Protocol - Global Mental Status Screener - Older Children and Adolescents

DATE OF CGAS RATING:

(IF RECORDED CLOSE TO TIME OF ‘INDEX’ REFERRAL)

OR FROM MEMORY

(PLEASE INDICATE AS APPROPRIATE)

100-91

DOING VERY WELL

Superior functioning in all areas (at home, at school, and with peers), involved in a range of activities and has many interests (e.g., has hobbies or participates in extracurricular activities or belongs to an organised group such as Scouts, etc.). Likeable, confident, everyday worries never get out of hand. Doing well in school. No symptoms.

90-81

DOING WELL

Good functioning in all areas. Secure in family, school, and with peers. There may be transient difficulties and "everyday" worries that occasionally get out of hand (e.g., mild anxiety associated with an important exam, occasionally "blow-ups" with siblings, parents, or peers).

80-71

DOING ALL RIGHT - minor impairment

No more than slight impairment in functioning at home, at school, or with peers. Some disturbance of behaviour or emotional distress may be present in response to life stresses (e.g., parental separations, deaths, birth of a sibling) but these are brief and interference with functioning is transient; such children are only minimally disturbing to others and are not considered deviant by those who know them.

70-61

SOME PROBLEMS - in one area only

Some difficulty in a single area, but generally functioning pretty well, (e.g., sporadic or isolated antisocial acts such as occasionally playing hooky, petty theft; consistent minor difficulties with school work, mood changes of brief duration, fears and anxieties which do not lead to gross avoidance behavior; self-doubts). Has some meaningful interpersonal relationships. Most people who do not know the child well would not consider him/her deviant but those who do know him/her well might express concern.

60 - 51

SOME NOTICEABLE PROBLEMS - in more than one area

Variable functioning with sporadic difficulties or symptoms in several but not all social areas. Disturbance would be apparent to those who encounter the child in a dysfunctional setting or time but not to those who see the child in other settings.

50 - 41

OBVIOUS PROBLEMS - moderate impairment in most areas or severe in one area

Moderate degree of interference in functioning in most social areas or severe impairment functioning in one area, such as might result from, for example, suicidal preoccupations and ruminations, school refusal and other forms of anxiety, obsessive rituals, major conversion symptoms, frequent anxiety attacks, frequent episodes of aggressive or other antisocial behavior with some preservation of meaningful social relationships.

40 - 31

SERIOUS PROBLEMS - major impairment in several areas and unable to function in one area

Major impairment in functioning in several areas and unable to function in one of these areas, i.e., disturbed at home, at school, with peers or in the society at large, e.g., persistent aggression without clear instigation; markedly withdrawn and isolated behaviour due to either mood or through disturbance, suicidal attempts with clear lethal intent. Such children are likely to require special schooling and/or hospitalisation or withdrawal from school (but this is not a sufficient criterion for inclusion in this category).

30 - 21

SEVERE PROBLEMS - unable to function in almost all situations

Unable to function in almost all areas, e.g., stays at home, in ward, or in bed all day without taking part in social activities OR severe impairment in reality testing OR serious impairment in communication (e.g., sometimes incoherent or inappropriate).

20 - 11

VERY SEVERELY IMPAIRED - considerable supervision is required for safety

Needs considerable supervision to prevent hurting others or self, e.g., frequently violent, repeated suicide attempts, OR to maintain personal hygiene OR gross impairment in all forms of communication, e.g., severe abnormalities in verbal and gestural communication, marked social aloofness, stupor, etc.

10 - 1

EXTREMELY IMPAIRED - constant supervision is required for safety

Needs constant supervision (24-hour care) due to severely aggressive or self-destructive behaviour or gross impairment in reality testing, communication, cognition, affect, or personal hygiene.

Specified time period: 1 month

CGAS SCORE =