Mental Health Index - brief griefassessment

Have you ever felt you ought to cut down on your drinking or drug use?
	OPTIONS
1. How much are you having trouble accepting the death of ______________?
2. How much does your grief still interfere with your life?
3. How much are you having images or thoughts of _____________ when s/he died or other thoughts about the death that really bother you?
4. Are there things you used to do when ______ was alive that you don’t feel comfortable doing anymore, or that you avoid? Like going somewhere you went with him/her, or doing things you used to enjoy together? Or avoiding looking at pictures or talking about _________? How much are you avoiding these things?
5. How much are you feeling cut off or distant from other people since _________ died, even people you used to be close to like family or friends?

Simple Steps