CHAT Tool - Offender Health Research Network

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Section 2: During conversation do you notice the following about the young person Tick No or Yes as appropriate for each question and include additional notes No Yes Speaks in a monotonous or unusual voice e.g. like a robot If Yes please provide details below: Shows little interest in the interviewer’s description of their experiences/interests If Yes please provide details below: Takes things literally and fails to understand implied meanings, inference, jokes or sarcasm. Note if the person misinterprets a question and you need to re-phrase the question using concrete examples. If Yes please provide details below: Talks about the same thing over and over e.g. repetitive talk about a particular hobby or difficulty stopping their topic to follow the interviewer’s introduction of a new topic. If Yes please provide details below: Surname: DOB: Forenames: NHS Number: CHAT Tool Secure Estate (Version 3 - June 2013) 95 | P age
Section 3: In social interactions do you notice the following about the young person Tick No or Yes as appropriate for each question and include additional notes No Yes Has a limited understanding of different types of relationships e.g. finds it difficult to describe the difference between a peer and a best friend. If Yes please provide details below: Does not like looking at people when talking or listening. If Yes please provide details below: Has a limited range of facial expressions or expressions do not match what they are saying. If Yes please provide details below: Is socially awkward or inappropriate even when trying to be polite. If Yes please provide details below: Surname: DOB: Forenames: NHS Number: CHAT Tool Secure Estate (Version 3 - June 2013) 96 | P age
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Comprehensive Health Assessment Too
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Mental Health Assessment No Yes Is
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CHAT RECEPTION SCREEN • Every you
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Medical and Psychiatric History Doc
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5. Do you have DIABETES MELLITUS If
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Reception Screen Section Two: Subst
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6. Is the young person withdrawing
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Tick No or Yes as appropriate for e
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Documents you have access to at the
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CHAT Immediate Care Plan Name: DOB:
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Substance Misuse Service No Yes No
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Is the young person subject to a CH
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MMR BCG HPV Hep A Hep B Typhoid Flu
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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
Page 63 and 64: Tick No or Yes as appropriate for e
Page 83 and 84: CHAT NEURODISABILITY ASSESSMENT •
Page 87 and 88: After a head injury or accident som
Page 89 and 90: NARRATIVE TASK Ask the young person
Page 91 and 92: Learning Disability and Educational
Page 93 and 94: INFORMATION FROM THE YOUNG PERSON T
Page 95: Autistic Spectrum Disorder Start by
Page 101 and 102: Name: CHAT CARE PLAN DOB: Date: NHS
Page 103 and 104: Problem/Issue Intervention/Action R
Page 105 and 106: Initial Weight: Date: Discharge Wei
Page 107 and 108: Summary of any current or previous
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CHAT Tool - Offender Health Research Network

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