• How's Your Mental Health?

  • According to a recent study, about 4 in 10 adults in the U.S. have reported symptoms of anxiety or depressive disorder during the COVID-19 pandemic. If you are experiencing mental health issues, it’s important to recognize the signs and seek help. Please tell COVID Health about your mental health by completing this survey. 

  • 1) How would you rate your overall mental health?
  • 2) During the last two weeks, how often have you felt sad or depressed?
  • 3) During the last two weeks, how often have you felt nervous, anxious or on edge?
  • 4) During the last two weeks, how often have you had trouble sleeping or slept too much?
  • 5) During the last two weeks, how often have you had trouble concentrating or paying attention?
  • 6) Do you ever have suicidal thoughts or feel like you want to harm yourself?
  • 7) How often does your mental health interfere with your personal relationships?
  • 8) How often does your mental health interfere with your health care?
  • 9) How often does your mental health interfere with your ability to get work done?
  • 10) Have you ever been diagnosed with a mental health condition (such as depression, anxiety or bipolar disorder)?
  • 11) Is there a history of mental health conditions in your family?
  • 12) Have you ever undergone treatment for a mental health condition?
  • 13) Have you ever had difficulty accessing mental health services?
  • 15) What is your gender?

  • 16) What is your sexual orientation?

  • 17) What is your ethnicity? (Check all that apply.)

  • 18) What is your current level of education?
  • 19) What is your annual household income?
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