This questionnaire asks about difficulties due to health/mental health conditions. Health conditions include diseases or illnesses, other health problems that may be short or long lasting, injuries, mental or emotional problems, and problems with alcohol or drugs. Think back over the past 30 days and answer these questions thinking about how much difficulty you had doing the following activities. For each question, please circle only one response.
In the last 30 days, how much difficulty did you have in:
Understanding and communicating
Getting around
Self-care
Getting along with people
Life activities—Household
Life activities—School/Work
If you work (paid, non-paid, self-employed) or go to school, complete questions D5.5–D5.8, below. Otherwise, skip to D6.1.
Because of your health condition, in the past 30 days, how much difficulty did you have in:
Participation in society.
In the past 30 days: