27 (27)    MH REPORT (601.93)

Name Value
REPORT NUMBER 27
INSTRUMENT PAS-EQUIP
RPT
|Enhancing Quality of Care in Psychosis||Date Given: <.Date_Given.>|Clinician: <.Staff_Ordered_By.>|Location: <.Location.>||Veteran: <.Patient_Name_Last_First.>|SSN: <.Patient_SSN.>|DOB: 
your doctor for mental health problems?|    <*Answer_4429*>|26.Do you know the names of your medications that you are prescribed?|    <*Answer_4430*>|27.Here is a list of medications you may be 
prescribed. Check all of the medications that you are currently prescribed.|    <*Answer_4431*>|28.Over the past month, to what extent have you taken the medications prescribed by your doctor for 
mental health problems?|    <*Answer_4432*>|29.What is your height: How many feet?|    <*Answer_4433*>|How many inches:|    <*Answer_4434*>|30.What is your weight in pounds?|    
<*Answer_4435*>|31.Have you been weighing yourself every week at home?|    <*Answer_4436*>|32.Over the past month, have you gained or lost weight or stayed the same?|    <*Answer_4437*>|33.How 
much weight have you gained?|    <*Answer_4438*>|34.How much weight have you lost?|    <*Answer_4439*>|35.Has your doctor recently talked with you about changing to medication that does not cause 
weight gain?|    <*Answer_4440*>|36.Has your doctor recently recommended that you go to wellness or weight loss groups?|    <*Answer_4441*>|37.How many times in the past month did you attend 
wellness or weight loss groups?|    <*Answer_4442*>|39.Have you changed your diet in order to lose weight?|    <*Answer_4443*>|40.Have you increased your physical activity recently in order to lose 
weight?|    <*Answer_4444*>|41.Have you ever had angina, a heart attack, or a stroke?|    <*Answer_4445*>|42.Do you currently have diabetes or hypertension, or are you being treated for diabetes or 
hypertension?|    <*Answer_4455*>|43.Are you currently working in a job for pay?|    <*Answer_4446*>|44.How many weeks have you worked at this job?|    <*Answer_4447*>|45.How many hours a week do 
you usually work?|    <*Answer_4448*>|46.Is this a job that anyone can apply for, or is it only for disabled people?|    <*Answer_4449*>|47.How many dollars did you earn last month?|    
<.Patient_Date_Of_Birth.> (<.Patient_Age.>)|Gender: <.Patient_Gender.>|||1.Managing your day-to-day life?|    <*Answer_4405*>|2.Coping with problems in your life?|    
<*Answer_4450*>|48.Is this the total gross income from the job, or the amount of take-home pay from the job?|    <*Answer_4456*>|49.Would you be interested in working at a paying job if it would 
not affect your benefits too much and you could get the support you need?|    <*Answer_4451*>|50.Has your doctor recently recommended that you go to the VA's work program---called "IPS" or 
"supported employment" ?|    <*Answer_4452*>|51.How many times in the past month did you attend the VA's work program called IPS or supported employment?|    <*Answer_4453*>|52.During the past 
month, how many job interviews have you gone to?|    <*Answer_4454*>| $~
<*Answer_4406*>|3.Concentrating?|    <*Answer_4407*>|4.Get along with people in your family?|    <*Answer_4408*>|5.Get along with people outside your family?|    <*Answer_4409*>|6.Get along well 
in social situations?|    <*Answer_4410*>|7.Feel close to another person?|    <*Answer_4411*>|8.Feel like you had someone to turn to if you needed help?|    <*Answer_4412*>|9.Feel confident in 
yourself?|    <*Answer_4413*>|10.Feel sad or depressed?|    <*Answer_4414*>|11.Think about ending your life?|    <*Answer_4415*>|12.Feel nervous?|    <*Answer_4416*>|13.Have thoughts racing 
through your head?|    <*Answer_4417*>|14.Think you had special powers?|    <*Answer_4418*>|15.Hear voices or see things?|    <*Answer_4419*>|16.Think people were watching you?|    
<*Answer_4420*>|17.Think people were against you?|    <*Answer_4421*>|18.Have mood swings?|    <*Answer_4422*>|19.Feel short-tempered?|    <*Answer_4423*>|20.Think about hurting yourself?|    
<*Answer_4424*>|21.Did you have an urge to drink alcohol or take street drugs?|    <*Answer_4425*>|22.Did anyone talk to you about your drinking or drug use?|    <*Answer_4426*>|23.Did you try to 
hide your drinking or drug use?|    <*Answer_4427*>|24.Did you have problems from your drinking or drug use?|    <*Answer_4428*>|25.Over the past month have you been prescribed any medication by