GHQ-28 Mental Health Screening Questionnaire

1. The Origins and Applications of the Mental Health Screening Tool

The General Health Questionnaire (GHQ) was developed by the British psychologist Goldberg in 1972, and GHQ-28, released in 1978 as its extended version, contains 28 items and is a widely used multidimensional mental health screening tool worldwide. Based on GHQ-12, this scale refines the assessment dimensions, evaluating an individual's mental health over recent weeks from four core dimensions: somatic symptoms, anxiety/insomnia, social dysfunction, and severe depression. It is widely used in clinical, community, and epidemiological investigations and has become a classic tool for the multidimensional assessment of mental health risk.

After decades of validation and promotion, GHQ-28 has been translated into 38 languages and shows good reliability and validity across different cultural backgrounds around the world. Compared with GHQ-12, GHQ-28 provides a more detailed assessment of mental health status: it not only identifies the overall level of mental health risk, but also locates specific dimensions of mental health problems, providing a more precise reference for subsequent mental health intervention and assessment.

2. The Core Purposes of Mental Health Screening

The core purpose of the GHQ-28 Mental Health Screening Questionnaire is to provide a comprehensive and precise reference for mental health assessment. Specifically, it:

• Comprehensively assesses an individual's mental health over recent weeks and overall health level from four dimensions
• Precisely screens for non-psychotic mental health problems (physical discomfort, anxiety, depression, impaired social functioning, etc.)
• Locates the specific dimension of a mental health problem, providing a reference for targeted mental health intervention
• Assesses the mental health of the general population and identifies high-risk individuals who need further professional assessment
• Serves as a tool for epidemiological investigation and follow-up assessment of group mental health status

3. Who Mental Health Screening Is For

This mental health screening scale is suitable for the following people who need a comprehensive assessment of their mental health:

• General individuals aged 16 and above with basic reading comprehension who want to understand their own mental health
• Patients in primary health care who need a comprehensive mental health screening
• Clients in clinical psychological assessment who need a multidimensional assessment of their mental health
• Screening subjects in in-depth employee/student mental health surveys conducted by companies, schools, and other organizations
• Comprehensive screening and assessment in community mental health services

Note: This scale is only for mental health screening. It is not suitable for assessing psychotic symptoms (such as hallucinations or delusions) and cannot replace a psychiatrist's professional diagnosis. For people with severe cognitive impairment or confusion, or those unable to complete a self-report, it is not recommended as a basis for mental health assessment.

4. Structure and Scoring of the Mental Health Screening Scale

The GHQ-28 Mental Health Screening Questionnaire contains 28 items divided into four core subscales, covering the key dimensions of mental health assessment:

• Subscale 1 (items 1-7): somatic symptoms (health perception, bodily weakness, headache, alternating feelings of hot and cold, etc.) - reflecting mental health signals at the physical level
• Subscale 2 (items 8-14): anxiety/insomnia (worry-related insomnia, sleep disturbance, stress, irritability, fear, tension, etc.) - reflecting mental health at the emotional level
• Subscale 3 (items 15-21): social dysfunction (work state, efficiency, self-efficacy, decision-making ability, enjoyment of life, etc.) - reflecting mental health at the level of social functioning
• Subscale 4 (items 22-28): severe depression (worthlessness, hopelessness, meaninglessness of life, suicidal ideation, etc.) - reflecting severe mental health risk

The scoring method is: a 4-point scale (0 = not at all, 1 = same as usual, 2 = somewhat more than usual, 3 = much more than usual), with all items scored positively. Add the scores of the 28 items to get the total mental health screening score (0-84 points), and you can also calculate the score of each subscale (0-21 points per dimension). The higher the total score, the higher the mental health risk; a score above 4 suggests seeking a professional mental health assessment, and each subscale score can reflect the degree of mental health problems in a specific dimension.

5. Limitations of the Mental Health Screening Tool

Although it is a classic multidimensional mental health screening tool, GHQ-28 still has some limitations:

• Screening, not diagnosis: used only for initial screening of mental health problems and cannot serve as a basis for diagnosing any mental disorder
• Time limitation: reflects only mental health over recent weeks and cannot assess long-term psychological traits
• Cultural differences: the expression and understanding of mental health symptoms differ across cultures, which may affect screening results
• Self-report bias: screening results depend on the respondent's subjective report and may be affected by factors such as mood and a tendency to conceal
• Lack of causal analysis: assesses only the symptoms of mental health problems and cannot analyze their root causes

6. Clinical and Practical Value of Mental Health Screening

As a multidimensional mental health screening tool, GHQ-28 can comprehensively assess an individual's mental health while precisely locating the specific dimensions of mental health problems, making it an important aid in primary health care and clinical psychological assessment. Its standardized scoring and multidimensional assessment system not only help individuals fully understand their own mental health status, but also provide professionals with a more detailed assessment reference, making it an important means of mental health screening, assessment, and intervention.