Mental Health Screening Form III

The Mental Health Screening Form-III is a rough screen that flags whether someone might have a mental health problem worth looking into. It was written for substance use treatment programs, where co-occurring psychiatric difficulties are common and often go unrecognized at intake.

Eighteen questions are answered yes or no, and all of them begin "Have you ever..." — so the form reflects a person's whole life history rather than the present moment. The first four are general; questions 5 through 17 map onto specific diagnostic categories, from schizophrenia and depressive disorders to PTSD, phobias, and eating disorders. The recommended approach is for a staff member to read each item aloud, then follow up every yes with questions about when it started and how long it lasted.

Licensing Notes: The form states plainly that this material may be reproduced or copied, in entirety, without permission, and citation of the source is appreciated