Please start by answering a few questions about yourself:

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* 1. Are you Hispanic or Latino? (optional)

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* 2. Race / Ethnicity (voluntary)

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* 3. Gender

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* 4. Age

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* 5. What type of mental health or substance abuse services do you receive?  (check all that apply)

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* 6. Please enter your Zip Code

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* 7. Consumer Leadership:  For each statement, indicate how much you agree or disagree with the statements.

For this survey, "Consumer" means: 

  • Persons being treated for mental or substance use disorders;
  • Persons in recovery for mental or substance use disorders;
  • Persons with lived experience of substance use or mental health disorders. 

  Disagree Sometimes Agree / Sometimes Disagree Agree
People who identify as consumers actively participate in coalitions, task forces, Boards, etc. that meet to discuss mental health issues.
People who identify as consumers are seen as experts and are respected by mental health providers.
People who identify as consumers are employed in mental health programs.

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* 8. Gaps in Service:  For each statement, indicate how accessible the service is for you.
Accessibility is defined as how easy is it for you to access, use, or obtain a service.

  There is no accessibility for me. There is adequate accessibility for me. There is outstanding accessibility for me.
A wide range of peer support services / groups (including self-help, WRAP etc.)
Safe, affordable housing options
Employment services / Individual Placement and Support
Transportation services
Mobile Crisis services (immediate response emergency services)
Substance abuse / addiction service (detox and rehab)
Psychiatrist
Outpatient Mental Health Services
Prevention and Screening Services
Crisis Intervention Services

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* 9. Barriers to Receiving Recovery-Oriented Services: Please indicate how often each of these statements below is a barrier for you to receive recovery-oriented services.  (A barrier is something that may get in the way or prevent you from accessing a service when it's needed.)

  Not a Barrier Sometimes a Barrier Often a Barrier
Long waiting lists.
No outreach to people who are homeless.
Language / cultural/ sexual orientation barriers (identify specific barrier)
Restrictive medication policies (e.g. formularies, monthly limit)
Limited hours of operation
Lack of transportation
Lack of appropriately trained staff, including cross training on substance abuse / addiction issues.

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