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  • Mho Afhf Reporting Tool 2022 - FINAL

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    1) 29 adolescents were screened with a Rapid Psychosocial Questionnaire, of which 20 were female and 9 were male. 2) 11 adolescents underwent a comprehensive psychosocial evaluation, of which 3 were female and 5 were male. 3) The 28 adolescents who were identified as having psychosocial concerns were referred to social workers for counseling and stress unloading.

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    Mho Afhf Reporting Tool 2022_FINAL

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    1) 29 adolescents were screened with a Rapid Psychosocial Questionnaire, of which 20 were female and 9 were male. 2) 11 adolescents underwent a comprehensive psychosocial evaluation, of which 3 were female and 5 were male. 3) The 28 adolescents who were identified as having psychosocial concerns were referred to social workers for counseling and stress unloading.

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    7 views2 pages

    Mho Afhf Reporting Tool 2022 - FINAL

    Uploaded by

    lemar aribal
    1) 29 adolescents were screened with a Rapid Psychosocial Questionnaire, of which 20 were female and 9 were male. 2) 11 adolescents underwent a comprehensive psychosocial evaluation, of which 3 were female and 5 were male. 3) The 28 adolescents who were identified as having psychosocial concerns were referred to social workers for counseling and stress unloading.

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    of 2

    REPORTING FORM 1

    Female Male
    Indicators TOTAL
    10-14 15-19 Total 10-14 15-19 Total

    Number of adolescents screened with


    1 Rapid Psychosocial Questionnaire
    (Rapid HEEADSSS) 29 9 11 20 4 5 9
    Number of students with
    1a psychosocial concerns based on
    Rapid HEEADSSS
    abuse and safety 8 3 1 4 3 1 4
    Stow-away behavior 7 2 2 4 0 3 3
    Bullying 6 0 4 4 1 1 2
    Suicidal ideations 3 0 2 2 1 0 1
    Smoking / vaping 1 0 0 0 0 1 1
    Alcoholic beverage drinking 2 0 0 0 0 2 2
    Illicit drugs 0 0 0 0 0 0 0
    Experience of romantic relationship 14 3 8 11 1 2 4
    Sexual encounter 1 0 1 1 0 0 0
    Sexual coercion/ abuse 1 0 0 0 0 1 1
    Pregnancy/ Parenthood 1 0 1 1 0 0 0
    Needs help/ Seeks counseling 9 1 3 4 2 3 5
    Number of adolescents who
    underwent comprehensive
    2 psychosocial evaluation
    (COMPREHENSIVE/FULL HEEADDSS
    INTERVIEW)
    11 1 2 3 3 2 5
    2a Psychosocial risks identified through
    comprehensive interview
    dysfunctional family 1 0 1 1 0 0 0
    Bullying 1 0 0 0 1 0 1
    Out of School 0 0 0 0 0 0 0
    Learning disabilities 0 0 0 0 0 0 0
    Eating disorders 0 0 0 0 0 0 0
    Internet overuse/ Internet gaming disorder 0 0 0 0 0 0 0
    Smoking exposure/ use/ abuse 1 0 0 0 0 1 1
    Alcohol drinking exposure. Use/abuse 1 0 0 0 0 1 1
    Mental health concerns 3 0 2 2 1 0 1
    Abuse 0 0 0 0 0 0 0
    Gender identity concerns (LGBTQIA) 1 1 0 0 0 0 0
    Risky sexual behaviors 1 0 0 0 0 1 1
    Physical risk behaviors (motorcycle, driving without license) 0 0 0 0 0 0 0
    Teen parent 0 0 0 0 0 0 0
    Others 0 0 0 0 0 0 0
    TOTAL NUMBER OF ADOLESCENTS
    8 WHO Followed up JUNE 23,2022
    9 INCOMING REFERRAL 29 9 11 20 4 5 9
    School 0 0 0 0 0 0 0
    RHU 0 0 0 0 0 0 0
    Private Hospital 0 0 0 0 0 0 0
    Lying-in Clinic 0 0 0 0 0 0 0
    Walk-In 0 0 0 0 0 0 0
    Others: BARANGAY OFFICIALS 28 9 10 19 4 5 9
    Others: BRGY. HEALTH STATION 1 0 1 1 0 0 0
    Others_____________________ 0 0 0 0 0 0 0
    10 Total Number of Outgoing Referrals
    School 1 0 1 1 0 0 0
    Barangay 0 0 0 0 0 0 0
    Hospital 0 0 0 0 0 0 0
    DSWD/ Social worker 28 9 10 19 4 5 9
    TESDA 0 0 0 0 0 0 0
    Others_____________________
    Others_____________________
    11 Reasons for referral
    Reason 1 STRESS UNLOADING 28 9 10 19 4 5 9
    Reason 2 COUNSELING 28 9 10 19 4 5 9
    Reason 3 ENROLLMENT 1 0 1 1 0 0 0
    Reason 4
    Reason 5
    Reason 6

    PREPARED BY:

    JEZIEL CAGAS UBATAY, RN


    REPORTING FORM 1
    Female Male
    Indicators TOTAL
    10-14 15-19 Total 10-14 15-19 Total

    Number of adolescents screened with


    1 Rapid Psychosocial Questionnaire
    (Rapid HEEADSSS)

    Number of students with


    1a psychosocial concerns based on
    Rapid HEEADSSS
    abuse and safety

    Stow-away behavior

    Bullying

    Suicidal ideations

    Smoking / vaping

    Alcoholic beverage drinking

    Illicit drugs

    Experience of romantic relationship

    Sexual encounter

    Sexual coercion/ abuse

    Pregnancy/ Parenthood

    Needs help/ Seeks counseling

    Number of adolescents who


    underwent comprehensive
    2 psychosocial evaluation
    (COMPREHENSIVE/FULL HEEADDSS
    INTERVIEW)

    2a Psychosocial risks identified through


    comprehensive interview
    dysfunctional family

    Bullying

    Out of School

    Learning disabilities

    Eating disorders

    Internet overuse/ Internet gaming disorder

    Smoking exposure/ use/ abuse

    Alcohol drinking exposure. Use/abuse

    Mental health concerns

    Abuse

    Gender identity concerns (LGBTQIA)

    Risky sexual behaviors

    Physical risk behaviors (motorcycle, driving without license)

    Teen parent

    Others

    TOTAL NUMBER OF ADOLESCENTS


    8 WHO Followed up
    9 INCOMING REFERRAL
    School
    RHU
    Private Hospital
    Lying-in Clinic
    Walk-In
    Others_____________________
    Others_____________________
    Others_____________________
    10 Total Number of Outgoing Referrals
    School
    Barangay
    Hospital
    DSWD/ Social worker
    TESDA
    Others_____________________
    Others_____________________
    11 Reasons for referral
    Reason 1
    Reason 2
    Reason 3
    Reason 4
    Reason 5
    Reason 6

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