Screening for Psychological Distress

1. Screening for Psychological Distress

2. Objectives of Session • To understand the principals of using the distress screening tool. • To provide participants with an opportunity to practice using the distress screening tool.

3. Who should undertake the DS? • The DS should only be administered by professionals at Level 2 and above competency • Level 2 practitioners must possess problem–solving skills and have at least one of the following: • Psychological Assessment Skills for UASC • Have attended DS training sessions • Those undertaking a DS should access consultation from Level 3 or 4 practitioners

4. When should DS be administered? • Undertake as part of the Early Intervention Framework at all the key points in a UASC journey i.e.: • At arrival • At FTT and dispersal • After significant change • At key asylum process moments • Other times when distress is apparent. • A quick screening tool to assess psychological needs from which care can be planned during • dispersal and in the new authority.

5. Principles of using DS • Explanation • Transparency • Normal process • Solution focused • Use of UASC's own resources • Assessment not therapy

6. Please circle the number (0–10) that best describes how much distress you have been experiencing in the past week including today. Problem list: Indicate if any of the following have been a problem to you in the past week. The Distress Screening Family: Bereavement Loss of contact with family Concern about family safety Emotional:Spiritual: Fear Loss of hope Anxiety Loss of spiritual Nightmares practices Hypervigilance Loss of spiritual community Physical: Unhappy with Fatigue how living life Constipation Loss of peace Sleep indigestion

7. The Distress Screening Solution Focused Care Plan: 0 – 5: UASC does not require additional EM&WB support. Watch, wait and see protocol to be maintained. Level 2 clinician required from a competencies perspective. 6 – 7: UASC requires additional EH&WB support based on the Early Intervention Framework and a level 3 clinician is required from a competencies perspective. 8 – 10: UASC requires additional EH&WB support and review based on the Early Intervention Framework and input from a level 4 clinician required from a competencies perspective. Solution process: Is sleep work required and been undertaken? Yes No Is re-feeding work required and been undertaken? Yes No Is hope work required and been undertaken? Yes No

8. Using the DS: Stage 1 • Explain what you are doing and ask the UASC if they are willing to go ahead • Show UASC DS & ask him/her to globally rate their distress over the past week • Ask them to tick any items that have been of concern to them over the past week, adding any concerns not on the form

9. Using the DT: Stage 1 • Ask the UASC to think about what is the most important concern contributing to their overall distress • Record this ranking (i.e. 1st) on the screening sheet • Then ask for the next most highly ranked concern. Work through main concerns in this way

10. Using the DS: Stage 2 • Record the scoring on the screening • From the problems list, see if any UASC Early Intervention work is required. • Refer the UASC to a relevant clinician according to scoring or ensure that this goes in the health passport to the new authority so that they can action a care plan.

11. Using the DS: Stage 3 • Summarise what you’ve discussed & what steps you will take, if any, & those others have agreed to take. • Ask UASC if they have any remaining questions/concerns. • Thank UASC and tell them DS will be placed in their case notes and/or in their health passport. • Take any actions you have agreed with UASC & inform other relevant parties

12. DS ratings • <5– UASC not exhibiting unusual signs of distress • ACTION - continue to monitor as per watch, wait and see protocol • >6 & <7– UASC is exhibiting non-urgent distress • ACTION - provide support within your skill-base, consult and/or refer to a Level 3/4 practitioners & continue to review progress • >8– UASC is exhibiting high levels of distress, pressing need for action • ACTION – use caseload supervision seek consultation with Level 3/4 practitioner, bring case to UASC Network, liaise with other relevant professionals if necessary e.g. if needs are financial, physical etc

13. Find a partner Partner A will take role of practitioner Partner B will take role of UASC Administer DS Then change roles 15 mins each. Now it’s your turn!

14. Summary of administration • This is part of a normal assessment • Be Transparent • Value the UASC's distress • Use a problem solving approach • Help UASC identify resources

15. Points to remember • When - At all key points in UASC. pathway, & if UASC express emotional distress • Who – min. Level 2 practitioners who have completed relevant training • Supervision – should be accessed from Level 3/4 practitioners • Support – score >4 & <6 provide support within your skill-base, consulting or ask for review with Level 3/4 • Referral– score >6 – discuss UASC with Level 3/4 practitioners or request for this as part of their care plan, bring to UASC Network, liaise with other professionals if necessary

16. Final point • We must remember: • The importance of identifying and managing emotional distress for UASC. • DS is a user-friendly tool that can simply and easily identify emotional distress • It gets quicker & easier to administer the more it is used!