How Our Mental Health Questionnaire Can Help You

Are you interested in learning more about your 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 mental health and wellbeing. You may also want to share this information with the health professionals in your circle of care if you are concerned about your 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.

Teen Grief and Loss Questionnaire

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

Teen Grief/Loss Mini-Questionnaire
Cry uncontrollably when I think about someone/something I have lost
Have become socially isolated since the loss
Struggle to do daily tasks because of grief
Avoid thinking about someone who died or something I have lost
Do lots of things that make me feel like I haven’t lost someone/something
Grief over the loss has impacted my school/work
Extremely sad compared to others about someone/something they have lost
Feel guilty that I wasn’t able to prevent the loss from happening
Spend a lot of my time wishing that I did not lose someone/something
Try not to let myself feel the emotions associated with grief
Avoid places, people, or situations that remind me of someone/something I have lost
People tell me I need to move on/let go in relation to my grief
Can’t get rid of things that have little meaning because they remind me of someone/something I have lost
Wish I could change my past with someone/something I have lost
Have struggled to believe that the loss happened