How do I fill in the health questionnaire?

The questions on the form

Tips and suggestions

11. Learning how to do tasks

Can you learn how to do an everyday task such as setting an alarm clock?

Can you learn how to do a more complicated task such as using a washing machine?

Does your illness or medication make it hard for you to concentrate on everyday tasks? These might be like setting an alarm clock or using the washing machine.

·         Was your concentration better when you were well?

·         Do you feel nervous about making a mistake?

·         Does this mean you just don’t try to complete the task?

·         Does it take you a lot longer?

Examples

·         I hear voices that make it hard for me to concentrate when trying to learn new tasks.

·         I get very anxious, which makes it hard to follow instructions. I get worried that I will do something wrong and so I have never learned to use the microwave.

·         If I have to do something new I think it will be hard so I avoid doing it. This means I don’t know how to use a computer and don’t go on the Internet.

The questions on the form

Tips and suggestions

12. Awareness of hazards or danger

Do you need someone to stay with you for most of the time to stay safe?

Sometimes people with mental illness can get easily distracted. This can mean they put themselves or other people in danger.

·         Do you ever start to make a meal, but then start doing something else and leave the cooker on?

·         Do you forget to lock your doors at night or when you leave the house?

·         Do you ever act dangerously and do things that you would not do if you were well?

·         Do you self-harm?

·         How often do these things happen? All of the time, most of the time or just sometimes? 

Possible dangers are:

·         Self-harm,

·         Not being able to concentrate which means you don’t take medication correctly, don’t check ‘use-by’ dates or leave the gas on, or

·         Giving personal information about you to strangers.

Examples

·         My depressive thoughts are so bad that sometimes I forget that pans are hot and hurt myself on them.

·         I forget to turn off the gas most of the time because I am constantly worrying about other things.

·         If someone did not supervise me, I would take the wrong amount of medication. This would lead to me becoming unwell and hurting others or myself.

The questions on the form

Tips and suggestions

13. Starting and finishing tasks

Can you manage to plan, start and finish daily tasks?

Think about how your condition changes – what are you like on a ‘bad day’ compared to a ‘good day’? List all the tasks you might not be able to do.

·         Does your condition mean you don’t have any motivation?

·         Does your medication affect your concentration for everyday tasks?

·         How often does it affect you? Is it all the time, most of the time or not at all?

·         Do you need help to plan and organise your day?

·         What would happen if you didn’t have any help?

·         Are you sometimes lost in your own thoughts and, without encouragement from others, would sit on your own?

·         Would you stay in bed all day?

·         Would you not eat all day because you don’t have the motivation to make yourself something to eat?

Examples of ‘tasks’.

·         Planning – like cooking and preparing a meal.

·         Organisation – like booking an appointment with a doctor or paying bills on time.

·         Problem solving –dealing with something that happens unexpectedly like a washing machine that breaks down.

·         Prioritising – being able to know what the important things are that you need to take care of like dealing with money, paying rent or your bills.

·         Switching tasks – being able to do different things that are connected like washing dishes and then putting them away.

Examples

·         Because of my depression, I cannot find the motivation to plan and then make a meal for myself most of the time. I eat takeaways all the time.

·         When I am in a manic phase, I cannot prioritise what I will do with my money. This means I spend all the money I need for bills on stuff I don’t need.

·         My illness makes me think things that are not real. This means I can never go to appointments with my doctor because I think that people want to harm me.

·         I can’t cope with feeling under pressure to deal with problems. This means my back door has been broken for three months and someone could easily break in.

·         My medication makes it hard to concentrate. This means I can’t do things I need to do like chores or going to my GP.

The questions on the form

Tips and suggestions

14. Coping with changes

Can you cope with small changes to your routine if you know about them before they happen?

Can you cope with small changes to your routine if they are unexpected?

·         Do you find it hard to cope if your day-to-day routine is changed? 

·         What would happen if you were told about a change? How would it make you feel?

·         If you are told about a change in your routine in advance (for example, if your doctors appointment changes), do you worry about it?

·         Does your ability to cope change from day to day or week to week?

·         What would happen if something unexpected happened? How would that make you feel?

Examples

·         Because of my Obsessive Compulsive Disorder (OCD), I have to go on the same bus route to my mother’s house every day. If there is an issue with the bus or a diversion I get very unwell. My symptoms get bad for days after and I can’t leave the house. 

·         When I am unexpectedly asked to go to the Job Centre, I feel so anxious that I feel physically sick and can’t think about anything else.

·         If my routine changes, I think that the government are trying to interfere with my life. I don’t go out in case anything bad happens.

·         Even when I plan to go to a hospital appointment, I cannot go unless someone agrees to take me there.

·         If I run out of milk and bread I have a panic attack because I only get my weekly shop when a family member can help me on a Saturday.

·         If I get letters in the post that I don’t recognise, I don’t open them because I think they must be bad news.

·         If my sister cannot come and take me shopping when we agreed I get so angry I break things in my house. I feel angry for a few days.

The questions on the form

Tips and suggestions

15. Going out

Can you leave home and go out to places you know?

Can you leave home and go to places you don’t know?

·         Are you able to go out to places that you are familiar with on your own?

·         What would happen if you had to go out? Explain how that would affect you.

·         Can you only go out if someone is with you? Write down how often you need someone with you.

·         Do you need someone with you to make sure you don't cause any harm to yourself? How often could that happen?

·         Are you able to get to places that you don't know on your own?

Think about how you would cope:

·         Going on public transport,

·         Getting to doctors appointments,

·         Doing your food shopping,

·         Going to the bank,

·         Going to the Jobcentre Plus, or

·         Visiting friends or family.

Examples

·         I feel trapped when I am using public transport and start panicking and so I have to go back to my house.

·         When I have an appointment at the bank I can’t get there. I feel like everyone I walk past in the street is looking at me and wants to hurt me.

·         I always need to go out with someone, otherwise I start to feel anxious and get angry with strangers.

·         If I know I have to go somewhere new that is all I can think about.  I start to panic and self-harm.

·         I live in the countryside so the buses only come every 30 minutes. If someone sits beside me on the bus I get so anxious I have to get off and wait for the next one. This means I am nearly always late for appointments.

The questions on the form

Tips and suggestions

16. Coping with social situations

Can you meet people you know without feeling too anxious or scared?

Can you meet people you don’t know without feeling too anxious or scared?

Think about how it would make you feel if you had to socialise with other people. If your ability to deal with social situations can change make it clear about how often and when you would have a problem.

·         Do you socialise with other people? If not, why?

·         What would happen if you did socialise? Would you show any physical symptoms? What are they?

·         Are you okay with people you know but don’t go to places where you would have to meet new people? 

This could include having difficulties:

·         Using public transport,

·         Shopping,

·         Talking to neighbours,

·         Visiting friends or family, or

·         Taking part in hobbies.

Examples

·         I always avoid meeting new people. My heart races, I get dizzy and feel like I can’t breathe. I feel like I am in danger. Because of this, I do all my shopping online so I don’t have to interact with people. Even thinking about meeting someone new is on my mind for days before and I can’t sleep properly.

·         I feel really paranoid and I cannot trust people. If someone tries to talk to me I always tell them to get away from me.

·         If there are people on the street I won’t put my bin out.

·         I am not able to use public transport most of the time because it means I have to be around people I don’t know.

·         I never answer the phone unless I have agreed for someone I know to call me at a certain time.

·         I won’t answer the door unless I know who it is and I am expecting them.

·         I stay at home most of the time and only ask people I trust to bring me the things I need.

·         I don’t have a phone or email because I don’t want people to be able to hack into them and spy on me.

The questions on the form

Tips and suggestions

17. Behaving appropriately

How often do you behave in a way that upsets other people?

·         How do other people describe you?

·         Do people comment that they feel you are aggressive or violent?

·         Has anyone said they felt what you have said or done was inappropriate?

·         Have you noticed a change in the way people act towards you now compared to when you were well?

·         Have you lost friends or relationships because of how you behave?

·         How often do you find these things happen? Daily, a lot of the time or occasionally?

Examples

·         I often feel paranoid that people in the street are staring at me so I shout and swear at them. 

·         I lost my last job because I got in an argument with my colleague and then shouted at my boss.

·         When I am on the bus I get really angry when people talk on their phone. I will tell them to shut up and have knocked people’s phones out of their hands if they don’t. I was arrested for this a few times, the police know me now.

·         I feel my neighbour has caused my depression so I write graffiti on their wall.

·         When I am in a manic phase I often try to have sex with lots of people, which makes it hard to have relationships.

·         When I have had panic attacks I have self-harmed at work and in public places.

·         I often say things that other people find insulting or inappropriate.