Mental Health Screening (DASS-21)

For each statement, choose how much it applied to you over the past week. There are no right or wrong answers.

1. I found it hard to wind down

   0 - Never 1 - Sometimes 2 - Often 3 - Almost always

2. I was aware of dryness of my mouth

   0 - Never 1 - Sometimes 2 - Often 3 - Almost always

3. I couldn't seem to experience any positive feeling at all

   0 - Never 1 - Sometimes 2 - Often 3 - Almost always

4. I experienced breathing difficulty (e.g. excessively rapid breathing, breathlessness in the absence of physical exertion)

   0 - Never 1 - Sometimes 2 - Often 3 - Almost always

5. I found it difficult to work up the initiative to do things

   0 - Never 1 - Sometimes 2 - Often 3 - Almost always

6. I tended to over-react to situations

   0 - Never 1 - Sometimes 2 - Often 3 - Almost always

7. I experienced trembling (e.g. in the hands)

   0 - Never 1 - Sometimes 2 - Often 3 - Almost always

8. I felt that I was using a lot of nervous energy

   0 - Never 1 - Sometimes 2 - Often 3 - Almost always

9. I was worried about situations in which I might panic and make a fool of myself

   0 - Never 1 - Sometimes 2 - Often 3 - Almost always

10. I felt that I had nothing to look forward to

    0 - Never 1 - Sometimes 2 - Often 3 - Almost always

11. I found myself getting agitated

    0 - Never 1 - Sometimes 2 - Often 3 - Almost always

12. I found it difficult to relax

    0 - Never 1 - Sometimes 2 - Often 3 - Almost always

13. I felt down-hearted and blue

    0 - Never 1 - Sometimes 2 - Often 3 - Almost always

14. I was intolerant of anything that kept me from getting on with what I was doing

    0 - Never 1 - Sometimes 2 - Often 3 - Almost always

15. I felt I was close to panic

    0 - Never 1 - Sometimes 2 - Often 3 - Almost always

16. I was unable to become enthusiastic about anything

    0 - Never 1 - Sometimes 2 - Often 3 - Almost always

17. I felt I wasn't worth much as a person

    0 - Never 1 - Sometimes 2 - Often 3 - Almost always

18. I felt that I was rather touchy

    0 - Never 1 - Sometimes 2 - Often 3 - Almost always

19. I was aware of the action of my heart in the absence of physical exertion (e.g. sense of heart rate increase, heart missing a beat)

    0 - Never 1 - Sometimes 2 - Often 3 - Almost always

20. I felt scared without any good reason

    0 - Never 1 - Sometimes 2 - Often 3 - Almost always

21. I felt that life was meaningless

    0 - Never 1 - Sometimes 2 - Often 3 - Almost always

Sleep over the past month

Tick any that apply to you.

Please answer every statement above before seeing your results.