in partnership with
Mental Health Assessment
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*
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Step
1
of
18
5%
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Feeling nervous, anxious or on edge?
Not At All
Several Days
More Than Half the days
Nearly Everyday
Not being able to stop or control worrying?
Not At All
Several Days
More Than Half the days
Nearly Everyday
Trouble relaxing?
Not At All
Several Days
More Than Half the days
Nearly Everyday
Being so restless that it is hard to sit still?
Not At All
Several Days
More Than Half the days
Nearly Everyday
Becoming easily annoyed or irritable?
Not At All
Several Days
More Than Half the days
Nearly Everyday
Feeling afraid as if something awful might happen?
Not At All
Several Days
More Than Half the days
Nearly Everyday
Little interest or pleasure in doing things?
Not At All
Several Days
More Than Half the days
Nearly Everyday
Feeling down, depressed, or hopeless?
Not At All
Several Days
More Than Half the days
Nearly Everyday
Trouble falling or staying asleep, or sleeping too much?
Not At All
Several Days
More Than Half the days
Nearly Everyday
Feeling tired or having little energy?
Not At All
Several Days
More Than Half the days
Nearly Everyday
Poor appetite or overeating?
Not At All
Several Days
More Than Half the days
Nearly Everyday
Feeling bad about yourself – or that you are a failure or have let yourself or your family down?
Not At All
Several Days
More Than Half the days
Nearly Everyday
Trouble concentrating on things, such as reading the newspaper or watching television?
Not At All
Several Days
More Than Half the days
Nearly Everyday
Moving or speaking so slowly that other people could have noticed? Or the opposite – being so fidgety or restless that you have been moving around a lot more than usual?
Not At All
Several Days
More Than Half the days
Nearly Everyday
Thoughts that you would be better off dead, or of hurting yourself in some way?
Not At All
Several Days
More Than Half the days
Nearly Everyday
Feeling Stressed, burdened or hassled?
Not At All
Several Days
More Than Half the days
Nearly Everyday
What are the top reasons for your stress / anxiety?
Relationship
Career
Academics (Exam / Grades)
Financial
Health
Self-esteem (weight, height, color, race etc)
Family / Parents
Sleep issues
Enter following details to get the result
Name
*
Email
(optional)
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Phone
Campus Name
*
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Campus Name Hidden
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Your Anxiety Score
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Low Anxiety Text
Hidden
Mild Anxiety Text
Hidden
Moderate Anxiety Text
Hidden
Severe Anxiety Text
Hidden
Your Depression Score
Hidden
Low Depression Text
Hidden
Mild Depression Text
Hidden
Moderate Depression Text
Hidden
Severe Depression Text
Hidden
Your Stress Score
Hidden
Low Stress Text
Hidden
Mild Stress Text
Hidden
Moderate Stress Text
Hidden
Severe Stress Text
Hidden
Overall Mental Health
Hidden
Low Overall Text
Hidden
Mild Overall Text
Hidden
Moderate Overall Text
Hidden
Severe Overall Text
Try MantraCare Wellness Program free
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Name
*
Company
*
Email
*
Phone
*
No. of employees
*
No. of employees for wellness program
0- 250
250- 500
500 – 1000
1000- 5000
5000+
Comments
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