Young people’s

healthAdolescents and General Practice

Based on Maggie Eisner, January 2011,Modified Heather Naylor October 2014

Teenagers!

http://www.bvtv.co.uk/kevin-becomes-a-teenager-bbc-comedy/

Aims of today

1. To recognise the barriers adolescents may face in accessing primary care services

2. To highlight areas of clinical concern in adolescent health

3. To consider issues and challenges around consultations with young people

4. To discuss how GP practices can be made more teenage friendly

Young people in our societyThere are 6 million aged 10-19 in UK

Why is adolescent health important?

Death rates in 15-19 year olds now exceed those in 1-4 year olds. Main causes Accidents Violence Suicide

25% of young people have seen their GP in the last 3 months, but there is evidence that some young people find it difficult to access health services appropriately.

Young people’s point of view

Your teenage experience

Think about when you were a teenager (or a teenager you know well).

What health concerns did you/they have?

What contacts did you/they have with health professionals?

What did the health contacts feel like?

What made/ may make these contacts more difficult than for adults?

Barriers for teenagers in accessing primary care Concern about confidentiality

Embarrassed about symptoms

Lack of information about services

Appointment system

Geography/ transport

Young people’s health agendas

Sexual health – c/c, pregnancy (TOP/parenthood), STDs, sexual orientation

Mental health – self esteem, exam stress, adolescent adjustment, home and school relationships

Appearance – skin, body image, size

Minor illness – not minor to them, not familiar with it

Chronic illness – may express resentment by non compliance

The GP’s point of view

Your medical experience

Think about consultations with teenage patients

In any context – not just GP

What were the issues?

How did the consultations differ from adult or child consultations?

Issues in the consultation

Communication/rapport

Confidentiality

Consent

Access

3 way consultations

Presenting problem vs hidden agenda vs health promotion

In the consultation Relate directly to young children so they’re

used to it by the time they’re teenagers

Extra explanation time for common problems (flu, cystitis)

Be very patient centred esp with non compliant teenagers with chronic diseases

Health promo sensitive to young people’s agendas

Don’t make assumptions

Get their mobile phone number

A scheme for assessing troubled teenagers (HEADSS)

Home – can you talk to your parents?

Education – ask about actual school performance

Activities – what do you like doing? Do you have friends you can trust?

Drugs (incl smoking and alcohol) – explain why you want to know

Sex – ask permission to ask the questions

Suicide risk – if consultation makes you feel you should ask

Contrasting agendasYoung people

Sexual health – c/c, pregnancy (TOP/parenthood), STDs, sexual orientation

Mental health – self esteem, exam stress, adolescent adjustment, home and school relationships

Appearance – skin, body image, size

Minor illness – not minor to them, not familiar with it

Chronic illness – may express resentment by non compliance

Health professionals

Lifestyle issues – smoking, alcohol, drugs, diet, exercise

Sexual health – c/c, STDs, pregnancy

Mental health – suicide prevention, behaviour in school

Consultations with young people

1 Evie

2. Ruth

Organising primary care for young people

Improving access

What can a practice do to provide a service which teenagers will use?

Resources:

RCGP “Getting it right for teenagers in your practice” 2002

In the practice

Confidentiality made clear

Staff trained to be welcoming

Accessibility – advance appts don’t work well for young people

Health promotion sensitive to young people’s concerns

Useful resources

For teenagers:

www.teenagehealthfreak.org

www.brook.org.uk

www.likeitis.org

For parents:

www.familylives.org.uk

(Choose “Advice”,“teenagers”)