Proposal Summary: International Branching Questionnaire System for Mental Health Exploration
Author: John B. Kirk
Date: 9/25/2025
Overview
This branching questionnaire was first made as a proposal for OpenAI. Written in available languages and at two reading levels, it is shared here to potentially help parents, guardians, and caregivers. It would give a basic and/or in-depth way to think about possible mental health concerns, while keeping answers private, easy to use, and adaptable to different cultures.
It would do this by having the participants pose their questions as though they were asking for a friend or about a friend’s child. Responses would be recorded on paper, not on computer. This would not be tool to diagnose anyone. It would be for learning and careful thinking.
The questionnaire starts with a few short, clear questions. These lead users to more detailed questions while keeping in mind different cultural, financial, and social situations. The goal would be to help people reflect, no matter what their reading level.
Reading Levels Participants can choose one or both levels. These levels were inspired by Wikipedia:
A – Simple English
B – Standard English
This would provide flexibility and support international use, including translation into other languages.
Stage 1: Entry Questions (Broad Scan) The questionnaire would start with general questions to determine the nature of the mental health concern:
- Main Challenge
- “In the last month, what has been hardest for this person: their feelings, their thoughts, or their body?”
- Timing & Triggers
- “Are they having trouble mostly because of sudden events, or because of something ongoing?”
- Daily Functions
- “Have their sleep, appetite, or energy changed significantly recently?”
- Safety
- “Do they seem safe right now — not likely to harm themselves or others?”
- “Have they ever expressed a desire to harm themselves or someone else?”
- Sharing Option
- “Would it help if someone could share this information with a doctor, counselor, or helper?”
Participants could also indicate their general context by rating:
- Economic Situation: A (Good access), B (Some resources), C (Very limited)
- Health Care Access: A (High), B (Moderate), C (Low)
- Stigma Level: High / Medium / Low
Stage 2: Branching Paths Based on responses, the questionnaire would branch into specific areas:
- Feelings Path (Emotions)
- “Do they often feel sad, hopeless, or cry frequently?”
- “Do they get angry or upset more than they want to?”
- Branch to depression, anxiety, or grief resources if relevant.
- Thoughts Path (Cognition)
- “Do they have recurring worries?”
- “Do they believe things others say are untrue?”
- Branch to anxiety, paranoia, psychosis, or memory support.
- Body Path (Physical or Sensory)
- “Do they feel frequent pain, tension, or unusual sensations?”
- Branch to somatic symptoms, panic, or stress relief tools.
- Dissociation / Identity Path
- “Do they sometimes act distant or forget events?”
- “Do they seem like different versions of themselves at different times?”
- Branch to grounding techniques, memory support, identity-related tools, or professional referral.
Stage 3: Next Steps & Resources
- Immediate Help: Crisis lines and urgent care if safety concerns exist.
- Self-Help Tools: Grounding exercises, journaling prompts, breathing guides.
- Professional Help: Referral to doctors, counselors, or trusted helpers if severe.
- Tracking Option: Printable or digital tracker to note changes over time.
Tone & Style Notes
- Short, concrete, optional questions.
- Gentle, supportive language suitable for broad audiences.
- Skip options included to avoid overwhelming users.
- Reflective tool, not a diagnosis; encourages independent learning.
Conclusion
This branching questionnaire system would empower users to explore mental health concerns safely and reflectively in their own language. It would also accommodate cultural, economic, and social contexts while providing structured guidance and multiple reading levels to ensure broad accessibility and international applicability.