Southeast Minnesota Mental Health Crisis Services Needs Assessment Survey

Introduction & Informed Consent
We are gathering community input to understand if there is a need for urgent mental health crisis services in Southeast Minnesota. Your participation is voluntary and anonymous. You may skip any question. Your feedback will help inform potential crisis services and programs for the community. The survey will take approximately 10 minutes to complete. Thank you for your input.

What is a mental health crisis?
A mental health crisis occurs when thoughts, feelings, or behaviors become overwhelming and immediate support is needed. Examples include:
● Feeling unable to cope or function
● Thoughts of suicide or self-harm
● Severe anxiety, panic, or emotional distress
● Feeling disconnected from reality or extremely confused
● Behavior that puts oneself or others at risk
● Being unable to manage basic daily needs

SECTION A: ABOUT YOU

1.Which best describes your connection to mental health crisis services? (Select all that apply)(Required.)

Person with lived experience of a mental health crisis

Family member, friend, or loved one of someone who has experienced a mental health crisis

Primary care/medical/healthcare provider

School staff

Mental health or substance use treatment provider

First responder/law enforcement/EMT

County health and human services, public health or non-profit

Other (please specify)

SECTION B: EXPERIENCES WITH MENTAL HEALTH CRISIS

6.In the past 5 years, has anyone close to you experienced a mental health crisis? (Select all that apply)(Required.)

I have experienced a crisis myself.

An adult family member, friend, or colleague has experienced a crisis.

My child has experienced a crisis

An adult client/patient/student, etc. that I worked with in my professional role has experienced a crisis.

A minor (under 18 years) client/patient/student, etc. that I worked with in my professional role has experienced a crisis.

None of the above