Mental Health High-5 Survey

Please take a moment to answer this brief questionnaire. The purpose of these questions are to generate discussions and awareness around mental health, and also to potentially inform focus areas for future mental health awareness activities. Your responses to this questionnaire are confidential and will be kept private. If you choose to enter your name and number for a weekly prize, and you win, you will be contacted directly.

Question Title

* 1. How important is the topic of mental health for you?

Extremely important

Very important

Somewhat important

Not so important

Not at all important

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* 2. Please type 1-5 activities you do to promote your wellness.

Activity 1

Activity 2

Activity 3

Activity 4

Activity 5

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* 3. Do you feel prepared to handle a mental health crisis?

Yes - Please indicate what has contributed to your readiness?

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* 4. How strongly do you agree or disagree with these statements?

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
I know resources in my community that promote mental health	I know resources in my community that promote mental health Strongly Disagree	I know resources in my community that promote mental health Disagree	I know resources in my community that promote mental health Neutral	I know resources in my community that promote mental health Agree	I know resources in my community that promote mental health Strongly Agree
I feel comfortable talking about mental health	I feel comfortable talking about mental health Strongly Disagree	I feel comfortable talking about mental health Disagree	I feel comfortable talking about mental health Neutral	I feel comfortable talking about mental health Agree	I feel comfortable talking about mental health Strongly Agree
You don't have to be an expert to help someone who is having difficulties with mental health	You don't have to be an expert to help someone who is having difficulties with mental health Strongly Disagree	You don't have to be an expert to help someone who is having difficulties with mental health Disagree	You don't have to be an expert to help someone who is having difficulties with mental health Neutral	You don't have to be an expert to help someone who is having difficulties with mental health Agree	You don't have to be an expert to help someone who is having difficulties with mental health Strongly Agree
The opposite of mental health is mental illness	The opposite of mental health is mental illness Strongly Disagree	The opposite of mental health is mental illness Disagree	The opposite of mental health is mental illness Neutral	The opposite of mental health is mental illness Agree	The opposite of mental health is mental illness Strongly Agree
Stigma around mental health issues keeps people from seeking help	Stigma around mental health issues keeps people from seeking help Strongly Disagree	Stigma around mental health issues keeps people from seeking help Disagree	Stigma around mental health issues keeps people from seeking help Neutral	Stigma around mental health issues keeps people from seeking help Agree	Stigma around mental health issues keeps people from seeking help Strongly Agree

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* 5. In a given week, how often do you:

	Not at all	Rarely	Sometimes	Most days	Everyday
experience stress or challenges	experience stress or challenges Not at all	experience stress or challenges Rarely	experience stress or challenges Sometimes	experience stress or challenges Most days	experience stress or challenges Everyday
actively participate in self-care	actively participate in self-care Not at all	actively participate in self-care Rarely	actively participate in self-care Sometimes	actively participate in self-care Most days	actively participate in self-care Everyday

Mental Health High-5

Brief Questionnaire

Question Title

* 1. How important is the topic of mental health for you?

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* 2. Please type 1-5 activities you do to promote your wellness.

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* 3. Do you feel prepared to handle a mental health crisis?

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* 4. How strongly do you agree or disagree with these statements?

Question Title

* 5. In a given week, how often do you:

Question Title

* 6. If you would like to be entered in a drawing for a prize, please enter your email address.