Mental Health Questionnaire For Parents/Guardians of Teen

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Teen Mental Health Screening Questionnaire Parents/Guardians
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Anxiety-6 - Feeling restless or tense
Anxiety-11 - Heart palpitations and/or increased heart rate
Emotion Regulation-7 - Rapid fluctuations in mood
Depression-17 - Wanting to die, but having no intention of carrying it out
Disordered Eating-7 - Binge eating (i.e., eating large amounts of food in a 2-hour sitting)
Inattention/Motor Restlessness-2 - Difficulties with procrastination
Trauma-9 - Difficulty remembering parts of a traumatic/stressful event
Addiction-9 - Feeling bad/guilty about their use of alcohol and/or substances
Emotion Regulation-14 - Stolen from someone
Anxiety-14 - Avoiding situations that cause anxiety/panic
Emotion Regulation-10 - Starting several projects (more than normal) and not completing them
Trauma-8 - Avoiding reminders of a previously upsetting or stressful experience
Disordered Eating-11 - Dislike the way they look
Inattention/Motor Restlessness-8 - Difficulties completing tasks requiring sustained attention (e.g., homework, sitting through a 2-hour movie, etc.)
Psychosis-7 - Feelings as if people are watching them

Thoughts/feelings of hopelessness, suicidality, homicidality, and/or self-harm were endorsed with respect to your child. For their safety/the safety of others, consider accessing the following resources if they are at imminent risk of harm to themselves or someone else:

  1. Call or text the suicide crisis helpline at 988 (available 24/7)
  2. Go to the Emergency Department at your local hospital or health centre (807-684-6100 for Thunder Bay)
  3. Call 911
  4. Contact Crisis Response: They offer mobile crisis response, crisis support residence, and 24/7 telephone services to both youth and adults who are experiencing a mental health crisis. Call or text locally at 807-346-8282 or District of Thunder Bay 1-866-888-8988
  5. Kids Help Phone: 24/7 mental health support for youth. Call 1-800-668-6868 or text 686868
  6. LGBT Youthline: Confidential, informed support and peer guidance for 2SLGBTQ+ youth. Call, text or chat at 647-694-4275 or https://www.youthline.ca/
  7. Contact Hope for Wellness Helpline: Available 24/7 to all Indigenous people across Canada for immediate support and crisis intervention. Call 1-855-242-3310 or chat online www.hopeforwellness.ca

If you are concerned about someone, please read the following for more information on preventing suicide, staying safe, and creating a safety plan:

https://ontario.cmha.ca/documents/preventing-suicide/

https://www.sp-rc.ca/wp-content/uploads/2021/12/Safety_Plan_Basic.pdf

https://988.ca/

https://www.mind.org.uk/for-young-people/information-for-parents/

https://suicideprevention.ca/im-concerned-about-someone/

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