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Abstract
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 standard 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.
Acknowledgements
We are extremely grateful to the many professionals who have supported the development of the CHAT and the young people and staff at Hindley YOI who gave up their time in the Phases 1 and 2 evaluation studies. We would also like to thank the national project group in supporting the development and implementation of the CHAT and particularly Caroline Twitchett (NHS England), Howard Jasper (Youth Justice Board) and Sam Cox (Public Health England).
