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Section 1 of 4
Mental Health Questionnaire
Thank you for taking your time to complete our Monash Mental Health Center Questionnaire! The questionnaire's purpose it to collect your response in relation to questions about a university Student's mental health. All response will be anonymous and kept secure. If you have any concerns or questions you can contact us here: josephku.jk@gmai.com 
What is your gender?
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Female
Male
Prefer not to say
Other:
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What is your ethnic background?
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English
Australian
Asian
African
European
American
Native pacific islander
Mixed
Other:
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What is your employment status?
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Casual/Part-time
Full time
Student
Unemployed
Self-employed
Other:
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Section 2 of 4
Technology Usage
On average, how much do you use your phone per day?
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1 Hour
2-3 hours
4-5 hours
More than 5 hours
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or
add "Other"
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Does the impact of Covid-19 increase your usage of digital contents?
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By alot
Somewhat a little
Neither Yes nor No
Somewhat did not
Not at all
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add "Other"
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How would you describe your level of computer/technological skills?
Question Type
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Poor
Expert
to
1
Label (optional)
5
Label (optional)
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How familiar are you with using mobile health apps?
Question Type
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Poor
Expert
to
1
Label (optional)
5
Label (optional)
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(0 points)
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What do you want to gain from a mental health app?
Question Type
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To maintain a healthier lifestyle
Improve my current mental health condition
Help manage my mental health
To track my mental health
Learn more about my mental health status
Join a community
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or
add "Other"
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Section 3 of 4
General Health
Do you struggle managing your diet?
Question Type
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Yes
No
Sometimes
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add "Other"
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On average, how much sleep would you say you get per night?
Question Type
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<3 hours
3 - 6 hours
6 - 8 hours
8 - 10 hours
10 hours or more
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or
add "Other"
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How well would you rate your sleep quality overall?  
Question Type
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Terrible
Excellent
to
1
Label (optional)
5
Label (optional)
Answer key
(0 points)
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Section 4 of 4
Mental Health
On a scale of 1-5 how would you rate your overall mental health?
Question Type
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Poor
Excellent
to
1
Label (optional)
5
Label (optional)
Answer key
(0 points)
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How often do you check-in on your mental health?
Question Type
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Never
Rarely
Sometimes
Frequently
Everyday
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or
add "Other"
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If any, do you suffer from any of the following mental illness/disorders?
Question Type
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Anxiety disorders
Mood disorders (e.g. depression)
Eating disorders
Personality disorders
Attention deficit hyperactivity disorder (ADHD)
Post-traumatic stress disorders
Psychotic disorders (e.g. schizophrenia)
Prefer not to say
None
Other:
Add option
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Answer key
(0 points)
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Of the following topics which do you find affect your mental health negatively?
Question Type
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School/university
Finances
Social scenarios
Work
Deadlines
Health
Other:
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(0 points)
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Do you think that the impact of COVID-19 affects your mental health negatively?
Question Type
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Not affected
Greatly affected
to
1
Label (optional)
5
Label (optional)
Answer key
(0 points)
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How do you normally cope when you feel overwhelmed?
Question Type
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Music
Watching movies/shows
Video games
Social
Meditate
Exercise
Other:
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Answer key
(0 points)
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Have you ever received any kind of psychological counselling?
Question Type
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Yes
No
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or
add "Other"
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(0 points)
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Where do you seek out support/help for dealing with your mental health?
Question Type
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Friends
Family
Helpline
Professional advice (therapists, psychologists, psychiatrists, etc)
Articles/documentation
Blogs/forums
Clips/videos
Podcasts
You don't
Other:
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Answer key
(0 points)
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If any, what type of medications are you taking for your mental health?
Question Type
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Antidepressants
Stimulants
Anti-anxiety medications
Mood stabilisers
Antipsychotics
None
Prefer not to say
Other:
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…
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(0 points)
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Are there any of the following addictions that is holding you back from a healthy mental state?
Question Type
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Gambling
Alcohol
Drugs
Tobacco
Binge eating
None
Prefer not to say
Other:
Add option
…
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What is your gender?
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What is your ethnic background?
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What is your employment status?
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Technology Usage
On average, how much do you use your phone per day?
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No responses yet for this question.
Does the impact of Covid-19 increase your usage of digital contents?
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No responses yet for this question.
How would you describe your level of computer/technological skills?
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No responses yet for this question.
How familiar are you with using mobile health apps?
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No responses yet for this question.
What do you want to gain from a mental health app?
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No responses yet for this question.
General Health
Do you struggle managing your diet?
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No responses yet for this question.
On average, how much sleep would you say you get per night?
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No responses yet for this question.
How well would you rate your sleep quality overall?  
Copy chart
No responses yet for this question.
Mental Health
On a scale of 1-5 how would you rate your overall mental health?
Copy chart
No responses yet for this question.
How often do you check-in on your mental health?
Copy chart
No responses yet for this question.
If any, do you suffer from any of the following mental illness/disorders?
Copy chart
No responses yet for this question.
Of the following topics which do you find affect your mental health negatively?
Copy chart
No responses yet for this question.
Do you think that the impact of COVID-19 affects your mental health negatively?
Copy chart
No responses yet for this question.
How do you normally cope when you feel overwhelmed?
Copy chart
No responses yet for this question.
Have you ever received any kind of psychological counselling?
Copy chart
No responses yet for this question.
Where do you seek out support/help for dealing with your mental health?
Copy chart
No responses yet for this question.
If any, what type of medications are you taking for your mental health?
Copy chart
No responses yet for this question.
Are there any of the following addictions that is holding you back from a healthy mental state?
Copy chart
No responses yet for this question.
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