Youth Health Risk Assessments at Northern Sydney Sexual Health Service

Published 18 September 2017. Last updated 21 May 2021.

This project developed a standardised process for conducting youth health risk assessments, to improve long-term health outcomes among young people.


To ensure that 100 per cent of young people aged 24 and under who attend Northern Sydney Sexual Health Service are given a youth health risk assessment, by September 2018.


  • Provides staff with the skills and knowledge to assess young people for health risks and vulnerabilities.
  • Provides support to young people with health risks and vulnerabilities.
  • Improves health outcomes in young people.


Adolescence is a time of increased risk-taking behaviour, which can have long-term effects on the health and wellbeing of young people. Some young people are more vulnerable due to disability, chronic illness or abuse, while others are marginalised due to sexual orientation or cultural background.

Key recommendations from the NSW Youth Health Policy 2011-20161 state that staff should receive training, supervision and support to work with young people aged 12-24 and manage youth health issues. It suggests that clinic confidentiality policies should be widely publicised to young people and youth health checks should be routinely used when caring for young people. These checks include the Home, Education/Employment, Eating, Activities, Drugs and Alcohol, Sexuality, Suicide and Depression, Safety (HEEADSSS) Assessment, which helps staff identify mental health, alcohol and other drug issues.

It was suggested by staff working in the clinic that not all young people attending Northern Sydney Sexual Health Service were being assessed for risk and vulnerability in a systematic way. Specifically, HEEADSSS assessments were not being routinely undertaken and the clinic’s confidentiality policies were not being adequately explained to young clients. A multidisciplinary team was developed to workshop the problem and identify potential solutions, including strategies to implement them in the service.


  • A one-hour face-to-face child protection training session was provided to clinic staff by the Northern Sydney Child Protection Service. This was tailored to sexual health staff and relevant to the HEADSSS assessment.
  • All staff completed mandatory online (My Health Learning) training and face-to-face child protection training within NSLHD.
  • All staff completed My Health Record HEEADSSS training online, to provide them with the skills to undertake the assessments effectively.
  • Further training in the form of a one-hour face-to-face HEADDSSS assessment workshop was provided to clinic staff by a Child Youth and Family Clinical Nurse Specialist, to provide staff with the high-level skills and confidence required to complete HEADDSSS assessments effectively.
  • The way confidentiality is explained to young people was reviewed and a brochure was developed in consultation with a youth health consumer focus group, to ensure confidentiality is understood clearly by young people.
  • A local work instruction was developed to standardise the youth health risk screening process for staff.
  • A Clinic 16 representative was invited to join the Child Wellbeing and Child Protection Reference Group in NSLHD as a permanent member. This provides Clinic 16 with a direct link to discussions around Youth Health and Child Protection policy in NSLHD, with two-way information flow.
  • Child protection and youth health was made a standing agenda item in the Clinic 16 team meeting, to provide an opportunity for discussion around pertinent issues or problems as they arise.


Implementation – The project is ready for implementation or is currently being implemented, piloted or tested.


January 2017 to September 2018

Implementation Sites

  • Clinic 16, Northern Sydney Sexual Health Service
  • Royal North Shore Community Health Centre
  • The Beachside Clinic, Manly


  • Child Youth and Family Health Directorate, NSLHD
  • Northern Sydney Child Protection Service, NSLHD
  • Northern Sydney Youth Health Promotion, NSLHD

Evaluation or Results

A full evaluation will be conducted in September 2018 to measure compliance with the following standards:

  • staff are confident in using the risk assessment tool, measured by staff surveys (target 100%)
  • staff see it as their role to perform youth health risk assessments, measured by staff surveys (target 100%)
  • clients have the confidentiality policy explained and feel supported when completing the youth health risk assessment, measured by client surveys (target 100%)
  • clients have a completed risk assessment in the Community Health and Outpatient Care electronic medical record, measured by a file audit (target 100%).

Lessons Learnt

A multidisciplinary team working together can create something far superior than one person working alone. It is best to define a problem before proposing a single solution. Changes took longer to implement than anticipated.


  1. NSW Ministry of Health. NSW Youth Health Policy 2011-2016: healthy bodies, healthy minds, vibrant futures. North Sydney: NSW Health; 2010.

Further Reading

HEEADSSS Psychosocial Assessment


Dr Rosalind Foster
Clinical Director, Sexual Health
Clinic 16, Northern Sydney Sexual Health, NSLHD
Phone: 02 9462 9500


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