!Kids and capability --- agk's phlog 28 September 2021 @ 1137 --- written on X61 after lunch at the kitchen table --- I wrote my research paper on a 16-question capability assessment, OxCAP-MH. It was developed in the UK ten years ago. A research group in Austria got into it and published a flurry of studies in the last 3 years. My first day back to work put me on the child unit of the psych hospital. When I was on leave, staff short- age and an adolescent riot led management to close an adolescent unit. I had patients aged 7 to 17 sleeping and programming together---a real challenge! Check-in had been the unit's first group. Kids hated answering the symptom-focused, pathologizing quest- ions three times per shift (by us, nurses, and social workers): * Wanna kill yourself? * Wanna kill anybody else? * Wanna hurt yourself? * Wanna run away? * Hearing anything I can't hear? * Seeing anything I can't see? * Pain anywhere in your body? * Do you feel loved? By who? * What are your triggers? * What's your coping skill? A kid says yes, he gets a high risk indicator on his 15-minute observation sheet, chart, and shift report. HRIs include "SI" (suicidal ideation), "SH" (self- harm risk), "AVH" (audiovisual hallucinations), "ELOPE" (elopement risk), etc. While I was on leave, check-in was abolished. I'd relied on check-in to get to know each kid each shift. I don't care about the question set. I just need the excuse to talk to each kid, listen, and establish rapport. It helps me plan programming, manage the millieu, and handle distress. I took the OxCAP-MH question set, more or less (our intranet blocks the TLD of the university website that hosts it), and translated it to kid-friendly language. I changed the five-item Likert scale to a three-item scale (YES/Sort of/NO). I ran it by the charge nurse. She okayed it. Each kid (and adolescents on the unit) answered my 16-item "OxCAP-MH (Child)" assessment at the start of my next three shifts. * I can play (or hang out) with friends. * I get too worried to sleep. * I can do stuff I think is fun. * I like where I live. * I feel safe at school. * Somebody will probably discriminate against me. * Somebody will probably beat me up or hurt me. * I get to help make decisions that affect me. * I can say what I think about things. * I get to play outside (or enjoy nature). * I like the people I'm around. * I have love, friends, and support. * I get to be creative. * My triggers are... * My best coping skills are... * My goal for today is... The program coordinator liked my improvised check- in. Now it's used every day. My observations: * Lots of our kids have sleep disrupted by worry, don't feel safe at school, and can't say what they think. * Play, fun, friends/support, and liking people cluster. * Kids' explanations matter. One can't play with friends/outside, have fun, etc., because she's tired or sick. Another's dad won't let him, or mom won't get out of bed. A third is shy, doesn't have friends, or is in a new foster family/school. It will take organized IRB-approved research to say anything defensible about what kind of mess I made by cutting the five-item scale down and yanking three questions, or how to score it and what scores mean. Still, it's been a fun project so far.