Students Mental Health Screener for Teachers

COVID-19 has changed our world. These changes can be challenging for many and in some cases can impact overall
functioning at home, school, or both for children and teens. 

Below are some questions to ask yourself about how well students in your class are adjusting to these new changes.

Results

If you selected at least one of the items on this checklist, the student could benefit from mental health services. Make a referral by completing our online enrollment form.

If you selected at least one of
the items on this checklist, the
student could benefit from
mental health services.
Make a referral by completing
our online enrollment form.

#1. Check all that apply below:

Select all that apply:

Constantly worries about health or self or others

Constantly worries about health or self or others

Experiences separation anxiety

Experiences separation anxiety

Has trouble concentration or being still at school, home or both

Has trouble concentration or being still at school, home or both

Demonstrates low mood, tearfulness, or feelings of hopelessness

Demonstrates low mood, tearfulness, or feelings of hopelessness

Has difficulty adapting to new routines (i.e. wearing facemasks, not seeing friends, social distancing, etc)

Has difficulty adapting to new routines (i.e. wearing facemasks, not seeing friends, social distancing, etc)

Frequently disruptive (unable to be redirected, pulls attention away from teacher, unable to follow directions)

Frequently disruptive (unable to be redirected, pulls attention away from teacher, unable to follow directions)

Finish

If you selected at least one of the items on this checklist, the student could benefit from mental health services. Make a referral by completing our online enrollment form.

Teachers aren’t immune to all of these difficult changes. HOPE is here for you too! Affordable self-pay rates are available. Call 706-279-0405 ext 149, email inquiries@gahope.org, or contact us online to learn more or get started today,