· Thank you for completing this survey for the Kahanui Wellbeing project, on behalf of the Mental Health and Addiction Services (MHAS) Te Whatu Ora South Canterbury, we value your feedback.
· We are seeking feedback on all mental health and addiction services and input across South Canterbury. The information you provide is at your discretion and any identifying factors will be de-identified or made anonymous when identifying themes.
· Any identifying factors will be removed unless it is required to help identify situations for discussion or following up eg where there is a safety or harm risk identified.
· Electronic Information obtained as part of the project will be stored with login and password access by the Project Facilitator for the duration of the project.
· Any written documentation will be housed in the Kensington Centre secure clinical notes storeroom.  Information will be shared within the project team discussion and summarised non-identifiable versions of the information will be emailed to the project team. It will also be shared with any future focus group participants and contributing individuals, please let us know if you wish to receive it. It may also be used to summarise and profile the project teams work locally and potentially nationally.
·The final questions are to help us understand who is participating in our survey, they won't identify you in any way.  
· If you have any questions or want to discuss anything, please email the project team on MHAS.feedback@scdhb.health.nz
 
 
· Kahanui Wellbeing Project is not a complaints process, if you wish to make a formal complaint there is a process for this. Te Whatu Ora South Canterbury willingly receives and investigates all complaints. You can make a complaint by:
- Discussing your concerns with any staff member,
- Asking to complete a complaint form (we can give you one), or ask a staff member to complete it for you,
- You can email a complaint to feedback@scdhb.health.nz.
-  If you need help making your complaint or want to speak to someone outside of Te Whatu Ora South Canterbury, you can do so by:
- Contacting the nationwide Health and Disability Advocacy Service, phone the local advocate on 03 687 2291, or the national call centre on toll free 0800 555 050,
- Calling the office of the Health and Disability Commissioner on 0800 11 22 33.
 

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* 1. Was it easy for you to access the Mental Health and Addictions Service support you/your whānau/family needed?

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* 2. Did you feel whakamana/able/empowered to make decisions in your own choice of care?

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* 3. Did you feel supported to develop (or build) your own ability to live well?

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* 4. What has worked well for you / your whānau / family?

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* 5. What did not work well for you / your whānau / family?

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* 6. What are the important things you want to share regarding your experience?

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* 7. What would have made your experience better?

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* 8. Your cultural needs are important to us. How did we support or how could we have supported you?

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* 9. During your experience, was the information you received easy to understand?

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* 10. If you have more information, how would you like to share this with us?

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* 11. Are you agreeable for us to make contact with you in regard to your feedback?

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* 12. If you are completing this survey in relation to someone else or on behalf of someone else, please advise of their age, ethnicity & gender

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* 13. Are you?

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* 14. How old are you? 

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* 15. What gender do you identify with?

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* 16. What ethnicity do you most identify with?

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* 17. Do you live Rural? (Rural area, Remote or outlying South Canterbury small town)

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