CHAT Tool - Offender Health Research Network

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Reception Screen Section Four: Immediate Safety Risks and Concerns One YES then complete ALL RELEVANT SECTIONS of the Mental Health Assessment BEFORE first night. Consider heightened observation and use local self-harm-suicide prevention procedures. Tick No or Yes as appropriate for each question and include additional notes No Yes 1. Have you HARMED yourself in the last month 2. Do you have FEELINGS of wanting to SELF-HARM now 3. Have you previously ATTEMPTED SUICIDE 4. Do you have SUICIDAL FEELINGS now 5. Is the young person showing signs of being DEPRESSED e.g. low in mood, withdrawn; slowed down 6. Are there any general RISKS/CONCERNS E.g. issues arising from ASSET; escorting officers; previous establishment; suicide/self-harm procedures; and safeguarding or child protection issues i.e. are they subject to a child protection plan. Surname: DOB: Forenames: NHS Number: CHAT Tool Secure Estate (Version 3 - June 2013) 17 | P age
Documents you have access to at the time of this Reception Health Screen (Tick No or Yes as appropriate) Document No Yes ASSET/AssetPlus Escort Record Suicide/self-harm documentation i.e. Assessment, Care in Custody and Teamwork Pre-Sentence Report Other documents you have access to: Documents you have requested: Surname: DOB: Forenames: NHS Number: CHAT Tool Secure Estate (Version 3 - June 2013) 18 | P age
Page 1 and 2: Comprehensive Health Assessment Too
Page 3 and 4: Mental Health Assessment No Yes Is
Page 5 and 6: CHAT RECEPTION SCREEN • Every you
Page 7 and 8: Medical and Psychiatric History Doc
Page 9 and 10: 5. Do you have DIABETES MELLITUS If
Page 11 and 12: Reception Screen Section Two: Subst
Page 13 and 14: 6. Is the young person withdrawing
Page 15 and 16: Tick No or Yes as appropriate for e
Page 17: Tick No or Yes as appropriate for e
Page 21 and 22: CHAT Immediate Care Plan Name: DOB:
Page 23 and 24: Substance Misuse Service No Yes No
Page 25 and 26: Is the young person subject to a CH
Page 27 and 28: MMR BCG HPV Hep A Hep B Typhoid Flu
Page 43 and 44: Disability and Impairment Invitatio
Page 45 and 46: Physical Health Summary/Review Summ
Page 47 and 48: Do the accompanying documents or in
Page 49 and 50: Drug/Alcohol History and Misuse (Co
Page 51 and 52: Drug/Alcohol History and Misuse (Co
Page 53 and 54: Withdrawal - These symptoms are der
Page 55 and 56: DRUG/ALCOHOL USE Where do you usual
Page 57 and 58: Employment E.g. lack of qualificati
Page 59 and 60: Risk Review Tick No or Yes as appro
Page 61 and 62: CHAT MENTAL HEALTH ASSESSMENT • E
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Tick No or Yes as appropriate for e
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Risk Review Tick No or Yes as appro
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CHAT NEURODISABILITY ASSESSMENT •
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After a head injury or accident som
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NARRATIVE TASK Ask the young person
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Learning Disability and Educational
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INFORMATION FROM THE YOUNG PERSON T
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Autistic Spectrum Disorder Start by
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Section 3: In social interactions d
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Risk Review Tick No or Yes as appro
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Name: CHAT CARE PLAN DOB: Date: NHS
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Problem/Issue Intervention/Action R
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Initial Weight: Date: Discharge Wei
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Summary of any current or previous
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