Updated
Original VAYEMA symptom and impact self-check – not a validated scale
Mental health and substance use
Answer the symptom statements below to see which experiences and areas of daily life you report as most affected. These are original VAYEMA questions, not a validated diagnostic scale. No clinical severity or probability score is calculated.
Answers are processed only in this page by this assessment. They are not submitted, monitored or automatically saved. No name, email or account is required. Use a private device and clear your answers when finished.
For adults aged 18 and over. This self-check cannot diagnose or rule out a condition. Concerns about a child require an age-appropriate professional assessment.
Thinking about the past four weeks, how well does each statement describe your experience?
Additional context – not included in any questionnaire score
These are original VAYEMA questions, not a diagnostic instrument or a validated severity scale. They summarise the experiences you select and do not predict a diagnosis or future harm. Background condition information; this source does not endorse this self-check.
Why the assessment considers both concerns together
Mental-health symptoms and substance use can interact in different ways. A clinician needs to understand the pattern rather than assume that one caused everything or that they should be assessed in isolation. The NIMH overview explains the interconnected nature of these difficulties. Appropriate assessment can address present needs while clarifying questions about the longer history.
The term dual diagnosis does not establish a single standard condition. It is commonly used here for mental-health and substance-use disorders occurring together, but the clinician must assess whether each is present. You can request help with symptoms and concerns without first proving two diagnoses. The understanding guide provides background; your own account remains the starting point.
Describe what is happening now before completing a long history
Begin with the changes that prompted you to seek help. These might involve mood, anxiety, sleep, substance use, medication or difficulty managing daily life. Explain any current safety or medical concern directly. A receiving professional can decide what needs immediate attention and what can be explored in a planned appointment. Preparation should not delay that decision.
You do not need a perfectly ordered account. A few concrete examples can be more useful than a long list of diagnostic labels. Mention what is still manageable as well as what has become difficult. This helps the clinician understand functioning and available support without judging the situation solely from appearance, employment or whether you can complete a form.
A timeline can help distinguish overlapping symptoms
The assessor may ask when mental-health symptoms began, when substance use changed and what happened during different periods. Symptoms around intoxication, withdrawal, medication changes or an independent condition can overlap. A timeline helps organise those questions but does not prove a cause. The clinician may need further observation, records or specialist input before the relationship becomes clearer.
Approximate dates and honest uncertainty are acceptable. Do not repeatedly reconstruct every episode or invent details to make the account appear complete. You also should not deliberately stop a substance or medicine to create a cleaner diagnostic picture without appropriate advice. The aim is safe understanding of the history you have, not an experiment undertaken alone before a clinician will see you.
Medical and withdrawal needs require direct assessment
A professional should ask about possible dependence, previous withdrawal complications, recent changes and relevant physical health. These questions can affect urgency and setting. Severe alcohol withdrawal can involve seizures or delirium, as described in UK clinical guidance. No short online worksheet can establish that an unsupported withdrawal or a routine outpatient plan is safe.
Suspected overdose, a seizure, severe confusion, breathing difficulty or another medical emergency requires immediate emergency services. Possible dependence needs appropriate medical advice before abrupt changes. The alcohol withdrawal assessment page is educational preparation, not a clearance tool. Do not wait for a score or a response to a general inquiry when a direct medical response is needed.
Bring medicines and existing treatment into the conversation
The clinician needs to know about prescribed medicines, non-prescribed products, alcohol and other substances, including relevant recent starts, stops or changes. A current list can help. Where you are unsure about a name or amount, say so and discuss how the information can be checked. Accurate uncertainty is safer than guessing or leaving something out because it feels embarrassing.
Physical dependence on a prescribed medicine does not automatically establish a substance-use disorder. The pattern, purpose and consequences need clinical interpretation. Our medicine-dependence guide explains a related distinction. Do not change treatment independently. If several clinicians are involved, identify them so the assessment can clarify responsibilities and avoid contradictory advice or duplicate prescribing.
Ask about mood, anxiety and unusual experiences openly
An assessment may explore depression, anxiety, trauma-related symptoms, high-mood episodes, unusual perceptions or beliefs and current safety. These questions are not a judgement about character. They help the professional consider the full clinical picture and whether a different service or faster response is appropriate. Distress should not be dismissed merely because substances are involved.
In the specific setting of psychosis with substance misuse, NICE recommends comprehensive assessment and collaborative care. That guidance is not a diagnosis of every unusual experience described online. Tell the receiving clinician what is happening, when it occurs and how it affects behaviour or functioning. Severe deterioration or inability to remain safe needs direct urgent support rather than another questionnaire.
Screening is useful only within a wider clinical process
Questionnaires may identify concerns that deserve further assessment or help track selected symptoms. They do not independently establish every diagnosis, its cause or a safe treatment setting. A depression score does not assess the full substance-use history, and a substance-use screen does not replace assessment of mood, psychosis or immediate safety. Several high scores should not simply be combined into a commercial programme recommendation.
SAMHSA describes integrated screening and treatment as part of connected care. The prompts on this page are different: they are original unscored notes, not a validated dual diagnosis or risk instrument. Use them to organise questions rather than diagnose yourself. You can seek help without completing several tools or repeating a test until the result appears convincing.
Daily circumstances, family and privacy matter
Work, housing, transport, caring responsibilities, language and available support can affect what care is workable. Explain these circumstances without feeling that you must solve them all before the appointment. The clinician can identify relevant practical help and distinguish barriers from lack of motivation. These considerations matter, but they should not override a medical recommendation about the necessary level of care.
A trusted person may help with arrangements or contribute agreed observations. Clarify what may be shared and whether you want private time with the clinician. Family support may address relatives’ own needs separately. Paying for treatment does not automatically provide access to another person’s clinical information, and a family account cannot replace appropriate assessment of the individual.
The assessment should explain a connected recommendation
Ask what the working understanding is, what remains uncertain and what the next clinical priority should be. The plan may involve medical stabilisation, condition-specific psychological treatment, substance-use care or referral. Each part should identify a responsible professional, initial format and review point. A broad label is not enough to explain why a particular setting or intensity has been recommended.
The treatment guide explains coordinated care. Case management can support practical communication but does not replace clinical leadership. You should know who reviews medicines, who provides therapy and who responds to changing needs. Where another service is required, ask what happens during the handover rather than being left with an unexplained referral.
Prepare briefly, keep information private and know when not to wait
All prompts are optional. Note the concerns and questions you want to bring, mark uncertainty and stop when preparation is no longer useful. The tool does not transmit entries, create a patient record or notify the clinic. A downloaded file remains under your control and should be stored privately. Share detailed information only through a clinical channel agreed with the relevant professional.
A VAYEMA assessment inquiry can discuss appropriate expertise and planned arrangements. It is not a crisis service, and suitability for outpatient care must be confirmed clinically. Immediate danger, severe withdrawal symptoms, suspected overdose or inability to remain safe requires suitable local urgent care. You can ask for help with an incomplete history; a worksheet should never stand between a person and an appropriate response.
Frequently asked questions about dual diagnosis assessment
Can two online tests confirm dual diagnosis?
No. Screening scores do not independently establish the full diagnoses, their relationship or the appropriate setting. A clinician needs history, current symptoms, substance-use information and relevant medical assessment. The worksheet here is unscored and supports preparation only.
Do I need to stop all substances before an assessment?
Do not make abrupt changes without appropriate advice where dependence may be present. Contact a suitable service and explain the current situation. A clinician can assess immediate needs and plan the safest next step. Urgent symptoms must not wait for a self-directed attempt to prepare.
What if I cannot remember the exact timeline?
Give approximate information and identify what is uncertain. Relevant records or agreed observations may help later. A clinician can begin addressing current concerns without a perfectly reconstructed history. Do not invent details or postpone necessary care while trying to make the account complete.
Does prescribed-medicine withdrawal mean I have a substance-use disorder?
Not automatically. Physical dependence and a substance-use disorder require different clinical considerations. Both can need appropriate care, and neither should be judged from a label alone. Discuss the prescription, pattern and symptoms with the responsible clinician rather than adjust it independently.
Can the assessment recommend a different service?
Yes. The recommendation should match the needs and the receiving service’s actual capabilities. Some people require specialist, medical or hospital support rather than routine outpatient care. Ask why a referral is appropriate and who remains responsible during the transition.
Will entering an urgent concern alert anyone?
No. The worksheet is not monitored and does not send information to VAYEMA. Use an appropriate direct medical or emergency service for urgent concerns. The tool is optional preparation for a planned conversation, not a risk assessment or a request for crisis help.
Resources and references
[1] NIMH: co-occurring substance-use and mental disorders
[2] SAMHSA: integrated screening and treatment for co-occurring disorders
[3] NICE CG120: assessment of psychosis with substance misuse
[4] UK clinical alcohol-treatment guidance: withdrawal and complications