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Mental health has emotional, behavioral, perceptual and cognitive components. When a child is seriously challenged in some or all of these areas, and/or has stress from a previous or ongoing trauma, research conducted in Maine* shows that members of the child’s immediate and extended family can be adversely impacted. A caregiver may have his/her own mental health challenges and/or stress from past or present trauma. As time passes, families increasingly tap their coping skills to get them through the day. Some families are better equipped to cope than others.

Below we are going to ask you questions regarding your physical and behavioral health. Behavioral health refers to a person’s overall mental health.

This survey asks families to identify the immediate and long-term effects of caregiver strain, as well as what would reduce the strain and improve health and wellbeing.

*Thrive Initiative Special Report: Quality Data Report, Spring 2009
Which of the following below describes your personal definition/situation as a "caregiver." Check all that apply.

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* 1. Which of the following below describes your personal definition/situation as a "caregiver." Check all that apply.

Did you have behavioral health challenge of your own before parenting your child with a behavioral health challenge?

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* 2. Did you have behavioral health challenge of your own before parenting your child with a behavioral health challenge?

If you answered yes to question #2 are those emotional challenges:

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* 3. If you answered yes to question #2 are those emotional challenges:

Did you have physical challenges before parenting your child with a behavioral health challenge?

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* 4. Did you have physical challenges before parenting your child with a behavioral health challenge?

If you answered yes to questions #4 are your physical challenges now:

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* 5. If you answered yes to questions #4 are your physical challenges now:

Has parenting a child with behavioral health challenge caused you to stop working?

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* 6. Has parenting a child with behavioral health challenge caused you to stop working?

Has parenting a child with a behavioral health challenge prevented you from gaining employment?

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* 7. Has parenting a child with a behavioral health challenge prevented you from gaining employment?

Has parenting a child with a behavioral health challenge caused you to reduce the number of hours you work?

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* 8. Has parenting a child with a behavioral health challenge caused you to reduce the number of hours you work?

Do you generally feel happy?

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* 9. Do you generally feel happy?

Do you have good extended family support now?

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* 10. Do you have good extended family support now?

Did you have good extended family support when your child was first diagnosed?

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* 11. Did you have good extended family support when your child was first diagnosed?

Do you have time for yourself?

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* 12. Do you have time for yourself?

If you do not have time for yourself what would you need to get time for yourself?

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* 13. If you do not have time for yourself what would you need to get time for yourself?

Before parenting your child with a behavioral health challenge did you have priorities for your life?

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* 14. Before parenting your child with a behavioral health challenge did you have priorities for your life?

Have those priorities changed since parenting your child with a behavioral health challenge?

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* 15. Have those priorities changed since parenting your child with a behavioral health challenge?

Have you experienced extremely stressful situations in obtaining or receiving services for your child? Rate your experience in receiving services for your child.

Check all answers that apply:

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* 16. Have you experienced extremely stressful situations in obtaining or receiving services for your child? Rate your experience in receiving services for your child.

Check all answers that apply:

Do you have a greater appreciation for life since parenting your child with behavioral health challenges?

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* 17. Do you have a greater appreciation for life since parenting your child with behavioral health challenges?

Do you have a clear understanding and awareness about your child's disability? Do you believe the behavioral health system has helped you gain a better understanding?

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* 18. Do you have a clear understanding and awareness about your child's disability? Do you believe the behavioral health system has helped you gain a better understanding?

Do you have a newly discovered interest in advocacy to improve the lives of children with behavioral health challenges in your journey of caring for a child with behavioral health issues?

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* 19. Do you have a newly discovered interest in advocacy to improve the lives of children with behavioral health challenges in your journey of caring for a child with behavioral health issues?

Are you worried about your financial portfolio for the current time?

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* 20. Are you worried about your financial portfolio for the current time?

What services would be helpful to you as a caregiver?

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* 21. What services would be helpful to you as a caregiver?

What other services not mentioned above would be helpful to you as a caregiver?

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* 22. What other services not mentioned above would be helpful to you as a caregiver?

What are the barriers to receiving the services mentioned above?

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* 23. What are the barriers to receiving the services mentioned above?

Additional comments or suggestions.

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* 24. Additional comments or suggestions.

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