Stickney Public Health District Behavioral Health Clinic Community Mental Health Survey
Thank you for completing this survey about the general status of mental health in the Stickney Township community. Many factors can impact on our mental health, so this survey asks a range of questions. There are a total of 15 questions on this survey. The survey is completed anonymously and cannot be traced back to you. It should take 5-10 minutes to complete. You must be 18 years or older to complete this survey. This survey is conducted by the Behavioral Health Clinic of Stickney Public Health District. The results will be shared in the Stickney Township’s Annual Report.
How long have you lived in Stickney Township?
*
0-5 years
6-10 years
11+ years
What is your age?
*
18-29
30-49
50-64
65+
What is you gender/sex?
What is your race/ethnicity?
How would you rate your overall emotional health?
Excellent
Good
Fair
Poor
Do you receive emotional support from friends and family?
Please Select
Yes
No
How often do you engage in activities that promote mental health, such as exercise, meditation, hobbies, or volunteer work?
Often
Occasionally
Never
Do you believe that increasing mental health awareness within the community is important?
Please Select
Yes
No
Do you feel like the neighborhood in which you live is a positive and supportive environment?
Please Select
Yes
No
In the past 12 months, have you experienced any of the following:
Excessive worrying/anxiety
Constant sadness/depression
Suicidal thoughts
Drug/alcohol abuse
Other
In the past 12 months, have you received any of the following services:
Individual counseling/therapy
Couples therapy
Family therapy with your child
Group therapy
Medication for mental health issues
Treatment for alcohol/drug use
Uses a crisis helpline
Did you know that Stickney Township residents can receive mental health services at the Stickney Health District’s Behavioral Health Clinic?
Please Select
Yes
No
If yes, have you ever received services at the Behavioral Health Clinic?
Please Select
Yes
No
If yes, how satisfied were you with the services provided at the Behavioral Health Clinic?
Very satisfied
Satisfied
Not satisfied
Please feel free to share any additional thoughts regarding promoting emotional health and providing services to meet the mental health needs of the Stickney Township Community.
Submit
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