Mental Health Evaluation
Anxiety, Depression, Bi Polar Disorder (BPD), Post Traumatic Stress Disorder (PTSD), and Addiction (Alcohol, Drugs, Gambling, Pornography)
It is important to be as truthful as possible; because the sooner a problem is related to the easier it is to take care of the issues that have arisen
Mental Health Evaluation
The evaluation should take between 10 and 20 minutes to complete dependant on how much time is needed to think through your answers
Please answer “Yes” or “No” to the questions below.
1. I experience shortness of breath, dizziness, rapid heart beat on a regular basis?
Yes / No
2. I have a fear of losing control or going crazy.
Yes / No
3. I avoid social situations because of a general fear or am worried about seeming foolish.
Yes / No
4. I have recurrent thoughts or images that refuse to go away?
Yes / No
5. I am nervous and jumpy more than 50% the time
Yes / No
6. I constantly worry that things will go wrong?
Yes / No
7. I am generally negative.
Yes / No
8. I put things off because they overwhelm me?
Yes / No
9. For no reason at all I get unusually “high” and optimistic or extremely irritable.
Yes / No
10. People tell me I get unrealistic, grandiose beliefs about my abilities or powers
Yes / No
11. I often have racing thoughts and jump quickly from one idea to the next.
Yes / No
12. I sometimes act recklessly without thinking about the consequences.
Yes / No
13. I have times when I have excessive impulsive behavior.
Yes / No
14. I feel regularly feel sad, unhappy or low.
Yes / No
15. The activities that used to interest me no longer provide pleasure and enjoyment.
Yes / No
16. I had severe trouble sleeping or sleep too much.
Yes / No
17. I have trouble thinking clearly.
Yes / No
This evaluation is not intended as a statement about the need for counseling; it is however, an easy screening tool, to see if a counselor should be consulted.
If you have answered “Yes” to more than 6 of the questions above it is a good idea to talk to a mental health professional to make an individualized assessment about the importance of getting treatment.