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Mount Olive Lutheran Church Fostering & Strengthening Healthy Faith Community Assessment Survey

Mental Health Assessment Survey – May 2021

Thank you for participating in our survey. Your feedback is important.

This assessment tool is designed to inform us about the mental health and substance use issues that face our local congregations.

The information you provide will be completely confidential and will help us determine the training needs of our community and measure the value of the training(s) received. We appreciate your time.

Please answer every question to the best of your ability.
1.Position of Person Completing Survey (if you belong to more than one, select the most discernible role)(Required.)
The following definitions apply to the survey as a whole:
  • Substance Use Disorders (i.e. dependence upon meth, marijuana, cocaine, heroin, etc.)
  • Anxiety Disorders (i.e. phobia, obsessive-compulsive disorder, generalized anxiety disorder, etc.)
  • Abuse Issues (physical or emotional)
  • Post-Traumatic Stress (a mental health condition that is triggered by a terrifying event — either experiencing it or witnessing it)
  • Severe Personality Disorders (a type of mental disorder in which one has a rigid and unhealthy pattern of thinking, functioning, and behaving)
  • Bipolar Disorders (a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks) or Schizophrenia (chronic and severe mental disorder that affects how a person thinks, feels, and behaves; people with schizophrenia may seem like they have lost touch with reality)
  • Behavior Problems of Children (child’s behavior or emotional difficulties lasting for more than a few weeks and are the cause of problems at school, at home, or with friends)
  • Gender Identity (an individual's personal sense of having a particular gender, which may correlate or differ from the individual's assigned sex)
  • Mental health advocate (an individual who shares their stories and help those who are struggling and take risks and show their vulnerability by telling their truth in hopes of encouraging someone else)
  • Professional counselors help clients identify goals and potential solutions to problems that cause emotional turmoil; seek to improve communication and coping skills; strengthen self-esteem; and promote behavior change and optimal mental health)
2.In your own words, can you define Mental Health? If yes, please write in the box below.
3.Is your understanding of Mental Health influenced by your spiritual or religious background?
4.What do you believe about Mental Health?
5.How comfortable are you with discussing the topic of Mental Health in your communal place of worship?
6.Do you feel like the people in your Faith community are safe to talk to if you were to be in some type of distress?
7.Are you satisfied with how Mental Health is addressed within your spiritual or religious community? 
8.The culture in my family and/or community growing up allowed for open dialogue about Mental Health issues.
9.Outside of calling 911, are you aware of the Mental Health Resources in your immediate community that could aid you or someone you know who might be having a Mental Health crisis?
The following questions are designed to help understand the perceived importance of certain issues in the lives of yourself, your family and your congregation.
10.Is the following issue present in your own life, in the life of your family or in the life of your congregation?(Required.)
Never
Rarely
Sometimes
Often
Alcoholism/Excessive Drinking
Drug Use/Substance Use
Anxiety
Post-Trauma or Abuse
Severe Personality Problems
Depression
Severe Mental Illness (ex. bipolar disorder, schizophrenia, etc.)
Children's Behavior Problems
Runaway or Homeless Youth
Military Veterans with Mental Health Issues
Distinguishing Sin or Willful Behavior from Mental Health Challenges
Uncertainty on how to support families with Mental Health Challenges
Not being sure when/where to refer someone for treatment
Unavailability of Housing
11.Are you or your family dealing with any of the following challenging life events?(Required.)
No
Yes
Family/Friend in a Nursing Home or Assisted Living
Family/Friend with Dementia or Alzheimer's
Chronic or Severe Physical Health Problem
Chronic or Severe Mental Health Problem
Food Insecurity
Loss of Job
Financial Distress
12.What is your degree of comfort and confidence in engaging with people in the following scenarios?(Required.)
None (don't want to get involved)
Low (want to; unsure how)
Medium (I think I might be able)
High (confident)
Responding if someone approaches you and asks you for money?
Responding if you see somebody sleeping nearby as you are walking down the street?
Approaching someone close to you pushing a shopping cart with personal belongings while in a parking lot?
Helping someone you hear loudly talking to themselves near a street corner?
Showing hospitality to someone who is homeless and walks into your business or church service?
Talking to someone whose breath smells of alcohol?
Assisting an adult or child who tells you they are being abused by a relative?
Explaining mental illness to a neighbor that tells you that mental illness is caused by demon possession?
Assisting a person (i.e. co- worker, relative, neighbor, classmate, etc.) who tells you they are thinking about suicide?
Helping a family member who seems to be sleeping a lot more lately and does not want to leave the house?
Providing support for a family dealing with Mental Health challenges or Substance Use?
Providing a referral for a member of your congregation to get counseling or therapy?
Assisting a member of your extended family who is evicted and needs a place to stay for a short time?
Interacting respectfully with someone you suspect is high on drugs?
The following are Pathways to Promise training programs and descriptions for your reference:

All Training Programs can be offered Virtually.
All 101 Training Programs can be offered via Zoom or Pre-Recorded.

  • Companionship Workshop - An engaging 4-hour workshop teaching a relational, community-based model supportive of healing and recovery. Communities learn how to be an active listener when people present their experiences with mental health challenges and share their first-hand accounts. The virtual workshop can be taught via Zoom in one 4-hour session, over two 2-hour sessions, or over three 1.5-hour sessions.

  • Mental Health 101 - A brief 1-2 hour introduction to mental health and mental illness.
  • Mental Health First Aid (Adult) - A thorough 8-hour training over one day that teaches you how to identify, understand and respond to signs of mental illnesses and substance use disorders in adults. Offered in English and Spanish.
  • Mental Health First Aid (Youth) - A thorough 8-hour training over one day that teaches you how to identify, understand and respond to signs of mental illnesses and substance use disorders in youth. Offered in English and Spanish.
  • Children's Mental Health 101 - A brief 1-2 hour introduction to children's mental health and mental illness.
  • Education for families coping with Mental Health challenges - One-Time or Ongoing Training Options on a variety of relevant topics. Some resources offered in Spanish.
  • Substance Use Disorder 101 - A brief 1-2 hour introduction to substance use and dependence.
  • Setting up a Mental Health and Substance Use Disorder Ministry - One-Time or Ongoing Virtual Training Options to discuss the logistics, process, challenges, and models in developing a congregational mental health or substance use disorder ministry. Some resources offered in Spanish.
  • Becoming a Trauma-Informed Congregation - A One-Time or Ongoing Virtual Training that teaching congregation members the widespread impact of trauma, how to recognize the signs and symptoms of trauma, how to integrate this new knowledge of trauma, and ways to avoid the re-traumatization of individuals. Some resources offered in Spanish.
13.If you would like to learn more about mental health let us know by completing the information below.(Required.)
14.Do you have any other comments, questions, or concerns?