Generated Narrative: Questionnaire MentalHealthAssessmentSurveyQuestionnaire Structure LinkID Text Cardinality Type Description & Constraints MentalHealthAssessmentSurveyQuestionnaire Te Whatu Ora Mental Health Assessment Survey Questionnaire https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/MentalHealthAssessmentSurveyQuestionnaire#0.4.4 #xD; p01 page 1. History and Examination 0..1 group #xD; p01-q01-IssueDescription page 1 question 1. Description of presenting issue 1..1 text #xD; p01-q02-Mood page 1 question 2. Assessment of Mood 1..1 text #xD; p01-q03-SleepHygine page 1 question 3. Assessment of sleep hygiene 1..1 text #xD; p01-q04-SupportStructure page 1 question 4. Assessment of whanau and support structures 1..1 text #xD; p01-q05-Trauma page 1 question 5. Is there a history of previous trauma and stressors? 1..1 boolean #xD; p01-q05-1-Trauma.Description page 1 question 5.1. Please provide information surrounding this history. 1..1 text Enable When: p01-q05-Trauma = #xD; p01-q06-SuicideAttemptHistory page 1 question 6. Have there been any previous suicide attempts? 1..1 boolean #xD; p01-q06-1-SuicideAttemptHistory.Description page 1 question 6.1. Please provide details surrounding these attempts 1..1 text Enable When: p01-q06-SuicideAttemptHistory = #xD; p01-q07-CigaretteSmoker page 1 question 7. Is the patient smoking cigarettes? 1..1 boolean #xD; p01-q01-1-CigaretteSmoker.HowMany page 1 question 7.1. How many cigarettes per day? 1..1 choice Enable When: p01-q07-CigaretteSmoker = Options: 2 options #xD; p01-q08-CurrentDrinker page 1 question 8. Does the patient consume alcohol? 1..1 boolean #xD; p01-q08-1-CurrentDrinker.HowMany page 1 question 8.1. How many drinks per week? 1..1 choice Enable When: p01-q08-CurrentDrinker = Options: 3 options #xD; p01-q09-RecreationalDrugs page 1 question 9. Does the patient use recreational drugs? 1..1 boolean #xD; p01-q10-PsychiatricMedication page 1 question 10. Psychiatric Medication? 0..1 text #xD; p02 page 2. Risk Assessment 0..1 group #xD; p02-q01-SuicidalIntent page 2 question 1. Suicidal Intent? 1..1 boolean #xD; p02-q02-HarmfulThoughts page 2 question 2. Threat to others? 1..1 boolean #xD; p03 page 3. Current and past psychiatric diagnosis 0..1 group #xD; p03-g01-AddDiagnosis page 3 group 1. Add Diagnosis 0..* group #xD; p03-g01-q01-AddDiagnosis.Diagnosis page 3 group 1 question 1. Diagnosis 1..1 text #xD; p03-g01-q02-AddDiagnosis.Year page 3 group 1 question 2. Year of Diagnosis 1..1 date #xD; p03-g01-q03-AddDiagnosis.Place page 3 group 1 question 3. Place of Diagnosis 1..1 string #xD; p03-g01-q04-AddDiagnosis.Hospitalisation page 3 group 1 question 4. Hospitalisation? 1..1 boolean #xD; p03-g01-q05-AddDiagnosis.Active page 3 group 1 question 5. Active? 1..1 boolean #xD; p04 page 4. General Practice Information 0..1 group #xD; p04-q01-SendNote page 4 question 1. Send note to GP Inbox? 1..1 boolean Initial Value: boolean = false #xD; p04-q02-PracticeName page 4 question 2. GP Practice Name 0..1 string #xD; p04-q03-PracticeEDI page 4 question 3. Practice EDI 0..1 string #xD; Documentation for this format Options Sets Answer options for p01-q01-1-CigaretteSmoker.HowMany null#Less than 10 ("Less than 10") null#10 or more ("10 or more") Answer options for p01-q08-1-CurrentDrinker.HowMany null#Less than 10 ("Less than 10") null#10 to 16 ("10 to 16") null#More than 16 ("More than 16")
Te Whatu Ora Mental Health Assessment Survey
Assessment of whanau and support structures
Is there a history of previous trauma and stressors?
Please provide information surrounding this history.
Have there been any previous suicide attempts?
Please provide details surrounding these attempts
Does the patient use recreational drugs?