Youth Mental Health Screening 

We are conducting studies with a variety of individuals, including those who are experiencing certain changes in their mood, thinking, and school or work performance. To find out if our studies are a good fit for you, we do a “screening” which involves asking for some information about your experiences, medical history, and treatment history. This form is one option for sharing this information with us, and should take roughly 10 minutes. The information you share will be kept confidential within our clinical team. The form requires you to submit some kind of identifier (your name, initial, or nickname), and an e-mail address, so you are providing us with some identifying information. If your responses suggest that you are eligible for the study, a clinician or research assistant will review your responses and follow up with you using the contact information you provide. If at any point you decide that you do not want to be contacted, you can exit the survey without submitting a response or email/call the researchers to opt out of future contact. This form is voluntary and you may refuse to answer any question. Please note that completing this electronic form is one way for us to get to know whether your experiences make you a good fit for our studies – if you would be more comfortable, you may also call or e-mail or us directly. If you prefer to speak with someone about your experiences, you may contact us at ResponsetoRisk@bidmc.harvard.edu or (617)209-9169

 

Do you agree to the information above and want to proceed with the screening survey?