More than one in four Americans suffer from a diagnosable psychiatric disorder at any given time, according to estimates from the National Institute of Mental Health (NIMH). Over our lifetime nearly one half of us suffer from such disorders. Unfortunately, nearly two thirds of our behavioral and emotional problems are never diagnosed or treated, even though in many cases effective treatment is available. More than 80 percent of people with major depression, for example, benefit substantially from a combination of medication and counseling.
When I served as editor in chief of Psychology Today, readers often asked me to direct them to screening tests for mental health problems. I looked for such tests on the Internet, which seemed the ideal tool for helping people find answers to questions about their mental health: Is this down feeling I’m experiencing normal? Why do I shout at my wife and kids all the time? Is my drinking out of control? Should I be seeing a therapist? I found the Internet riddled with thousands of homemade tests, but none had been scientifically validated. Worse, many of them served as marketing vehicles for videos, books or services—sending the test taker straight to a sales pitch. No broad, reliable, consumer-friendly test seemed to exist.
So I created a test, now called the Epstein Mental Health Inventory (EMHI), based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the guidebook most therapists use for making diagnoses. The test covers 18 common psychiatric problems in the U.S., such as major depression, phobias, bipolar disorder and substance abuse, a selection I made using prevalence data from the NIMH, among other sources. For each disorder, the test screens for three of the DSM-IV criteria, which I restated in plain language.
On supporting science journalism
If you're enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.
The EMHI does not make diagnoses. Its goal is to direct individuals who might be at risk for a disorder to qualified professionals who can make diagnoses and, more important, help people feel and function better. Given how few people actually seek treatment, any legitimate way to get people to consult with a therapist would, I reasoned, have value.
Laura Muzzatti, a student at the University of California, San Diego, and I presented an evaluation of the EMHI last year. Using a sample of 3,403 people who took the test after it was posted online in 2007, we found that test scores predicted seven important factors related to mental health. These included how happy people said they are; how highly they rated their personal and professional success; whether they were employed; whether they had ever been in therapy; whether they had ever been hospitalized for behavioral or emotional problems; and whether they were currently in therapy. The scores did not differ by race, but females scored about 17 percent higher than males; that is, they seemed to have more mental health problems, a result consistent with those of other studies.
Consumers and some clinics are now using the EMHI every day. You can, too. Visit http://DoYouNeedTherapy.com for the complete test. Or take the abbreviated version, which covers 10 disorders, immediately below. Place a check next to all the statements that apply to you.
Impulse-Control Disorders
I am sometimes unable to control my anger.
I often act impulsively, and this causes me great difficulty at times.
I am preoccupied with gambling, and I seem to have trouble controlling my gambling behavior.
Substance Abuse
Over the past year I have had to drink more alcohol or take more drugs to satisfy my needs.
Over the past year I have tried but have been unable to decrease the amount of alcohol I drink, drugs
I use or cigarettes I smoke.
Over the past year I have had to use larger and larger amounts of alcohol or drugs to get satisfaction or to cope with my problems.
Major Depression
For at least the past two weeks, I have found it difficult to get any pleasure from daily activities that I used to enjoy.
For at least the past two weeks, I have been thinking frequently about wanting to die.
For at least the past two weeks, I have felt depressed most of every day.
Specific Phobias
I suffer from an extreme fear of some object or situation, and I believe this fear may be excessive or unreasonable.
I am extremely afraid of some object or situation, and my fear interferes with my ability to function normally in my work or home life.
I am extremely afraid of an object or a particular situation, and when exposed to that object or situation I experience great fear or panic.
Social Phobias
I am afraid to be around other people in certain situations, and I realize that my fears may be unreasonable or excessive.
In certain social situations, I feel extremely anxious.
I am highly fearful of one or more situations in which I need to interact with other people.
Eating Disorders
I regularly eat a great deal and then vomit or use laxatives or other extreme means to prevent weight gain.
I am preoccupied with my weight or the shape of my body, and as a result I eat or exercise in ways that some people might consider unusual.
I am unwilling or unable to eat or to digest enough food to maintain a healthy body weight.
Post-Traumatic Stress Disorder
I often find myself having disturbing recollections related to a traumatic event I experienced in the past.
I often have disturbing dreams about a terrible experience I had in the past.
I sometimes find myself reliving the horror of a traumatic event I experienced in the past.
Generalized Anxiety Disorder
For at least the past six months, I have experienced worry and excessive nervousness that I find difficult to control.
For at least the past six months, I have been extremely anxious and worried about a number of different events and activities.
For at least the past six months, I have felt unusually restless, fatigued, irritable, tense or distractible.
Bipolar Disorder
Over the past year my mood has sometimes shifted without any apparent reason.
My mood shifts rapidly from depressed to highly elevated without any apparent reason.
Over the past year my mood has shifted more than once from depressed to highly elevated.
Obsessive-Compulsive Disorder
I repeat certain behaviors or thoughts excessively, and I can’t seem to stop doing so.
Certain thoughts occur to me over and over again and cause me great anxiety, and I think that these thoughts might be irrational or excessive.
I do certain things or think certain things over and over again to calm myself or to prevent something terrible from happening.
Scoring
If you left all the items blank, congratulations! Your mental health is probably first rate (although bear in mind that this is not the complete test). If you checked off one item in one or more categories, you might not need therapy, but if you have any concerns about the way you are feeling or functioning, consider seeking help from a qualified mental health professional.
If you marked two or three items in one or more categories, a visit with a mental health professional would probably be a good idea. Most treatable mental health problems, such as depression, are never even diagnosed, which means many people are suffering unnecessarily. You can find a qualified therapist through a physician or with the help of a variety of powerful new Internet directories.