Resident Survey- CommUNITY Adult Mental Health Initiative (CAMHI) Needs Assessment Survey

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* 1. Which county do you live in?

Benton

Sherburne

Stearns

Wright

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* 2. Of the following programs/areas that CAMHI helps fund, please select all that you are familiar with/have heard of:

Educational Resources (resource guides, promotional materials) and/or Anti-Stigma Workgroup (community outreach, website articles, radio advertisements)

Financial Assistance (flex funds, medical flex, furniture program)

Housing (vouchers and coordination services)

Peer Socialization (peer mentor, Imagine Network, Virtual Peer Support Network)

Trainings/Scholarships

Employment Services (supported employment, job seeking)

Assertive Community Treatment (ACT) teams (non-MA funding)

Crisis Bed (non-MA funding)

Intensive Residential Treatment Services (IRTS) (non-MA funding)

Community Outreach Program (homeless and jail services)

Crisis Line/Mobile Crisis Services

None of the above

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* 3. Which of the funded programs have you used? (Select all that apply)

Educational Resources (resource guides, promotional materials) and/or Anti-Stigma Workgroup (community outreach, website articles, radio advertisements)

Financial Assistance (flex funds, medical flex, furniture program)

Housing (vouchers and coordination services)

Peer Socialization (peer mentor, Imagine Network, Virtual Peer Support Network)

Trainings/Scholarships

Employment Services (supported employment, job seeking)

Assertive Community Treatment (ACT) teams (non-MA funding)

Crisis Bed (non-MA funding)

Intensive Residential Treatment Services (IRTS) (non-MA funding)

Community Outreach Program (homeless and jail services)

Crisis Line/Mobile Crisis Services

None of the above

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* 4. Of the following services/programs, which are the most important to you? Please select up to FIVE (no particular order)

Educational Resources (resource guides, promotional materials) and/or Anti-Stigma Workgroup (community outreach, website articles, radio advertisements)

Financial Assistance (flex funds, medical flex, furniture program)

Housing (vouchers and coordination services)

Peer Socialization (peer mentor, Imagine Network, Virtual Peer Support Network)

Trainings/Scholarships

Employment Services (supported employment, job seeking)

Assertive Community Treatment (ACT) teams (non-MA funding)

Crisis Bed (non-MA funding)

Intensive Residential Treatment Services (IRTS) (non-MA funding)

Community Outreach Program (homeless and jail services)

Crisis Line/Mobile Crisis Services

Please provide any feedback or explanation of your selections below

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* 5. Do you have any ideas for new ideas for services or programs, that are not currently in existence, for our region?

Yes

If yes, please briefly describe your idea

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* 6. If you answered Yes to the question above, may we contact you to discuss your idea?

Yes

Not applicable

If yes, please enter your contact information (name, phone number and email)

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* 7. Are you aware of any existing service or program that is not currently in our four-county region that CAMHI could potentially help fund and bring to our region?

Yes

If yes, please list those service/program ideas below

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* 8. If you answered Yes to the question above, may we contact you to discuss your idea?

Yes

Not applicable

If yes, please enter your contact information (name, phone number and email)

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* 9. Have you signed up via the CAMHI website to get email notices on upcoming events, trainings, and other news from our area?

Yes. THANK YOU for staying connected with CAMHI!

No- Please go to www.mnmentalhealth.org and sign up on the bottom of the homepage with your email where it says Get Connected!