Six Month Mental Health Survey

Over the last 6 months what type of supportive services have you received? (select all that apply)

The Patient Health Questionnaire-9 is a self-administered diagnostic instrument for depression, which scores each of the 9 DSM-IV criteria as “0” (not at all) to “3” (nearly every day).

Over the last two weeks, how often have you been bothered by any of the following problems:

The PCL-5 is a 20-item self-report measure that assesses the 20 DSM-5 symptoms of PTSD. The PCL-5 has a variety of purposes, including:

• Monitoring symptom change during and after treatment
• Screening individuals for PTSD
• Making a provisional PTSD diagnosis

Instructions: Below is a list of problems that people sometimes have in response to a very stressful experience. Please read each problem and then select one of the options to indicate how much you have been bothered by that problem in the past week. The options include not at all, a little bit, moderately, quite a bit, and extremely.

In the past week, how much were you bothered by: