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25 J. Forensic Psychiatry & Psych. 1 (2014)

handle is hein.journals/jnlofncpy25 and id is 1 raw text is: The Journal of Forensic Psychiatry & Psychology, 2014 1 Routledge Vol. 25, No. 1, 1-25, http://dx.doi.org/10.1080/14789949.2014.882387 * Taylor&FrancisGroup The development of the comprehensive health assessment tool for young offenders within the secure estate Prathiba Chitsabesana*, Charlotte Lennoxa, Louise Theodosioua, Heather Law, Sue Bailey' and Jenny Shawa aManchester Academic Health Science Centre, University of Manchester, UK; bGreater Manchester West NHS Foundation Trust, UK; °School of Social Work, University of Central Lancashire, London, UK (Received 7 October 2013; accepted 18 December 2013) Health inequalities are high among offending groups. The comprehensive health assessment tool (CHAT) is a semi-structured assessment developed to provide a standardised approach to health screening for all young offenders admitted to the secure estate. The four sections of the CHAT (physical health, mental health, substance misuse and neurodisability) were evaluated within a two-phased study of male adolescents (aged 15-18 years) within a young offenders institution in the north-west of England. Within Phase 1, a consecutive sample of 127 new receptions was assessed using the physical health, mental health and substance misuse sections of the CHAT against a range of reference standard assessments. Phase 2 of the study evaluated the neurodisability section on 93 male adolescents against reference standard tools. The four sections of the CHAT demonstrated fair to good convergent validity when compared against reference standard tools in male offenders. The diagnostic accuracy rate was 76% for mental health, 63% for physical health, 83% for substance misuse and 53% for neurodisability when compared against reference stan- dard assessment tools. The introduction of the CHAT offers the opportunity to enhance existing reception screening practices and create an integrated approach to the assessment of health needs across the secure estate. Keywords: young offenders; screening; mental health; physical health; substance misuse and neurodisability Introduction Young people in contact with the youth justice system (YJS) have well documented multiple vulnerabilities including high rates of mental and physical health need and poor engagement with health services (Chitsabesan et al., 2006; Lader, Singleton, & Meltzer, 2000). Chronic physical complaints includ- ing poorly controlled asthma (Lader et al., 2000) are exacerbated by lifestyle factors such as smoking, poor diet and lack of exercise. Studies exploring *Corresponding author. Email: pchitsabesan@nhs.net © 2014 Taylor & Francis