Mental Health Provider Experience Survey

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1. Which of the following best describes your role in providing treatment?

Which of the following best describes your role in providing treatment? Director

Psychiatrist

Psychologist

Licensed Professional Clinical Counselor

Marriage and Family Therapist

Clinical Nurse Specialist/Nurse Practitioner

Mental Health Practitioner

Other (please specify)

2. When working with patients who have a mental illness do you:

	Always	Almost Always	Sometimes	Infrequently	Almost Never	Never
Communicate that treatment can lead to recovery?	*When working with patients who have a mental illness do you: Communicate that treatment can lead to recovery? Always	Communicate that treatment can lead to recovery? Almost Always	Communicate that treatment can lead to recovery? Sometimes	Communicate that treatment can lead to recovery? Infrequently	Communicate that treatment can lead to recovery? Almost Never	Communicate that treatment can lead to recovery? Never
Display posters of successful people who live/lived with mental illnesses?	Display posters of successful people who live/lived with mental illnesses? Always	Display posters of successful people who live/lived with mental illnesses? Almost Always	Display posters of successful people who live/lived with mental illnesses? Sometimes	Display posters of successful people who live/lived with mental illnesses? Infrequently	Display posters of successful people who live/lived with mental illnesses? Almost Never	Display posters of successful people who live/lived with mental illnesses? Never
Have educational material on mental illnesses readily available?	Have educational material on mental illnesses readily available? Always	Have educational material on mental illnesses readily available? Almost Always	Have educational material on mental illnesses readily available? Sometimes	Have educational material on mental illnesses readily available? Infrequently	Have educational material on mental illnesses readily available? Almost Never	Have educational material on mental illnesses readily available? Never
Treat patients with respect and empathy?	Treat patients with respect and empathy? Always	Treat patients with respect and empathy? Almost Always	Treat patients with respect and empathy? Sometimes	Treat patients with respect and empathy? Infrequently	Treat patients with respect and empathy? Almost Never	Treat patients with respect and empathy? Never
Encourage patients to involve family and friends in their recovery?	Encourage patients to involve family and friends in their recovery? Always	Encourage patients to involve family and friends in their recovery? Almost Always	Encourage patients to involve family and friends in their recovery? Sometimes	Encourage patients to involve family and friends in their recovery? Infrequently	Encourage patients to involve family and friends in their recovery? Almost Never	Encourage patients to involve family and friends in their recovery? Never
Connect patients with support groups and resources in the community?	Connect patients with support groups and resources in the community? Always	Connect patients with support groups and resources in the community? Almost Always	Connect patients with support groups and resources in the community? Sometimes	Connect patients with support groups and resources in the community? Infrequently	Connect patients with support groups and resources in the community? Almost Never	Connect patients with support groups and resources in the community? Never
Discuss options for follow-up treatment?	Discuss options for follow-up treatment? Always	Discuss options for follow-up treatment? Almost Always	Discuss options for follow-up treatment? Sometimes	Discuss options for follow-up treatment? Infrequently	Discuss options for follow-up treatment? Almost Never	Discuss options for follow-up treatment? Never
Explain medications that are given and the possible side effects?	Explain medications that are given and the possible side effects? Always	Explain medications that are given and the possible side effects? Almost Always	Explain medications that are given and the possible side effects? Sometimes	Explain medications that are given and the possible side effects? Infrequently	Explain medications that are given and the possible side effects? Almost Never	Explain medications that are given and the possible side effects? Never
Treat them as you would a patient with any other illness or injury?	Treat them as you would a patient with any other illness or injury? Always	Treat them as you would a patient with any other illness or injury? Almost Always	Treat them as you would a patient with any other illness or injury? Sometimes	Treat them as you would a patient with any other illness or injury? Infrequently	Treat them as you would a patient with any other illness or injury? Almost Never	Treat them as you would a patient with any other illness or injury? Never
Encourage them to sign a privacy release to keep their family informed and involved?	Encourage them to sign a privacy release to keep their family informed and involved? Always	Encourage them to sign a privacy release to keep their family informed and involved? Almost Always	Encourage them to sign a privacy release to keep their family informed and involved? Sometimes	Encourage them to sign a privacy release to keep their family informed and involved? Infrequently	Encourage them to sign a privacy release to keep their family informed and involved? Almost Never	Encourage them to sign a privacy release to keep their family informed and involved? Never

Comments please

3. When talking with the family members and friends of a patient do you:

	Always	Almost Always	Sometimes	Infrequently	Almost Never	Never
Provide education on mental illnesses and treatments?	*When talking with the family members and friends of a patient do you: Provide education on mental illnesses and treatments? Always	Provide education on mental illnesses and treatments? Almost Always	Provide education on mental illnesses and treatments? Sometimes	Provide education on mental illnesses and treatments? Infrequently	Provide education on mental illnesses and treatments? Almost Never	Provide education on mental illnesses and treatments? Never
Have a supply of educational material readily available in the waiting room?	Have a supply of educational material readily available in the waiting room? Always	Have a supply of educational material readily available in the waiting room? Almost Always	Have a supply of educational material readily available in the waiting room? Sometimes	Have a supply of educational material readily available in the waiting room? Infrequently	Have a supply of educational material readily available in the waiting room? Almost Never	Have a supply of educational material readily available in the waiting room? Never
Connect families with support groups and resources in the community?	Connect families with support groups and resources in the community? Always	Connect families with support groups and resources in the community? Almost Always	Connect families with support groups and resources in the community? Sometimes	Connect families with support groups and resources in the community? Infrequently	Connect families with support groups and resources in the community? Almost Never	Connect families with support groups and resources in the community? Never
Instill in them hope for the recovery of their loved one?	Instill in them hope for the recovery of their loved one? Always	Instill in them hope for the recovery of their loved one? Almost Always	Instill in them hope for the recovery of their loved one? Sometimes	Instill in them hope for the recovery of their loved one? Infrequently	Instill in them hope for the recovery of their loved one? Almost Never	Instill in them hope for the recovery of their loved one? Never
If permission has been given, do you ask family members for input into the planning of treatment for their loved one?	If permission has been given, do you ask family members for input into the planning of treatment for their loved one? Always	If permission has been given, do you ask family members for input into the planning of treatment for their loved one? Almost Always	If permission has been given, do you ask family members for input into the planning of treatment for their loved one? Sometimes	If permission has been given, do you ask family members for input into the planning of treatment for their loved one? Infrequently	If permission has been given, do you ask family members for input into the planning of treatment for their loved one? Almost Never	If permission has been given, do you ask family members for input into the planning of treatment for their loved one? Never
Treat all family members with respect and empathy?	Treat all family members with respect and empathy? Always	Treat all family members with respect and empathy? Almost Always	Treat all family members with respect and empathy? Sometimes	Treat all family members with respect and empathy? Infrequently	Treat all family members with respect and empathy? Almost Never	Treat all family members with respect and empathy? Never
Encourage them to send cards and flowers as they would if their loved one had any other illness or injury?	Encourage them to send cards and flowers as they would if their loved one had any other illness or injury? Always	Encourage them to send cards and flowers as they would if their loved one had any other illness or injury? Almost Always	Encourage them to send cards and flowers as they would if their loved one had any other illness or injury? Sometimes	Encourage them to send cards and flowers as they would if their loved one had any other illness or injury? Infrequently	Encourage them to send cards and flowers as they would if their loved one had any other illness or injury? Almost Never	Encourage them to send cards and flowers as they would if their loved one had any other illness or injury? Never
Educate families on how to keep their loved one safe (removal of guns, large amounts of medications, etc.)	Educate families on how to keep their loved one safe (removal of guns, large amounts of medications, etc.) Always	Educate families on how to keep their loved one safe (removal of guns, large amounts of medications, etc.) Almost Always	Educate families on how to keep their loved one safe (removal of guns, large amounts of medications, etc.) Sometimes	Educate families on how to keep their loved one safe (removal of guns, large amounts of medications, etc.) Infrequently	Educate families on how to keep their loved one safe (removal of guns, large amounts of medications, etc.) Almost Never	Educate families on how to keep their loved one safe (removal of guns, large amounts of medications, etc.) Never

Comments please

4. Do you have suggestions on what individuals and their family members can do to improve their experiences working with providers?

Do you have suggestions on what individuals and their family members can do to improve their experiences working with providers?

5. What are the barriers you experience when involving friends and family?

What are the barriers you experience when involving friends and family?

Mental Health Provider Experience
Exit this survey

1. Mental Health Provider survey

*
1. Which of the following best describes your role in providing treatment?

2. When working with patients who have a mental illness do you:

3. When talking with the family members and friends of a patient do you:

4. Do you have suggestions on what individuals and their family members can do to improve their experiences working with providers?

5. What are the barriers you experience when involving friends and family?

Mental Health Provider ExperienceExit this survey

1. Mental Health Provider survey

*1. Which of the following best describes your role in providing treatment?

2. When working with patients who have a mental illness do you:

3. When talking with the family members and friends of a patient do you:

4. Do you have suggestions on what individuals and their family members can do to improve their experiences working with providers?

5. What are the barriers you experience when involving friends and family?

Mental Health Provider Experience
Exit this survey

*
1. Which of the following best describes your role in providing treatment?