Mental Health Crisis Toolkit Evaluation Survey

Question Title

* 4. What is your relationship to your child (Please choose response)?

Mother

Father

Other (please specify)

Question Title

* 5. How old is your child?

Question Title

* 6. Please specify the location or organization where your child received crisis services

Question Title

* 7. Date your child visited the emergency department

Question Title

* 8. What is your child’s birth sex?

Male

Female

Question Title

* 9. What is your child’s gender identity? OPTIONAL

Female

Male

Transgender (Male)

Transgender (Female)

Non-binary

Other (please specify)

Question Title

* 10. What is your child’s ethnicity?

White/Not of Hispanic Origin

African American/Black

Indigenous American

Hispanic/Latino

Asian American/Pacific Islander

Other or Multiracial

Prefer not to respond

Other (please specify)

Question Title

* 11. Is this your first experience with a child in crisis?

Yes

Question Title

* 12. Did the Toolkit help you know what to expect while your child was in the hospital or receiving crisis intervention services?

Yes

Question Title

* 13. Did the Toolkit help you better understand and navigate the process of being in the hospital?

Yes

Question Title

* 14. Did the Toolkit help reduce your stress level with regards to coping with the experience of your child being in the hospital?

Yes

Question Title

* 15. Did the Toolkit provide tips and help you feel more comfortable discussing your child’s circumstances with his/her family, friends, others, and school?

Yes

Question Title

* 16. Did the Toolkit help you feel more comfortable talking to your child’s treatment team and knowing appropriate questions to ask?

Yes

Question Title

* 17. Do you have a better understanding of treatment options (e.g., psychotherapy, medications, outpatient programs) for suicide prevention provided in the Toolkit?

Yes

Question Title

* 18. Did you find the resources (e.g., websites, helplines, Apps) provided in the Toolkit helpful?

Yes

Question Title

* 19. Do you believe the information included in the Toolkit is important to know if your child is brought to the hospital again for an emergency mental health assessment?

Yes

Question Title

* 20. Would you recommend this Toolkit to other parents who are experiencing similar circumstances with their child?

Yes

Question Title

* 21. Was there any information that you wished would have been included in the Toolkit, but wasn’t?

Yes (please elaborate)

Mental Health Crisis Toolkit Evaluation

Question Title

* 1. First Name

Question Title

* 2. Last Name (Optional)

Question Title

* 3. Email Address

Question Title

* 4. What is your relationship to your child (Please choose response)?

Question Title

* 5. How old is your child?

Question Title

* 6. Please specify the location or organization where your child received crisis services

Question Title

* 7. Date your child visited the emergency department

Question Title

* 8. What is your child’s birth sex?

Question Title

* 9. What is your child’s gender identity? OPTIONAL

Question Title

* 10. What is your child’s ethnicity?

Question Title

* 11. Is this your first experience with a child in crisis?

Question Title

* 12. Did the Toolkit help you know what to expect while your child was in the hospital or receiving crisis intervention services?

Question Title

* 13. Did the Toolkit help you better understand and navigate the process of being in the hospital?

Question Title

* 14. Did the Toolkit help reduce your stress level with regards to coping with the experience of your child being in the hospital?

Question Title

* 15. Did the Toolkit provide tips and help you feel more comfortable discussing your child’s circumstances with his/her family, friends, others, and school?

Question Title

* 16. Did the Toolkit help you feel more comfortable talking to your child’s treatment team and knowing appropriate questions to ask?

Question Title

* 17. Do you have a better understanding of treatment options (e.g., psychotherapy, medications, outpatient programs) for suicide prevention provided in the Toolkit?

Question Title

* 18. Did you find the resources (e.g., websites, helplines, Apps) provided in the Toolkit helpful?

Question Title

* 19. Do you believe the information included in the Toolkit is important to know if your child is brought to the hospital again for an emergency mental health assessment?

Question Title

* 20. Would you recommend this Toolkit to other parents who are experiencing similar circumstances with their child?

Question Title

* 21. Was there any information that you wished would have been included in the Toolkit, but wasn’t?