Mental Health Screener by UMass.doc - integration samhsa 2026

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The document is a Patient Stress Questionnaire designed to assess various mental health issues, including depression, anxiety, and alcohol consumption. It includes a series of questions that ask patients to rate their experiences over the past two weeks regarding feelings of sadness, nervousness, sleep disturbances, and alcohol use. The questionnaire aims to identify potential psychological distress and drinking habits to provide appropriate support and intervention.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your name and birthdate at the top of the form. This personal information is essential for tracking your responses.
Proceed to the first section, where you will answer questions about your mental health over the past two weeks. Circle the number that best represents your experience for each question.
For each problem listed, check any boxes that apply to you. This helps provide a comprehensive view of your mental health status.
Continue through the subsequent sections regarding physical pain and alcohol consumption. Answer each question honestly, circling or checking as required.
Once completed, review your answers for accuracy before saving or exporting the document directly from our editor.

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