Skip to content
Mental Health Self-Assessment Survey
Love the Lord you GOD with all your MIND..
1.
How old are you?
Under 21
22-35
36-49
Over 50
2.
What gender are you?
FEMALE
MALE
3.
How would you describe your overall mood in the past two months?
Very Positive
Somewhat Positive
Neutral
Somewhat Negative
Very Negative
4.
How often do you feel overwhelmed by your emotions?
Never
Rarely
Sometimes
Often
Always
5.
How frequently do you experience feelings of anxiety or panic?
Never
Rarely
Sometimes
Often
Always
6.
How would you rate your self-esteem?
Very Satisfied
Satisfied
Neutral
Unsatisfied
Very Unsatisfied
7.
Do you ever find it difficult to concentrate?
Never
Rarely
Sometimes
Often
Always
8.
How would you rate your ability to manage stress?
Very Good
Good
Average
Poor
Very Poor
9.
Have you ever had thoughts of harming yourself?
No
Yes
10.
How comfortable do you feel talking about your mental health with others?
Very Comfortable
Comfortable
Neutral
Uncomfortable
Very Uncomfortable
11.
Do you know where you can go to find the resources necessary to help you if needed?
Yes
No
Additional Comments?