The Act-Belong-Commit

Self-Assessment Tool

Well done on taking the first step to boosting your mental wellbeing by completing this interactive Act-Belong-Commit Self-Assessment Tool.

It should take less than 10 minutes to complete and at the end you will have the option to print or email your scores to yourself.

Please note, this tool is not designed to evaluate your mental health - it’s simply designed to help you rate your involvement in mentally healthy activities.

We hope it inspires you to Act, Belong and Commit to improve your mental health and wellbeing.

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Some Basic Details

Before you begin, please fill in a few basic details below. These details will be kept strictly confidential within Act-Belong-Commit. Providing these details will give us more accurate statistics to help improve our programs and internal focus.




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Your Overall Wellbeing

This set of questions measures your current state of overall wellbeing. Answer the questions in the order that they appear. You can then work out your overall wellbeing score and see what it means.

Below are some statements about your feelings and thoughts over the last two weeks. For each one, please indicate how often you have felt that way over the last 2 weeks.

Over the last 2 weeks...

Q1. I've been feeling optimistic about the future

Q2. I've been feeling useful

Q3. I've been feeling relaxed

Q4. I've been feeling interested in other people

Q5. I've had energy to spare

Q6. I've been dealing with problems well

Q7. I've been thinking clearly

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Your Overall Wellbeing Continued

This set of questions measures your current state of overall wellbeing. Answer the questions in the order that they appear. You can then work out your overall wellbeing score and see what it means.

Below are some statements about your feelings and thoughts over the last two weeks. For each one, please indicate how often you have felt that way over the last 2 weeks.

Over the last 2 weeks...

Q8. I've been feeling good about myself

Q9. I've been feeling closer to other people

Q10. I've been feeling confident

Q11. I've been able to make up my own mind about things

Q12. I've been feeling loved

Q13. I've been interested in new things

Q14. I've been feeling cheerful

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Act

Answer the following questions and find out how active you are.

Physical Activity

Q1. Apart from your job and household tasks, how often do you do something physically active (e.g. walking, gardening, dancing, golfing)?

Mental Activity

Q2. Apart from your job, how often do you do something requiring thinking and concentration (e.g. read, paint, learn something, do a crossword puzzle, play video games)?

Social Activity

Q3. Apart from your job and members of your household, how often do you have contact with other people where you stop for a chat, talk on the phone or chat online?

Spiritual Activity

Q4. How often do you engage in spiritual activities like attending a service, meeting with others for a spiritual purpose, meditating, reflecting on the meaning of life or the natural world?

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Belong

Now answer the following questions to find out how much you belong.

Friends and family

Q1.How often do you get together with a group of friends, workmates or family for outings, meals or special events?

Local Community

Q2. How often do you attend community events (e.g. music festivals, theatre, markets, local sporting events, school fairs, residents' meetings, local government events, local business groups, local 'clean up' events)?

Specific Interest Groups

Q3a. Do you belong to any formal or informal specific interest groups, clubs or organisations, (e.g. sports club, car club, book club, fitness group, dance class, theatre group, social club, cooking group, card group, hobby group, cultural or ethnic group)?

Large Public Events

Q4. How often do you attend large public events such as major sporting fixtures, major musical events, or any events where there are very large crowds?

At Work

Q5. If you are in paid employment, how much do you feel part of a close knit team?

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Commit

Answer the following questions to find out how much you 'commit'.

Personal challenges and goals

Q1a. Are you doing anything challenging at the moment (e.g. learning a language, building a gazebo, enrolled in a course, training for a fun run or competitive sport, learning a new skill like music or painting, etc)

Challenges at Work

Q2. If you are employed, is your work challenging and involve learning new things or is it fairly easy?

Group Roles

Q3. Do you hold any committee or office roles in any groups? For example, are you the treasurer, a committee member, organiser, president, vice-president, secretary, and so on in any group?

Activism

Q4a. Are you actively involved with an activist or cause-related group seeking additional resources, legislative or policy change? (For example, for disadvantaged groups, environmental preservation, etc.?)

Volunteering

Q5a. Are you a volunteer for any charitable organisations, community groups, health or social welfare organisations, or other non-government organisations? (Including, for example, coaching a sporting team, mentoring a colleague, volunteering for Red Cross, meals on wheels, etc.?)

General Helping Others

Q6. Apart from any formal volunteering work, how often do you do something to help someone? (For example, help a neighbour, cook a meal or clean for a sick friend, help students with projects?)

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