This free Mental Health Survey Template consists of questions and examples that help evaluate a person’s overall mental health. Use this sample survey template to collect data from the respondents about any history of mental illness in their family, previous diagnosis, and other important personal details that will help researchers better understand their mental health condition.
When it comes to mental health, it's really important to understand how our emotions, thoughts, and overall well-being work. One way researchers do this is by using mental health surveys.
These surveys are like questionnaires that help gather important information, allowing researchers to explore the inner workings of our minds. They can uncover valuable insights and help us understand more about what makes us tick.
By employing these surveys, we can start the path toward better mental health and well-being for individuals and communities alike. Let’s explore the significance of mental health surveys, the types of questions they encompass, and how we can use mental health survey templates to conduct impactful studies.
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Please take a few minutes to fill out this survey on the overall status of your mental health. We value your feedback and your responses will be kept confidential. Thank you for your input. Age: Gender: Overall how would you rate your physical health? Overall how would you rate your mental health? During the past 4 weeks, have you had any problems with your work or daily life due to your physical health? During the past 4 weeks, have you had any problems with your work or daily life due to any emotional problems, such as feeling depressed, sad or anxious? During the past 4 weeks, how often has your mental health affected your ability to get work done? Have you felt particularly low or down for more than 2 weeks in a row? During the past two weeks, how often has your mental health affected your relationships? How often do you experience below? Have you noticed any change in your diet habits? When was the last time you were really happy? When was the last time you felt good about yourself? How often do you feel positive about your life? When was the last time you had a positive outlook on life? Have you ever been diagnosed with a mental disorder before? When did you last get your mental health examination done? Is there a history of mental disorder in your family? If "Yes", please select which of the family member(s) had a history of mental illness. Does your health limit you in doing daily activities? Have you seen a therapist in the recent past? Are you currently taking any medication? How many hours do you sleep per day? How is your quality of sleep? What is your relationship status? Do you feel content with your relationships and family? How often do you smoke? How often do you drink? Have you changed your job recently? Have you changed your routine recently? Are you going through a tough emotional situation? Do you want to share any other information? |
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Creating a survey with QuestionPro is optimized for use on larger screens -
Though you're welcome to continue on your mobile screen, we'd suggest a desktop or notebook experience for optimal results.
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