Republic of the Philippines
RITO MONTE DE RAMOS SR. MEMORIAL NAHAONG NATIONAL HIGH SCHOOL
Nahaong, Libagon, Southern Leyte
Title: Student’s Mental Health Issues: A Matter of Academic Concern
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Dear Respondents,
You have been selected as a respondent for this study. In this regard, I am respectfully
requesting for your participation in the said study. Answering all the questions honestly and carefully
will aid me in analyzing the data accurately. Rest assured that all of the data gathered from the study
will be treated with respect and confidentiality.
Thank you very much.
-The Researcher
__________________________________________________________________________________
(Choose only the learners’ profile that are relevant to your study)
NAME: (optional)_______________________________________________
AGE: ______________ SEX: [ ] Male [ ] Female
GRADE LEVEL: __________
Directions: Please fill in the following questionnaire on the basis of the facts of your company by
checking [✓] the appropriate boxes. Please answer the questionnaire honestly.
1. Have you ever experienced any mental health problems in Academics?
Yes [ ] No [ ]
2. On a scale of 1 to 10, how would you rate your overall mental health?
Yes [ ] No [ ]
3. Have you observed signs of mental health issues in your friends or classmates?
Yes [ ] No [ ]
4. Do you think most of the students are aware of Mental Health Issues?
Yes [ ] No [ ]
5. Do you think that mental health could be acquired in school environment?
Yes [ ] No [ ]
6. Have you noticed an acquaintance having a mental breakdown?
Yes [ ] No [ ]
7. Have you encountered someone who has mental issues?
Yes [ ] No [ ]
8. In school environment, does mental health really matters?
Yes [ ] No [ ]
9. Do you feel like having a breakdown?
Yes [ ] No [ ]
10. Have you ever had a mental breakdown due to Academic Stress?
Yes [ ] No [ ]