Close
Assessments
Store
Free Stuff
Newsletter
Webinars
Featured Content
About
Meet the Team
About Impact
Sign Up For Free!
Sign In
Mental Health Provider Survey
4%
4%
Please enter your zip code below.
*
1. Over the past 12 months, which of these best applies to your organization?
*
Served or worked with youth (younger than 18 years of age)
Served or worked with adults (18+)
Served both age groups
2. Which of these most closely matches your role?
*
Principal
Teacher
Counselor/therapist
School nurse
Psychiatrist/physician
Psychologist
Administrator
Social worker
Other
If "Other," please describe.
Physical Health
3. In the past 12 months, how do you feel the youth in your community have changed in getting adequate exercise or physical activity?
*
Greatly improved
Somewhat improved
About the same
Somewhat declined
Greatly declined
Not sure, no opinion
4. In the past 12 months, how do you feel the adults in your community have changed in getting adequate exercise or physical activity?
*
Greatly improved
Somewhat improved
About the same
Somewhat declined
Greatly declined
Not sure, no opinion
5. In the past 12 months, how do you feel the youth in your community have changed in getting adequate sleep?
*
Greatly improved
Somewhat improved
About the same
Somewhat declined
Greatly declined
Not sure, no opinion
6. In the past 12 months, how do you feel the adults in your community have changed in getting adequate sleep?
*
Greatly improved
Somewhat improved
About the same
Somewhat declined
Greatly declined
Not sure, no opinion
7. In the past 12 months, how do you feel the number of youth experiencing physical abuse has changed?
*
Greatly increased
Somewhat increased
About the same
Somewhat decreased
Greatly decreased
Not sure, no opinion
8. In the past 12 months, how do you feel the number of adults experiencing domestic violence has changed?
*
Greatly increased
Somewhat increased
About the same
Somewhat decreased
Greatly decreased
Not sure, no opinion
9. In the past 12 months, how do you feel the number of youth experiencing sexual abuse has changed?
*
Greatly increased
Somewhat increased
About the same
Somewhat decreased
Greatly decreased
Not sure, no opinion
10. In the past 12 months, how do you feel the number of adults experiencing sexual violence has changed?
*
Greatly increased
Somewhat increased
About the same
Somewhat decreased
Greatly decreased
Not sure, no opinion
Mental/Behavioral Health
11. During the past 12 months, did your organization provide any mental/behavioral health services or support to youth?
*
Yes
No
Not sure
12. During the past 12 months, did your organization provide any mental/behavioral health services or support to adults?
*
Yes
No
Not sure
13. In the past 12 months, how do you feel the youth in your community have changed in overall mental/behavioral health?
*
Somewhat improved
About the same
Somewhat declined
Greatly declined
Not sure, no opinion
14. In the past 12 months, how do you feel the adults in your community have changed in overall mental/behavioral health?
*
Somewhat improved
About the same
Somewhat declined
Greatly declined
Not sure, no opinion
15. In the past 12 months, how do you feel the youth in your community have changed in experiencing positive emotions?
*
Somewhat improved
About the same
Somewhat declined
Greatly declined
Not sure, no opinion
16. In the past 12 months, how do you feel the adults in your community have changed in experiencing positive emotions?
*
Somewhat improved
About the same
Somewhat declined
Greatly declined
Not sure, no opinion
17. In the past 12 months, how do you feel the youth in your community have changed in coping with stress in a healthy way?
*
Somewhat improved
About the same
Somewhat declined
Greatly declined
Not sure, no opinion
18. In the past 12 months, how do you feel the adults in your community have changed in coping with stress in a healthy way?
*
Somewhat improved
About the same
Somewhat declined
Greatly declined
Not sure, no opinion
19. In the past 12 months, how do you feel the youth in your community have changed in being optimistic about their future?
*
Somewhat improved
About the same
Somewhat declined
Greatly declined
Not sure, no opinion
20. In the past 12 months, how do you feel the adults in your community have changed in being optimistic about their future?
*
Somewhat improved
About the same
Somewhat declined
Greatly declined
Not sure, no opinion
21. In the past 12 months, how do you feel the number of youth experiencing harassment or bullying has changed (including electronically by phone, text, or social media)?
*
Greatly increased
Somewhat increased
About the same
Somewhat decreased
Greatly decreased
Not sure, no opinion
22. In the past 12 months, how do you feel the number of adults experiencing harassment or bullying has changed (including electronically by phone, text, or social media)?
*
Greatly increased
Somewhat increased
About the same
Somewhat decreased
Greatly decreased
Not sure, no opinion
23. In the past 12 months, how do you feel the number of youth experiencing psychological abuse has changed?
*
Greatly increased
Somewhat increased
About the same
Somewhat decreased
Greatly decreased
Not sure, no opinion
24. In the past 12 months, how do you feel the number of adults experiencing psychological abuse has changed?
*
Greatly increased
Somewhat increased
About the same
Somewhat decreased
Greatly decreased
Not sure, no opinion
25. In the past 12 months, how do you feel the number of youth experiencing self-harm or suicidal thoughts has changed?
*
Greatly increased
Somewhat increased
About the same
Somewhat decreased
Greatly decreased
Not sure, no opinion
26. In the past 12 months, how do you feel the number of adults experiencing self-harm or suicidal thoughts has changed?
*
Greatly increased
Somewhat increased
About the same
Somewhat decreased
Greatly decreased
Not sure, no opinion
27. In the past 12 months, how do you feel the number of youth using substances has changed (nicotine, alcohol, marijuana, or other drugs not prescribed to them)?
*
Greatly increased
Somewhat increased
About the same
Somewhat decreased
Greatly decreased
Not sure, no opinion
28. In the past 12 months, how do you feel the number of adults using substances has changed (nicotine, alcohol, marijuana, or other drugs not prescribed to them)?
*
Greatly increased
Somewhat increased
About the same
Somewhat decreased
Greatly decreased
Not sure, no opinion
29. Do you feel there is adequate support in your community for youth experiencing mental/behavioral health challenges?
*
Yes
No
Not sure, no opinion
30. Do you feel there is adequate support in your community for adults experiencing mental/behavioral health challenges?
*
Yes
No
Not sure, no opinion
Social Health
31. In the past 12 months, how do you feel the youth in your community have changed in getting enough face-to-face social interaction with peers?
*
Greatly improved
Somewhat improved
About the same
Somewhat declined
Greatly declined
Not sure, no opinion
32. In the past 12 months, how do you feel the adults in your community have changed in getting enough face-to-face social interaction with peers?
*
Greatly improved
Somewhat improved
About the same
Somewhat declined
Greatly declined
Not sure, no opinion
33. In the past 12 months, how do you feel the youth in your community have changed in getting enough face-to-face social interaction with caring adults?
*
Greatly improved
Somewhat improved
About the same
Somewhat declined
Greatly declined
Not sure, no opinion
34. In the past 12 months, how do you feel the youth in your community have changed in having a healthy social life?
*
Somewhat improved
About the same
Somewhat declined
Greatly declined
Not sure, no opinion
35. In the past 12 months, how do you feel the adults in your community have changed in having a healthy social life?
*
Somewhat improved
About the same
Somewhat declined
Greatly declined
Not sure, no opinion
36. In the past 12 months, how do you feel the youth in your community have changed in healthy use of electronic devices and/or social media?
*
Greatly increased
Somewhat increased
About the same
Somewhat decreased
Greatly decreased
Not sure, no opinion
37. In the past 12 months, how do you feel the adults in your community have changed in healthy use of electronic devices and/or social media?
*
Greatly increased
Somewhat increaased
About the same
Somewhat decreased
Greatly decreased
Not sure, no opinion
Healthcare Workforce
38. In the past 12 months, demand for mental/behavioral health services from our organization has:
*
Greatly increased
Somewhat increased
Stayed about the same
Somewhat decreased
Greatly decreased
Not sure, no opinion
39. In the past 12 months, wait times to receive mental/behavioral health services from our organization has:
*
Greatly increased
Somewhat increased
Stayed about the same
Somewhat decreased
Greatly decreased
Not sure, no opinion
40. What is the average wait period for clients to receive mental/behavioral healthcare services from your organization (excluding emergency room visits)?
*
Less than 1 week
Less than 1 month
1-3 months
4-6 months
More than 6 months
Open-Ended Questions
41. What are the top challenges currently facing your organization as it relates to providing mental/behavioral health services, including any barriers to accessing care?
*
42. Please identify some potential solutions to the challenges you listed above.
*
43. Please list all of the mental health services provided by your organization.
*
44. Please list any positions your organization has had difficulty securing. Also include an estimate of how long a typical search takes.
*
45. In your opinion, what are the root causes of the declining mental health status of youth?
*
46. In your opinion, what are the root causes of the declining mental health status of adults?
*
Powered By
MemberPress WooCommerce Plus Integration
Sign up for our newsletter!
Nullam id dolor id nibh ultricies vehicula ut id elit.
Invalid email address
We promise not to spam you. You can unsubscribe at any time.
Thanks for subscribing!
