How Our Mental Health Questionnaire Can Help You

Are you interested in learning more about your teen’s current mental health status? Take our brief questionnaire!

Please note: This questionnaire is a brief screening tool developed by mental health professionals at Sullivan + Associates Clinical Psychology. It is not intended for diagnostic purposes or to replace a formal mental health assessment. However, feel free to use it for personal interest and/or as a starting point towards improving your teen’s mental health and wellbeing. You may also want to share this information with your teen and/or the health professionals in their circle of care if you are concerned about their mental health.

Benefits of Taking our Mental Health Questionnaire

  • Easy to Do – It’s a rating scale style questionnaire. Just click on the selection that best describes you.
  • Confidential – Your responses and results are 100% confidential.
  • Direction – Suggests helpful next steps, such as suggestions for resources and services based on your responses.
  • Cost Effective – It’s free to use as many times as you want.
  • Quick to Use – It takes approximately 5-10 minutes to complete the test.
  • Immediate Results – You will receive your results immediately upon completing the test.
  • Free Report – If you enter your email address, you will receive a copy of your results. If you chose to provide your email address, your responses and results will remain 100% confidential.
  • Anonymous – You don’t need to provide any identifying information to complete the test.

Parents/Guardians of Teens: Self-Harm Questionnaire

Answer each question, then click submit to see your results.

Teen Self-harm Behaviour Mini-Questionnaire: Parents/Guardians
Intentionally cut, burned, or hit themself
Friends/family are worried about their self-harm
Hurt themself to cope with difficult feelings
Wear clothes or accessories to cover up self-harm scars
Plan to hurt themselves
Thought about hurting themselves
Made themself bleed through self-harm
Scars from hurting themself
Hurt themself to feel something or change how they feel
Avoid going places where people might see their self-harm scars (e.g., gym class, swimming)
Dug their nails into their skin when overwhelmed or stressed out
Lied to people about their self-harm scars
Keep items specifically for hurting themself (e.g., sharp objects)
Taken more than the recommended dose of medication
Hurting themself gives them a sense of control

Section

You endorsed thoughts/feelings of hopelessness, suicidality, homicidality, and/or self-harm. Please note that you are not alone and that there is help available. For your safety/the safety of others, consider accessing the following resources if you are at imminent risk of harm to yourself 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

For more information on preventing suicide, staying safe, and creating a safety plan, please read the following:

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/feelings-and-experiences/coping-with-self-harm/

https://www.youthranch.org/coping-skills-overcome-self-harmhttp://sioutreach.org

Do you wish to end the questionnaire here and contact crisis response?
The questionnaire is over. Please contact crisis response.

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