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Mental Health Hospital Emergency Room Care Survey

You are invited to participate in an online survey about patients who recently visited a hospital emergency room in New York City for psychiatric evaluation. National Alliance on Mental Illness of NYC (NAMI NYC) and Manhattan Together want to learn about people’s experiences to help launch an initiative to improve mental health care in emergency rooms.  The survey can be completed by a patient or by a family member or friend who accompanied a patient to a hospital emergency room for psychiatric evaluation. 

The survey should take about 10-15 minutes to answer.

Your participation in this survey is voluntary. You are free not to answer the survey or any particular question you do not wish to answer for any reason.

Participation in the survey has no affect on any services the patient receives.
 
Your survey answers will be sent to a link at SurveyMonkey.com where data will be stored in a password protected electronic format. Survey Monkey does not collect identifying information such as your name, email address, or IP address. Therefore, your responses will remain anonymous. No one will be able to identify you or your answers, and no one will know whether or not you participated in the study.
 
At the end of the survey you will be asked if you are interested in participating in an-in-depth conversation on your experience. If you choose to provide contact information, your survey responses may no longer be anonymous. However, no names or identifying information would be included in any reports or presentations based on these data, and your responses to this survey will remain confidential.

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* 1. ELECTRONIC CONSENT: Please select your choice below. Clicking on the “Agree” button indicates that
  • You have read the above information
  • You voluntarily agree to participate
  • You are 18 years of age or older

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* 2. If you are answering the survey as a patient,

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* 3. Questions for Patients:

Part 1: Background questions

Please select the borough of the hospital you visited most recently:

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* 4. Please select the hospital you visited:

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* 5. About when did you visit the Emergency Room?

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* 6. Was this your first visit to an emergency room for a mental health condition?

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* 7. How did you arrive?

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* 8. Did you go to the emergency Room voluntarily?

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* 9. About what time of day you arrived in the Emergency Room?

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* 10. How long did you wait until someone saw you for the reason for your visit

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* 11. About how much time did you spend in the ER?

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* 12. Were you admitted to the hospital?

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* 13. If not admitted, were you given information or any referral to other care?

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* 14. If yes to #10, was the information or referral helpful?

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* 15. Part II: Experience at the ER

Please answer the following questions based on your experience in the ER while you were being evaluated.

Doctors, nurses and other staff treated me with respect.

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* 16. I was provided a private area while I waited in the ER.

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* 17. Hospital staff allowed a family member or other person of my choice to stay with me in  the ER.

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* 18. Doctors and other hospital staff told me about my privacy rights.

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* 19. To the best of my knowledge, doctors and other hospital staff did not tell anyone any
confidential treatment information without my permission.

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* 20. The doctor, social worker or peer counselor listened to me and gave me emotional support -
or advise.

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* 21. Do you have a “Psychiatric Advanced Directive” (PAD), or other legal document, which is a legal document you wrote while not in crisis, directing your mental health treatment preferences?

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* 22. If yes to question #7, did the hospital follow the PAD?

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* 23. I received the care I needed at the hospital and my overall experience was positive.

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* 24. I would recommend this Emergency Room to others.

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* 25. I felt I was allowed to be involved in making decisions about my care.

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* 26. How can this hospital improve the care of patients in the psychiatric ER?

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* 27. Part III. Follow Up. We are looking to have more detailed conversations about ER experiences and hope to find more people who would like to get involved in working to improve conditions in ERs.

Would you agree to talk with us about this psychiatric ER experience?

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* 28. If yes, please provide information about how to contact you:

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* 29. Which of the following best describes you? (Check all that apply)

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* 30. To which gender identity does the patient most identify?

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* 31. Do you have medical insurance?

0 of 31 answered
 

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