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2009 Veteran and Family "Learning Your Needs" Survey
1. MACC Veteran and Family "Learning Your Needs" Survey
33%
1
. I am a
I am a
Veteran
Family Member of Veteran
2
. Military Branch (yours or your family member's)
Military Branch (yours or your family member's)
US Army or Reserve
US Navy or Reserve
US Air Force or Reserve
US National Guard (Army or Air Force)
US Marines or Reserve
US Coast Guard or Reserve
3
. I (or my family member) is currently
I (or my family member) is currently
Active Duty
Reservist/National Guard
Retired or Honorably Discharged
Discharged (Dishonorable)
4
. Marital Status
Marital Status
Married
Single
Divorced
Widow
5
. Number of children (e.g. 1, 2, 3)
Number of children (e.g. 1, 2, 3)
6
. Please specify which conflict(s) you or your family member were involved in.
Please specify which conflict(s) you or your family member were involved in.
World War II
Korean War
Vietnam War
Invasion of Grenada
Invasion of Panama
Gulf War
Somali Civil War
Bosnian War
Kosovo War
War in Afghanistan
Iraq War
7
. Your age
Your age
Under 18
18-24
25-34
35-44
45-54
55-64
65-74
75-84
85-Over
8
. Gender
Gender
Male
Female
Transgender
Other (please specify)
9
. What race/ethnicity do you identify with the most
What race/ethnicity do you identify with the most
American Indian or Alaskan Native
Black or African American
Asian
Hispanic or Latino (All races)
Whites
More than one race
Other (please specify)
10
. Where do you live?
Where do you live?
Urban
Suburban
Rural
Other (please specify)
11
. Zip Code
Zip Code
12
. What types of mental health services have you or your family member received (at any point in your life)?
(check all that apply)
What types of mental health services have you or your family member received (at any point in your life)? (check all that apply)
None
Individual therapy
Group therapy
Social support group
Marital Therapy
Hospitalization (Both inpatient or outpatient)
Professional services for addiction
Medication (e.g. Prozac)
AA/NA/OA/Addiction self-help group
Nutritional counseling (dietary changes to improve mental health)
Other (please specify)
13
. If you have behavioral health issues, which category(ies) would best describes you or your family member's diagnosis (either self-classified or based on a professional diagnosis)? (check all that apply)
If you have behavioral health issues, which category(ies) would best describes you or your family member's diagnosis (either self-classified or based on a professional diagnosis)? (check all that apply)
Not applicable
Gender Identify Disorder
Depression (i.e. soldier Melancholy)
Anxiety
Adjustment Disorder
Sleep Disorder
Post Traumatic Stress Disorder
Psychotic Disorder/Schizophrenia
Bipolar/Manic depression
Substance Abuse
Other (please specify)
14
. Where do you go to receive behavioral health services?
(Check all the apply)
Where do you go to receive behavioral health services? (Check all the apply)
Veteran's Administration or Military Mental Health Services
Community Based Mental Health Center (i.e. locally run health systems, Public or Private Hospital, etc.)
Private Therapist
Veteran's Center
EAP (Employee Assistance Program) Resources
Other (please specify)
15
. Please rate your level of personal knowledge about the behavioral health care benefits available to you as a veteran or a family member of a veteran?
Please rate your level of personal knowledge about the behavioral health care benefits available to you as a veteran or a family member of a veteran?
Well Informed
Somewhat Informed
Not Informed at All
N/A
16
. Based on your experiences and/or those of fellow veterans and family members, how well do behavioral health providers meet the needs of veterans through their service delivery? (If both family and vet has received services, rate overall experience of both. Explain below, where necessary.)
Based on your experiences and/or those of fellow veterans and family members, how well do behavioral health providers meet the needs of veterans through their service delivery? (If both family and vet has received services, rate overall experience of both. Explain below, where necessary.)
Excellent
Good
Fair
Poor
Don't Know
Comment
17
. What "techniques" have you used to maintain or improve your behavioral health?
What "techniques" have you used to maintain or improve your behavioral health?
Therapy
Prescribed Medication
Journaling
Alternative/Spiritual remedies(New Age)
Self-Medication
Exercise
Herbal supplements
Prayer/Meditation
Vitamins or supplements
Diet
Substance Abuse (Alcohol or Drugs)
Other (please specify)
18
. Do you have health insurance that covers behavioral health services?
Do you have health insurance that covers behavioral health services?
Yes, my health insurance covers mental health services
No, my health insurance excludes mental health services
I don't know
I don't have insurance
Other (please specify)
19
. Type of Insurance
Type of Insurance
Medicare
Tri-Care
Tri-Care for Life
Private Insurance
VA Insurance
Medicaid
Other (please specify)
20
. If your insurance does cover behavioral health services, are there restrictions about where you can go to receive care?
If your insurance does cover behavioral health services, are there restrictions about where you can go to receive care?
Yes
No
Not Applicable
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