University Student Mental Health Self-Screening
Basic Information
Name
Email
Program/Major
Year of Study
1st Year
2nd Year
3rd Year
4th Year
Other
Self-Screening Questions
1. How often have you been bothered by feeling down, depressed, or hopeless in the past two weeks?
Not at all
Several days
More than half the days
Nearly every day
2. How often have you had trouble sleeping or staying asleep?
Not at all
Several days
More than half the days
Nearly every day
3. How often have you felt anxious, nervous, or on edge?
Not at all
Several days
More than half the days
Nearly every day
4. How often have you had difficulty concentrating on your studies or daily tasks?
Not at all
Several days
More than half the days
Nearly every day
5. In the past month, have you lost interest or pleasure in doing things you usually enjoy?
No
Yes
6. Have you felt isolated or withdrawn from friends or family?
No
Yes
7. Do you feel overwhelmed by academic or personal responsibilities?
No
Sometimes
Often
Describe any additional mental health concerns or support you may need