Survey Templates COVID 19 Health Evaluation Surveys 40 Mental Health Survey Questions for Questionnaire + Sample Template

40 Mental Health Survey Questions for Questionnaire + Sample Template

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.

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.
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?
Once in a while
About half the time
Most of the time
Calm and peaceful
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? 
Very less
Very much
No problem
Light physical activities
Moderate physical activities
Heavy physical 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?

Why use this example survey questionnaire to conduct a mental health survey?

Mental health is as important as physical health. It includes a person’s emotional, psychological, and social well-being. It affects how a person thinks, feels, and acts. Having sound mental health is important as it determines how people can handle stress, make choices, and interact with others. Here are some of the reasons why you should conduct a mental health survey:

  1. 1. To know the availability of mental care: Researchers can use this mental health questionnaire to understand the availability of health care around patients and know if it is adequate. Today, people are being diagnosed with various psychological and mental health issues. So, it is important a person receives immediate help and attention. Through this survey, a researcher can know if ample care facilities are available to the respondents.
  2. 2. Find out areas of mental health care that can be improved: Once the respondents fill in the survey, analyze the data collected to know if there are areas that need immediate attention. Patients experiencing mental discomfort must be treated with care and patience. Through this sample mental health survey questionnaire, researchers can understand the state of mind of the patients in a better way.
  3. 3. Know the most common mental disorders: The survey questions on mental health help the respondents fill in the elaborate details about what they experiencing. Researchers can identify mental health patients, issues and suggest treatment for them.
  4. 4. Identify population segments prone to a certain disorder: Use our mental health assessment questionnaire to identify if the person is prone to mental illness such as depression or carries a risk of suicide.
  5. 5. Know the reasons behind mental illness: Mental illness can be quite disturbing for the families of the people suffering from it. There can be various reasons causing mental stress. These factors may lead to mental illness gradually. Also, these factors can vary depending on the demographics, work environment, income, etc. Hence, the responses to mental health survey questions for college students, teenagers, and youth might be different from those for mental illness questions for adults.

Customize this example mental health survey questionnaire to include open-ended questions and apply logic to ask personalized questions based on their responses.