Mental Health Screening Test

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Mental Health Screening Test

Mental Health Screening Test

Would you like to know how is your mental health status for the past week? Why don’t you try the following questions to know how you are.

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1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Phone NumberPlease provide us with your contact no. so we can reach you.
+60
Phone Number
4
1. I found it hard to wind down* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
5
2. I was aware of dryness of my mouth* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
6
3. I couldn't seem to experience any positive feeling at all* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
7
4. I experienced breathing difficulty (eg: excessively rapid breathing, breathlessness in the absence of physical exertion)* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
8
5. I found it difficult to work up the initiative to do things* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
9
6. I tended to over-react to situations* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
10
7. I experienced trembling (eg, in the hands)* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
11
8. I felt that I was using a lot of nervous energy)* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
12
9. I was worried about situations in which I might panic and make a fool of myself* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
13
10. I felt that I had nothing to look forward to* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
14
11. I found myself getting agitated* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
15
12. I found it difficult to relax* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
16
13. I felt down-hearted and blue* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
17
14. I was intolerant of anything that kept me from getting on with what I was doing* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
18
15. I felt I was close to panic* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
19
16. I was unable to become enthusiastic about anything* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
20
17. I felt I wasn't worth much as a person* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
21
18. I felt that I was rather touchy* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
22
19. I was aware of the action of my heart in the absence of physical exertion ( eg: the sense of heart rate increase, heart missing a beat)* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
23
20. I felt scared without any good reason* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
24
21. I felt that life was meaningless* This field is required.
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me a considerable degree or a good part of time
Applied to me very much or most of the time
25
Stress Score
26
Anxiety Score
27
Depression Score
Should be Empty:

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