Transforming Crisis Care for Serious Mental Illness: Focusing on Lived Experience

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1. Name (Required.)

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2. Email (Required.)

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3. Phone (optional)

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4. What is your 5-digit zipcode?

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5. What is your racial or ethnic identity? (Select all that apply.)

African-American/Black

East Asian

Hispanic/Latinx

Middle Eastern

American Indian/Alaskan Native

Pacific Islander

South Asian

Southeast Asian

White

Other (please specify)

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6. What is your age?

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 or older

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7. Which of the following applies to you? Select all that apply.

Mental Health Advocate

Someone with lived experience of mental health challenges

Mental Health Care Provider

Undergraduate Student

Graduate Student

Faculty Researcher

Family member of someone who struggles with their mental health

Other (please specify)

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8. How did you first hear about this event?

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9. Do you want to be contacted about future MHRC/NAMI Lansing Events?

Yes

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10. Following the lecture, there will be a panel discussion related to mental health crisis care from experts in this field—including care providers, people with lived experience of a mental health crisis, etc. Are there any questions or topics you would like the panel to address?

Transforming Crisis Care for Serious Mental Illness: Focusing on Lived Experience

Question Title

* 1. Name (Required.)

Question Title

* 2. Email (Required.)

Question Title

* 3. Phone (optional)

Question Title

* 4. What is your 5-digit zipcode?

Question Title

* 5. What is your racial or ethnic identity? (Select all that apply.)

Question Title

* 6. What is your age?

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* 7. Which of the following applies to you? Select all that apply.

Question Title

* 8. How did you first hear about this event?

Question Title

* 9. Do you want to be contacted about future MHRC/NAMI Lansing Events?

Question Title

* 10. Following the lecture, there will be a panel discussion related to mental health crisis care from experts in this field—including care providers, people with lived experience of a mental health crisis, etc. Are there any questions or topics you would like the panel to address?

1. Name (Required.)

2. Email (Required.)

3. Phone (optional)

4. What is your 5-digit zipcode?

5. What is your racial or ethnic identity? (Select all that apply.)

6. What is your age?

7. Which of the following applies to you? Select all that apply.

8. How did you first hear about this event?

9. Do you want to be contacted about future MHRC/NAMI Lansing Events?

10. Following the lecture, there will be a panel discussion related to mental health crisis care from experts in this field—including care providers, people with lived experience of a mental health crisis, etc. Are there any questions or topics you would like the panel to address?