol
  
  • Do any of your friends smoke or drink, how about you
  • Have you ever tried cannabis
  • How much do you smoke/drink
• Sexuality
  
  • Do any of your friends have boyfriends/girlfriends, how about you
  • Have you ever had sex, do you use condoms/pill
• Suicide/self-harm
  
  • How would you describe your mood, do you ever get really down
  • Some people who feel really down often feel like hurting themselves or even killing themselves, have you ever felt like that
• (Sleep)
  
  • Do you have difficulty falling asleep
  • What time do you go to bed, what time do you fall asleep
  • Electron screens before bed
  • Napping during day

Question 8

What should you ask about for the following for adolescents:

• home
• education
• activities
• drugs/alcohol
• sexuality
• suicide/self-harm
• sleep

Answer 8

• Home
  
  • Where do you live, who stays with you
  • How do you get on with them
  • Who would you talk to if you had a problem
• Education (or employment)
  
  • What school, what year
  • What subjects enjoy, what are you good at
  • Who do you spend time with at school
• Activities
  
  • What do you do outside school
  • Are you in any clubs or teams
  • Who do you meet up with on weekends
• Drugs/alcohol
  
  • Do any of your friends smoke or drink, how about you
  • Have you ever tried cannabis
  • How much do you smoke/drink
• Sexuality
  
  • Do any of your friends have boyfriends/girlfriends, how about you
  • Have you ever had sex, do you use condoms/pill
• Suicide/self-harm
  
  • How would you describe your mood, do you ever get really down
  • Some people who feel really down often feel like hurting themselves or even killing themselves, have you ever felt like that
• (Sleep)
  
  • Do you have difficulty falling asleep
  • What time do you go to bed, what time do you fall asleep
  • Electron screens before bed
  • Napping during day

Question 9

When does the transition from paediatric to adult services occur?

Answer 9

Usually occurs around age 16 years:

• For new patients
• If already in paediatric start thinking about process of handing over to adults at around 16 but is flexible

Question 10

What are some differences between paediatric and adult services?

Answer 10

Question 11

What can be done to support the change from adolescents to adult services?

Answer 11

• Treat transition as process rather than event
• Begin process early
  
  • 11-12 years
• Ensure good understanding of condition and medications
• Initial joint appointments with adult and paediatric teams

Question 12

What toolkit can be used to assist transition from paediatric to adult services?

Answer 12

“Ready steady go” toolkit can be used to assist in transition:

• Begins at age 11-12 years
• Checklist at age stage to assist transition