Health New Zealand Te Whatu Ora Shared Care FHIR API
0.4.3 - release

Health New Zealand Te Whatu Ora Shared Care FHIR API - Local Development build (v0.4.3) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Questionnaire: Mental Health Assessment Survey

Official URL: https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/MentalHealthAssessmentSurveyQuestionnaire | Version: 0.4.3
Draft as of 2025-11-25 | Computable Name: MentalHealthAssessmentSurveyQuestionnaire
Other Identifiers: MentalHealthAssessmentSurveyQuestionnaire (use: official, period: 8/16/23 --> (ongoing)), Questionnaire-MentalHealthAssessmentSurveyQuestionnaire (use: temp, period: 3/7/23 --> 7/26/23)

Te Whatu Ora Mental Health Assessment Survey

Structure

LinkID | Text | Cardinality | Type | Description & Constraints
--- | --- | --- | --- | ---
MentalHealthAssessmentSurveyQuestionnaire | Te Whatu Ora Mental Health Assessment Survey |  | Questionnaire | https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/MentalHealthAssessmentSurveyQuestionnaire#0.4.3
p01 | page 1. History and Examination | 0..1 | group |
p01-q01-IssueDescription | page 1 question 1. Description of presenting issue | 1..1 | text |
p01-q02-Mood | page 1 question 2. Assessment of Mood | 1..1 | text |
p01-q03-SleepHygine | page 1 question 3. Assessment of sleep hygiene | 1..1 | text |
p01-q04-SupportStructure | page 1 question 4. Assessment of whanau and support structures | 1..1 | text |
p01-q05-Trauma | page 1 question 5. Is there a history of previous trauma and stressors? | 1..1 | boolean |
p01-q05-1-Trauma.Description | page 1 question 5.1. Please provide information surrounding this history. | 1..1 | text | Enable When: p01-q05-Trauma =
p01-q06-SuicideAttemptHistory | page 1 question 6. Have there been any previous suicide attempts? | 1..1 | boolean |
p01-q06-1-SuicideAttemptHistory.Description | page 1 question 6.1. Please provide details surrounding these attempts | 1..1 | text | Enable When: p01-q06-SuicideAttemptHistory =
p01-q07-CigaretteSmoker | page 1 question 7. Is the patient smoking cigarettes? | 1..1 | boolean |
p01-q01-1-CigaretteSmoker.HowMany | page 1 question 7.1. How many cigarettes per day? | 1..1 | choice | Enable When: p01-q07-CigaretteSmoker = Options: 2 options
p01-q08-CurrentDrinker | page 1 question 8. Does the patient consume alcohol? | 1..1 | boolean |
p01-q08-1-CurrentDrinker.HowMany | page 1 question 8.1. How many drinks per week? | 1..1 | choice | Enable When: p01-q08-CurrentDrinker = Options: 3 options
p01-q09-RecreationalDrugs | page 1 question 9. Does the patient use recreational drugs? | 1..1 | boolean |
p01-q10-PsychiatricMedication | page 1 question 10. Psychiatric Medication? | 0..1 | text |
p02 | page 2. Risk Assessment | 0..1 | group |
p02-q01-SuicidalIntent | page 2 question 1. Suicidal Intent? | 1..1 | boolean |
p02-q02-HarmfulThoughts | page 2 question 2. Threat to others? | 1..1 | boolean |
p03 | page 3. Current and past psychiatric diagnosis | 0..1 | group |
p03-g01-AddDiagnosis | page 3 group 1. Add Diagnosis | 0..* | group |
p03-g01-q01-AddDiagnosis.Diagnosis | page 3 group 1 question 1. Diagnosis | 1..1 | text |
p03-g01-q02-AddDiagnosis.Year | page 3 group 1 question 2. Year of Diagnosis | 1..1 | date |
p03-g01-q03-AddDiagnosis.Place | page 3 group 1 question 3. Place of Diagnosis | 1..1 | string |
p03-g01-q04-AddDiagnosis.Hospitalisation | page 3 group 1 question 4. Hospitalisation? | 1..1 | boolean |
p03-g01-q05-AddDiagnosis.Active | page 3 group 1 question 5. Active? | 1..1 | boolean |
p04 | page 4. General Practice Information | 0..1 | group |
p04-q01-SendNote | page 4 question 1. Send note to GP Inbox? | 1..1 | boolean | Initial Value: boolean = false
p04-q02-PracticeName | page 4 question 2. GP Practice Name | 0..1 | string |
p04-q03-PracticeEDI | page 4 question 3. Practice EDI | 0..1 | string |
Documentation for this format

Options Sets

Answer options for p01-q01-1-CigaretteSmoker.HowMany

- null#Less than 10 ("Less than 10")
- null#10 or more ("10 or more")

Answer options for p01-q08-1-CurrentDrinker.HowMany

- null#Less than 10 ("Less than 10")
- null#10 to 16 ("10 to 16")
- null#More than 16 ("More than 16")