This is a completely anonymous and confidential survey conducted by the Iowa Healthiest State Initiative about knowledge of and attitudes around mental health. Please answer the following questions as honestly as you can. There are no right or wrong answers.

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* 1. The following is a list of factors that may impact a person's overall health and well-being. In general, how much of an impact do you think each of these has?

  No impact Some impact Moderate impact Large impact Very large impact
Relationships
Finances
Community
Sense of meaning and purpose in daily life
Main job or daily activities
Emotional and mental health
Physical health
The following questions will ask about what experience you or those close to you may have had with mental illness. This information will be used to improve programs in your community.

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* 2. Do you have a close friend or family member with mental illness?

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* 3. How comfortable are you talking with someone about their mental illness?

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* 4. Please answer the following questions as though you had a mental illness, whether or not you do. To what extent do you agree or disagree with the following statements.

If I thought I had a mental illness...

  Strongly agree Agree Neutral Disagree Strongly disagree
I would be reluctant to seek help
I would tell my friends
I would see myself as weak 

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* 5. How much do you agree or disagree with the following statements? 

  Strongly agree Agree Neutral Disagree Strongly disagree
People with mental illness do not try hard enough to get better
I am more comfortable helping a person who has a physical illness than I am helping a person who has a mental illness 
People are generally caring and sympathetic to people with mental illness
There are negative impressions, stereotypes or stigma about mental illness in my community 

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* 6. Are you aware of any programs or campaigns in your community that help raise awareness about mental illness? 

0 of 13 answered
 

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