Mental Health Test

Over the last 2 weeks, how often have you been bothered by any of the following problems?
Please note, all fields are required.



1. Little interest or pleasure in doing things
Not at allSeveral daysMore than half the daysNearly every day


2. Feeling down, depressed, or hopeless
Not at allSeveral daysMore than half the daysNearly every day


3. Trouble falling or staying asleep, or sleeping too much
Not at allSeveral daysMore than half the daysNearly every day


4. Feeling tired or having little energy
Not at allSeveral daysMore than half the daysNearly every day


5. Poor appetite or overeating
Not at allSeveral daysMore than half the daysNearly every day


6. Feeling bad about yourself - or that you are a failure or have let yourself or your family down
Not at allSeveral daysMore than half the daysNearly every day


7. Trouble concentrating on things, such as reading the newspaper or watching television
Not at allSeveral daysMore than half the daysNearly every day


8. Moving or speaking so slowly that other people could have noticed
Not at allSeveral daysMore than half the daysNearly every day


9. Thoughts that you would be better off dead, or of hurting yourself
Not at allSeveral daysMore than half the daysNearly every day


10. If you checked off any problems, how difficult have these problems made it for you at work, home, or with other people?
Not at allSeveral daysMore than half the daysNearly every day

Over the last 2 weeks, how often have you been bothered by any of the following problems?
Please note, all fields are required.

Before you get to your results, please take a moment to answer the following optional questions. If you aren’t comfortable sharing any or all of the information, you can click “submit” right away. Otherwise, your answers will help us better understand how we can achieve our mission. Don’t worry; we won’t be able to identify you based on this information.

Sex



Race/Ethnicity



Age



Household Income



Zip/Postal Code



State



Are you currently, or have you ever been, diagnosed with a mental health condition by a professional?



Which of the following populations describe you?
Veteran or active duty militaryCaregiver of someone living with emotional or physical illnessLGBTQStudentNew or expecting mother


Do you have any of the following general health conditions?
Heart diseaseDiabetesAlzheimer's or other dementiasCancerArthritis or other chronic painCOPD or other lung conditionsOther


If 'Other' please specify (for general health conditions)



How can Answers Thru Counseling help you?
A phone number to get immediate support or guidanceAdditional information about mental healthReferrals to local ATC affiliates or other organizations that can helpWorksheets or coping skills to use at homeAn online or mobile program or app that can help you track or manage your symptomsOther


If 'Other' please specify (for how ATC can help you)



What next steps do you plan to take after screening?



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