90-Question Mental Health Screening Questionnaire219

This comprehensive mental health screening questionnaire is designed to provide an overview of your mental well-being. By answering the questions honestly and thoroughly, you can gain a better understanding of your current mental state and identify any potential areas of concern. Remember, this questionnaire is not a substitute for professional diagnosis or treatment, but it can serve as a starting point for discussing your mental health with a qualified mental health professional.

Instructions:
Read each question carefully.
Choose the answer that best describes your experience or feelings in the past two weeks.
Answer all questions as honestly as possible.
Your responses will be confidential.

Questions:Section 1: Mood and Anxiety

During the past two weeks, how often have you been bothered by feeling down, depressed, or hopeless?
During the past two weeks, how often have you been bothered by little interest or pleasure in doing things?
During the past two weeks, how often have you been bothered by feeling tired or having little energy?
During the past two weeks, how often have you been bothered by poor appetite or overeating?
During the past two weeks, how often have you been bothered by trouble falling or staying asleep, or sleeping too much?
During the past two weeks, how often have you been bothered by feeling bad about yourself, or that you are a failure or have let yourself or your family down?
During the past two weeks, how often have you been bothered by trouble concentrating on things, such as reading the newspaper or watching television?
During the past two weeks, how often have you been bothered by moving or speaking so slowly that other people could have noticed? Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual?
During the past two weeks, how often have you been bothered by thoughts that you would be better off dead, or of hurting yourself in some way?

Section 2: Substance Use

During the past year, have you used an illegal drug or used a prescription medication for non-medical purposes?
During the past year, have you used alcohol in a way that put you or others at risk, or that caused problems at work, home, or in your relationships?

Section 3: Eating Disorders

During the past three months, have you had any episodes of binge eating?
During the past three months, have you tried to lose weight by vomiting or taking diet pills?

Section 4: Thinking and Behavior Patterns

During the past two weeks, how often have you been bothered by feeling unusually irritable and easily angered?
During the past two weeks, how often have you been bothered by having difficulty controlling your temper?
During the past two weeks, how often have you been bothered by having difficulty controlling your thoughts, such as having to check things over and over?
During the past two weeks, how often have you been bothered by having strange or unusual thoughts?
During the past two weeks, how often have you been bothered by hearing voices that other people don't hear?
During the past two weeks, how often have you been bothered by believing that people are trying to harm or control you?
During the past two weeks, how often have you been bothered by having thoughts or memories that you wish you could forget or block out?
During the past two weeks, how often have you been bothered by having intense fears or anxieties that are difficult to control?

Section 5: Social Functioning

During the past two weeks, how often have you been bothered by feeling lonely or isolated?
During the past two weeks, how often have you been bothered by having difficulty getting along with other people?
During the past two weeks, how often have you been bothered by feeling unable to keep up with your responsibilities at work, at school, or at home?

Scoring and Interpretation:

This questionnaire is not scored or interpreted. If you are concerned about your mental health, please consult with a qualified mental health professional for a proper diagnosis and treatment plan.

2025-02-21

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