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Grant Precedent

Match / Substance Abuse and Mental Health Services Administration (SAMHSA) / SAMHSA discretionary grants: SUPRT-C client/caregiver form

Measure 5499

On a scale of 0 to 100, if 0 represents no quality of life and 100 is perfect quality of life, how would you rate your quality of life? | | | |

RequiredoutcomeB3

Tier 2: Add one free instrument

Asks for a reported change in knowledge, attitude, behavior or condition.

Instruments for mental health and well-being
  • Rosenberg Self-Esteem Scale Public domain 10 items, about 2-3 min

    License: “freely available; permission not required for use.”

    EN; Chinese. Measures global self-esteem, not mentoring quality or employment readiness.

    Form
  • PHQ-9 Public domain 9, plus unscored functioning question items, about 2-5 min

    License: “public domain.”

    EN form verified; translations not audited. Two-week recall. Item 9 requires an operational response process if administered. The developer instructions permit reproduction, translation, display and distribution without permission.

    Form
  • GAD-7 Public domain 7 core items, about 2-3 min

    License: “public domain.”

    EN verified. Two-week recall; symptom score is not a diagnosis.

    Form
  • PCL-5 (Past Month) Public domain 20 items, about 5-10 min

    License: “This measure was developed by staff at VA's National Center for PTSD and is in the public domain and not copyrighted.”

    Intended for qualified professionals; Spanish unvalidated. Taken from 2A-grok.md under TRIAGE.md (VA public-domain quote, ptsd.va.gov form).

    Form
  • Strengths and Difficulties Questionnaire (SDQ) Free, with conditions 25 core items, about 5-10 min

    License: “Paper copies "without charge by individuals or non-profit organisations," subject to the owner's conditions. Electronic reproduction requires separate authorization; no unauthorized modification.”

    EN; many translations. Select the authorized 25-item, one-sided form. Impact supplements and administrative additions can push the administered packet above 30 items. Embedding it in software is a separate, paid-permission case (see the trap list).

    Form
  • WHO-5 Well-Being Index Free, with conditions 5 items, about 1-2 min

    License: “CC BY-NC-SA 3.0 IGO.”

    EN verified. Attribution, noncommercial use and share-alike conditions apply; adaptations and translations have additional requirements. Use the 2024 rights statement; older descriptions calling it unrestricted public domain are insufficient for the current publication.

    Form
  • DASS-21 Free, with conditions 21 items, about 5-7 min

    License: “downloaded and copied without restriction”

    EN; translations. One-week recall. The owner also prohibits modification and sale for profit. The paid manual does not make the questionnaire license paid. Do not invent a single diagnostic total.

    Form
  • Satisfaction With Life Scale (SWLS) Free, with conditions 5 items, about 1 min

    License: “free to use without permission or charge by researchers”

    EN; extensive translations. The current owner page specifies "non-commercial purposes only" and asks users to credit the authors; keep that wording in your rights metadata.

    Form
  • PHQ-2 Screening only 2 items, about <1 min

    License: “public domain.”

    EN verified. Efficient screening; limited precision for tracking small changes.

    Form
  • PHQ-4 Screening only 4 items, about 1-2 min

    License: “public domain.”

    EN verified. PHQ-2 plus GAD-2; do not count all three as independent instrument families.

    Form
  • GAD-2 Screening only 2 items, about <1 min

    License: “public domain.”

    EN verified. This is an established two-item instrument, not an arbitrary truncation. The form is the PHQ-4: its first two questions are GAD-2.

    Form
  • Kessler K6 Screening only 6 core; optional follow-ups items, about 1-2 min

    License: “free and does not require any formal permission or approval”

    EN; Spanish, Arabic, Chinese and others. The author asks users to retain copyright and citation. Do not mix US 0-24 coding with alternative 6-30 coding.

    Form
  • Kessler K10 Screening only 10 core; optional follow-ups items, about 2-3 min

    License: “free and does not require any formal permission or approval”

    EN; Spanish, Arabic, Mandarin and others. The author asks users to retain copyright and citation. Alternative 10-50 scoring is a different coding convention.

    Form
  • Geriatric Depression Scale, GDS-15 Screening only 15 items, about 5-7 min

    License: “The original scale is in the public domain.”

    EN; numerous translations. The instrument is public domain; the surrounding HIGN teaching sheet has its own publication rights.

    Form
  • Geriatric Depression Scale, GDS-30 Screening only 30 items, about 5-10 min

    License: “The original scale is in the public domain.”

    EN; translations. Exactly at the 30-item ceiling. Cognitive impairment can affect suitability.

    Form
  • PC-PTSD-5 Screening only 5 items, about 1-2 min

    License: “This measure was developed by staff at VA's National Center for PTSD and is in the public domain and not copyrighted.”

    Screen only; follow with the PCL-5. Spanish unvalidated. Taken from 2A-grok.md under TRIAGE.md.

    Form
Instrument
SUPRT-C
Reporting
reassessment
Target
No target rule stated
Source document, 6

Grantee precedent for this measure

No precedent measure is paired with this one. Pairs require equal names or a written alias, and the same agency.