Equity in Mental Health on Campus Initiative Interest Form
Primary Contact Information
Name
*
First Name
Last Name
Email
*
example@example.com
Title
*
School Information
School Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Institution/School Name:
*
School Type:
*
Public 4-year
Private 4-year
Community College
Is your school a Minority Serving Institution? (specify):
Student Population:
*
0 - 499
500-999
1,000 - 1,999
2,000 - 2,999
3,000 - 3,999
5,000 - 9,000
10,000 +
What are the mental health and wellness challenges students of color face on your campus?
*
What are some of your most effective mental health and wellness campus efforts?
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The Equity in Mental Health on Campus initiative recommends that you have a team of campus stakeholders for implementing your strategic plan. Please list the names of 5-8 campus leaders and/or faculty members that would champion this initiative. In selecting the team, we welcome you to consider the composition of members based on campus unit affiliation, roles, and demographics.
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What programs and/or services that are geared towards supporting students of color?
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What are some efforts or plans that your campus has adopted to support the wellbeing of students of color post COVID-19 and the recent race-related social movements?
*
Is your campus a JED Campus?
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Yes
No
Unsure
Has your campus participated in the Healthy Minds Study?
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Yes
No
Unsure
Where did you learn about the Equity in Mental Health Framework?
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Is there anything else you would like to share regarding your campus community and structure that may influence the participation in this initiative?
*
Submit
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