Behavioral Health CAHPS Survey - English Question Title * 1. What location are you receiving behavioral health care at? 281 Main Street, East Hartford 16 Coventry Street, Hartford 828 Sullivan Ave, South Windsor 500 Blue Hills Ave - Detox 500 Blue Hills Ave - Intensive 500 Blue Hills Ave - Intermediate 56 Coventry Street - Recovery House 46 Coventry Street - Coventry House 203 Williams Street - Clayton House Community Support Services - BHH Community Support Services - ACT Community Support Services - CST Question Title * 2. Our records show that you received care from a clinician in the last 12 months. Please type in the clinician's name below. Question Title * 3. People can get counseling, treatment or medicine for many different reasons, such as: For feeling depressed, anxious, or “stressed out” Personal problems (like when a loved one dies or when there are problems at work) Family problems (like marriage problems or when parents and children have trouble getting along) Needing help with drug or alcohol use For mental or emotional illness In the last 12 months, did you get counseling, treatment or medicine for any of these reasons? Yes No (If No, go to Question #46) Question Title * 4. The next questions ask about your counseling or treatment. Do not include counseling or treatment during an overnight stay or from a self-help group.In the last 12 months, did you call someone to get professional counseling on the phone for yourself? Yes No (If No, go to question #6) Question Title * 5. In the last 12 months, how often did you get the professional counseling you needed on the phone? Never Sometimes Usually Always Question Title * 6. In the last 12 months, did you need counseling or treatment right away? Yes No (If No, go to question #8) Question Title * 7. In the last 12 months, when you needed counseling or treatment right away, how often did you see someone as soon as you wanted? Never Sometimes Usually Always Question Title * 8. In the last 12 months, not counting times you needed counseling or treatment right away, did you make any appointments for counseling or treatment? Yes No (If No, go to question #10) Question Title * 9. In the last 12 months, not counting times you needed counseling or treatment right away, how often did you get an appointment for counseling or treatment as soon as you wanted? Never Sometimes Usually Always Question Title * 10. In the last 12 months, how many times did you go to an emergency room or crisis center to get counseling or treatment for yourself? None 1 2 3 or more Question Title * 11. In the last 12 months (not counting emergency rooms or crisis centers), how many times did you go to an office, clinic, or other treatment program to get counseling, treatment or medicine for yourself? None (If None, go to question #29) 1 to 10 22 to 20 21 or more Question Title * 12. In the last 12 months, how often were you seen within 15 minutes of your appointment? Never Sometimes Usually Always Question Title * 13. The next questions are about all the counseling or treatment you got in the last 12 months during office, clinic, and emergency room visits as well as over the phone. Please do the best you can to include all the different people you went to for counseling or treatment in your answers.In the last 12 months, how often did the people you went to for counseling or treatment listen carefully to you? Never Sometimes Usually Always Question Title * 14. In the last 12 months, how often did the people you went to for counseling or treatment explain things in a way you could understand? Never Sometimes Usually Always Question Title * 15. In the last 12 months, how often did the people you went to for counseling or treatment show respect for what you had to say? Never Sometimes Usually Always Question Title * 16. In the last 12 months, how often did the people you went to for counseling or treatment spend enough time with you? Never Sometimes Usually Always Question Title * 17. In the last 12 months, how often did you feel safe when you were with the people you went to for counseling or treatment? Never Sometimes Usually Always Question Title * 18. In the last 12 months, did you take any prescription medicines as part of your treatment? Yes No (If No, go to question #18) Question Title * 19. In the last 12 months, were you told what side effects of those medicines to watch for? Yes No Question Title * 20. In the last 12 months, how often were you involved as much as you wanted in your counseling or treatment? Never Sometimes Usually Always Question Title * 21. In the last 12 months, did anyone talk to you about whether to include your family or friends in your counseling or treatment? Yes No Question Title * 22. In the last 12 months, were you told about self‑help or support groups, such as consumer‑run groups or 12‑step programs? Yes No Question Title * 23. In the last 12 months, were you given information about different kinds of counseling or treatment that are available? Yes No Question Title * 24. In the last 12 months, were you given as much information as you wanted about what you could do to manage your condition? Yes No Question Title * 25. In the last 12 months, were you given information about your rights as a patient? Yes No Question Title * 26. In the last 12 months, did you feel you could refuse a specific type of medicine or treatment? Yes No Question Title * 27. In the last 12 months, as far as you know did anyone you went to for counseling or treatment share information with others that should have been kept private? Yes No Question Title * 28. Does your language, race, religion, ethnic background or culture make any difference in the kind of counseling or treatment you need? Yes No (If No, go to question #28) Question Title * 29. In the last 12 months, was the care you received responsive to those needs? Yes No Question Title * 30. Using any number from 0 to 10, where 0 is the worst counseling or treatment possible and 10 is the best counseling or treatment possible, what number would you use to rate all your counseling or treatment in the last 12 months? 0 Worst counseling or treatment possible 1 2 3 4 5 6 7 8 9 10 Best counseling or treatment possible Question Title * 31. In the last 12 months, how much were you helped by the counseling or treatment you got? Not at all A little Somewhat A lot Question Title * 32. In general, how would you rate your overall mental health now? Excellent Very good Good Fair Poor Question Title * 33. Compared to 12 months ago, how would you rate your ability to deal with daily problems now? Much better A little better About the same A little worse Much worse Question Title * 34. Compared to 12 months ago, how would you rate your ability to deal with social situations now? Much better A little better About the same A little worse Much worse Question Title * 35. Compared to 12 months ago, how would you rate your ability to accomplish the things you want to do now? Much better A little better About the same A little worse Much worse Question Title * 36. Compared to 12 months ago, how would you rate your problems or symptoms now? Much better A little better About the same A little worse Much worse Question Title * 37. The next questions ask about your experience with the company or organization that handles your benefits for counseling or treatment. In the last 12 months, did you use up all your benefits for counseling or treatment? Yes No Question Title * 38. At the time benefits were used up, did you think you still needed counseling or treatment? Yes No Question Title * 39. Were you told about other ways to get counseling, treatment, or medicine? Yes No Question Title * 40. In the last 12 months, did you need approval for any counseling or treatment? Yes No (If No, go to question #42) Question Title * 41. In the last 12 months, how much of a problem, if any, were delays in counseling or treatment while you waited for approval? A big problem A small problem Not a problem Question Title * 42. In the last 12 months, did you call customer service to get information or help about counseling or treatment? Yes No (If No, go to question #44) Question Title * 43. In the last 12 months, how much of a problem, if any, was it to get the help you needed when you called customer service? A big problem A small problem Not a problem Question Title * 44. In the last 12 months, was any of your counseling or treatment for personal problems, family problems, emotional illness, or mental illness? Yes No Question Title * 45. In the last 12 months, was any of your counseling or treatment for help with alcohol use or drug use? Yes No Question Title * 46. In general, how would you rate your overall health now? Excellent Very good Good Fair Poor Question Title * 47. What is your age now? 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 or older Question Title * 48. Are you male or female? Male Female Question Title * 49. What is the highest grade or level of school that you have completed? 8th grade or less Some high school, but did not graduate High school graduate or GED Some college or 2-year degree 4-year college graduate More than 4-year college degree Question Title * 50. Are you of Hispanic or Latino origin or descent? Yes, Hispanic or Latino No, not Hispanic or Latino Question Title * 51. What is your race. Mark one or more. White Black or African American Asian Native Hawaiian or Other Pacific Islander American Indian or Alaska Native Other Question Title * 52. Did someone help you complete the survey? Yes (if yes, answer Question #53) No (if no, you have completed the survey) Question Title * 53. How did that person help you? Mark one or more. Read the questions to me Selected the answers I gave Answered the questions for me Translated the questions into my language Helped in some other way Question Title * 54. Is there anything our Practice can do to improve care and services we provide to you? Done