Mental Health Assessment Form


This form uses the Kessler Psychological Distress Scale, which measures a person's distress using signs of depression and anxiety. It is scored out of 50, with higher scores indicating higher levels of distress. Different responses can be shown based on the submitter's score. You can use this form to collect all the necessary information for an appointment, along with their score on the scale.

About how often did you feel tired out for no good reason?
About how often did you feel nervous?
About how often did you feel so nervous that nothing could calm you down?
About how often did you feel hopeless?
About how often did you feel restless or fidgety?
About how often did you feel so restless you could not sit still?
About how often did you feel depressed?
About how often did you feel that everything was an effort?
About how often did you feel so sad that nothing could cheer you up?
About how often did you feel worthless?
This question is required

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