Mental health self assessment worksheet

Answer the following questions

How are you feeling from the last 4 weeks?

_____________________________________________________________

Are you experiencing any obvious change in your mood from the last 4 weeks?

_____________________________________________________________

Do you have any negative/irrational thoughts from the last four weeks?

_____________________________________________________________

Are you experiencing more nervousness/anxiousness than usual?

____________________________________________________________

_____________________________________________________________

Do you feel pleasure in activities that you would normally find enjoyable?

_____________________________________________________________

Do you frequently have headaches, aches, and pains?

_____________________________________________________________

Do you feel hopeless or unworthy?

_____________________________________________________________

Have you had any recent thoughts of wanting to harm self or others?

_____________________________________________________________

Has anything changed about your mental health? Do you struggle with attention, confusion, reality testing, or memory issues?

_____________________________________________________________

How are you doing at work, with your friends, and with your family?

_____________________________________________________________

Do you have any peculiar mental health symptoms at the moment? If not, have they previously occurred? if you said yes, then describe briefly what happened and what the condition?

_____________________________________________________________

References

How aware are you of your own mental health? (n.d.). value is what Coveo indexes and uses as the title in Search Results.--> ACOG. https://www.acog.org/news/news-articles/2019/05/how-aware-are-you-of-your-own-mental-health

These are the telltale signs you need a mental health break. (2022, July 1). The Zoe Report. https://www.thezoereport.com/wellness/mental-health-self-assessment

Super User. (n.d.). Stress assessment checklist. Mental Health America of Eastern Missouri. https://www.mha-em.org/im-looking-for/mental-health-knowledge-base/wellness/82-stress-assessment-checklist

You can download more Mental Health worksheets here.

Please note: There may be a more up-to-date and editable version of this worksheet available here which may be more suitable to present to clients if you are a therapist or to use in a classroom as a teacher or guidance counsellor.