Questionnaire template
Psychological Distress Screening (K6)
Screens adults for non-specific psychological distress over the past 30 days with the free six-item Kessler K6 scale.
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Healthcare · Mental health assessment. All Healthcare templates
Questions in this template
Nervousness and Hope
Thank you for taking part. Six short questions ask how you have felt over the past month, and your answers are kept confidential.
This questionnaire is the Kessler Psychological Distress Scale (K6), developed by Ronald C. Kessler and colleagues at Harvard Medical School. It is free to use.
Your result is a screening aid, not a diagnosis. If you are struggling, please talk to a health professional.
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During the last 30 days, about how often did you feel nervous?
Choose one:
- None of the time
- A little of the time
- Some of the time
- Most of the time
- All of the time
-
During the last 30 days, about how often did you feel hopeless?
Choose one:
- None of the time
- A little of the time
- Some of the time
- Most of the time
- All of the time
Restlessness and Low Mood
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During the last 30 days, about how often did you feel restless or fidgety?
Choose one:
- None of the time
- A little of the time
- Some of the time
- Most of the time
- All of the time
-
During the last 30 days, about how often did you feel so depressed that nothing could cheer you up?
Choose one:
- None of the time
- A little of the time
- Some of the time
- Most of the time
- All of the time
Effort and Self-Worth
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During the last 30 days, about how often did you feel that everything was an effort?
Choose one:
- None of the time
- A little of the time
- Some of the time
- Most of the time
- All of the time
-
During the last 30 days, about how often did you feel worthless?
Choose one:
- None of the time
- A little of the time
- Some of the time
- Most of the time
- All of the time