Substance Use Disorder Services Questionnaire for the Parents of Youth (Somerset County Residents Only)Somerset County Comprehensive Planning Survey

Thank you for taking the time to complete this very important questionnaire to address the substance use disorder needs of Somerset County. This questionnaire will take less than 5 minutes to complete. Below you will find questions regarding your experience with substance use disorder services in Somerset County. We need your feedback in order to better serve our youth community. Your answers are anonymous; however if you would like to share your experience or provide additional information you may contact the Somerset County Alcoholism and Drug Abuse Coordinator at (908)704-6309.

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* 1. If your child/adolescent needed substance use disorder services would you know where to go for help?

YES

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* 2. Have you tried to access substance use disorder services for your child/adolescent in Somerset County?

YES (Please ANSWER Question 3)

NO (Please SKIP Question 3, ANSWER Question 4)

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* 3. Was your child/adolescent needs for substance use disorder services met in Somerset County?

YES (Please SKIP Questions 4 AND 5, ANSWER Question 6)

NO (Please SKIP Question 4, ANSWER Questions 5 AND 6)

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* 4. Please indicate the reason you have not tried to access substance use disorder services (check all that apply):

My child/adolescent has not needed substance use services

I do not want others to know my child/adolescent needs substance use services

System of care is too overwhelming or confusing

Accessing services is too overwhelming or confusing

Limited support from family/friends to seek help

My child/adolescent did not meet criteria for treatment services

My insurance was not accepted

Type of service needed not available

Location of services

Language barrier

No transportation to services

High Copay

Program hours

High deductible

Other (please specify)

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* 5. Please indicate the reason your child/adolescent needs were not met (check all that apply):

Insurance not accepted

Location of treatment services

No transportation to services

Did not meet criteria for treatment services

System of care is too overwhelming or confusing

Limited support from family/friends to seek help

My child/adolescent also has a disability (i.e. developmental; physical)

High Copay

Language barriers

Program Hours

High deductible

Other (please specify)

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* 6. How did your child/adolescent get connected to substance use services (check all that apply)?

Self-referred

Insurance carrier

PerformCare

Primary Medical Care Physician

School/College Personnel

Family Member/Friend

Psychiatric Hospital

NJ Division of Child Protection and Permanency (DCP&P)

Family Crisis Intervention Unit (FCIU)

Care Management Organization (CMO)

Family Support Organization (FSO)

Psychiatric Emergency Screening Services (PESS-Bridgeway)

Local Police Department

Local Hospital (Emergency Department)

Detox/Rehab Provider

Opioid Overdose Recovery Program (OORP)

Mobile Response Stabilization Services (MRSS)

Outpatient Provider

Juvenile Justice System

Other (please specify)

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* 7. Which substance(s) were you seeking services for your child/adolescent (check all that apply)?

Alcohol

Marijuana

Heroin

Cocaine/Crack

Prescription Drugs

Other Illicit Drugs

Other (please specify)

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* 8. Did you have to wait for your child/adolescent to receive substance use services?

YES (Please ANSWER Questions 9 AND 10)

NO (Please SKIP Question 9, ANSWER Question 10)

Other (please specify)

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* 9. If yes, how long?

1-2 days

3-5 days

1 week

2-3 weeks

1 month

Over 1 month

More than 2 months

More than 3 months

Other (please specify)

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* 10. Were the substance use services you were looking for your child/adolescent available within Somerset County?

YES (Please SKIP Question 11, ANSWER Question 12)

NO (Please ANSWER Questions 11 AND 12)

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* 11. If no what service(s) were you looking for (check all that apply)?

Assessment/Evaluation

Detoxification

Transitional/Halfway House

Rehabilitation

Residential

In-home services

Outpatient Services (OP)

Sober-Living Housing

Intensive Outpatient (IOP)

Partial Hospitalization (PHP)

Psychiatrist

Other (please specify)

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* 12. Were the services your child/adolescent received in Somerset County helpful?

YES

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* 13. What area(s) for your child/adolescent substance use disorder services need improvement (check all that apply)?

Outpatient

Transportation

Case Management

Detoxification

Rehabilitation

Psychiatrist

Residential

Intensive Outpatient (IOP)

Partial Hospitalization (PHP)

Recovery Support Services

Other (please specify)

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* 14. Which recovery support service(s) was your child/adolescent connected to by a professional (check all that apply)?

None

Transportation

Relapse Prevention

Family Counseling

Coping/Life Skills

Case Management

Sponsor/Ala-teen/AA/NA

Sober Living Housing

Job Training

Mentoring Program

Community Center

Other (please specify)

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* 15. What is your child's/adolescent's GENDER?

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* 16. What is your child's/adolescent's AGE?

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* 17. What is your child's/adolescent's RACE?

Other (please specify)

Substance Use Disorder Services Questionnaire for the Parents of Youth (Somerset County Residents Only)
Somerset County Comprehensive Planning

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* 1. If your child/adolescent needed substance use disorder services would you know where to go for help?

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* 2. Have you tried to access substance use disorder services for your child/adolescent in Somerset County?

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* 3. Was your child/adolescent needs for substance use disorder services met in Somerset County?

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* 4. Please indicate the reason you have not tried to access substance use disorder services (check all that apply):

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* 5. Please indicate the reason your child/adolescent needs were not met (check all that apply):

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* 6. How did your child/adolescent get connected to substance use services (check all that apply)?

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* 7. Which substance(s) were you seeking services for your child/adolescent (check all that apply)?

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* 8. Did you have to wait for your child/adolescent to receive substance use services?

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* 9. If yes, how long?

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* 10. Were the substance use services you were looking for your child/adolescent available within Somerset County?

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* 11. If no what service(s) were you looking for (check all that apply)?

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* 12. Were the services your child/adolescent received in Somerset County helpful?

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* 13. What area(s) for your child/adolescent substance use disorder services need improvement (check all that apply)?

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* 14. Which recovery support service(s) was your child/adolescent connected to by a professional (check all that apply)?

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* 15. What is your child's/adolescent's GENDER?

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* 16. What is your child's/adolescent's AGE?

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* 17. What is your child's/adolescent's RACE?

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* 18. What municipality does your child/adolescent live in?

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* 19. Please share any additional comments to help us better understand your experience:

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* 1. If your child/adolescent needed substance use disorder services would you know where to go for help?

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* 2. Have you tried to access substance use disorder services for your child/adolescent in Somerset County?

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* 3. Was your child/adolescent needs for substance use disorder services met in Somerset County?

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* 4. Please indicate the reason you have not tried to access substance use disorder services (check all that apply):

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* 5. Please indicate the reason your child/adolescent needs were not met (check all that apply):

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* 6. How did your child/adolescent get connected to substance use services (check all that apply)?

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* 7. Which substance(s) were you seeking services for your child/adolescent (check all that apply)?﻿

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* 8. Did you have to wait for your child/adolescent to receive substance use services?

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* 9. If yes, how long?

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* 10. Were the substance use services you were looking for your child/adolescent available within Somerset County?

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* 11. If no what service(s) were you looking for (check all that apply)?

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* 12. Were the services your child/adolescent received in Somerset County helpful?

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* 13. What area(s) for your child/adolescent substance use disorder services need improvement (check all that apply)?

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* 14. Which recovery support service(s) was your child/adolescent connected to by a professional (check all that apply)?

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* 15. What is your child's/adolescent's GENDER?

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* 16. What is your child's/adolescent's AGE?

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* 17. What is your child's/adolescent's RACE?

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* 18. What municipality does your child/adolescent live in?

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* 19. Please share any additional comments to help us better understand your experience:

* 7. Which substance(s) were you seeking services for your child/adolescent (check all that apply)?