HOPE ASSESSMENT Consumer Survey

St Vincent's Hospital, Melbourne: HOPE Enhancement Project

Suicide affects everyone and we all have a part to play in suicide prevention.

It is recognised that substantial change is needed to improve current services for people in crisis and develop alternative supports to better meet people's needs. This survey will be looking at how you felt about the assessment process by our mental health service.

Be assured, your opinion will make a difference and ideas will impact on the future design of our regional suicide prevention strategy.

If any of these questions trigger you at all support can be found through the HOPE Enhancement Project lived experience officer or other services such as Beyond Blue (1300 22 4636) and Lifeline (13 11 14).

*Questions with asterisk are compulsory to answer to complete the survey. Others are optional.

Question Title

* 1. What gender do you identify with?

Male

Female

Non-gender conforming

Non-binary

Trans woman

Trans man

Gender fluid

Gender queer

Decline to answer

Other (please specify)

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* 2. What is your age?

18-24

25-29

30-39

40-49

50-59

60-69

70-79

Above 80

Decline to answer

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* 3. Do you identify as Aboriginal and/or Torres Strait Islander?

Aboriginal

Torres Strait Islander

Both

Neither

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* 4. With which ethnic group do you identify?

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* 5. Do you identify with any religion?

Yes

If Yes, please specify what religion you identify with. (Optional)

Question Title

* 6. How did you feel when you were completing the assessment through HOPE?
Select all that apply.

	Not at all	Slightly	Moderately	Very	Extremely
Frustrated	Frustrated Not at all	Frustrated Slightly	Frustrated Moderately	Frustrated Very	Frustrated Extremely
Relieved	Relieved Not at all	Relieved Slightly	Relieved Moderately	Relieved Very	Relieved Extremely
Determined	Determined Not at all	Determined Slightly	Determined Moderately	Determined Very	Determined Extremely
Irate	Irate Not at all	Irate Slightly	Irate Moderately	Irate Very	Irate Extremely
Safe	Safe Not at all	Safe Slightly	Safe Moderately	Safe Very	Safe Extremely
Vulnerable	Vulnerable Not at all	Vulnerable Slightly	Vulnerable Moderately	Vulnerable Very	Vulnerable Extremely
Empowered	Empowered Not at all	Empowered Slightly	Empowered Moderately	Empowered Very	Empowered Extremely
Disappointed	Disappointed Not at all	Disappointed Slightly	Disappointed Moderately	Disappointed Very	Disappointed Extremely
Confused	Confused Not at all	Confused Slightly	Confused Moderately	Confused Very	Confused Extremely
Disconnected	Disconnected Not at all	Disconnected Slightly	Disconnected Moderately	Disconnected Very	Disconnected Extremely
Judged	Judged Not at all	Judged Slightly	Judged Moderately	Judged Very	Judged Extremely
Satisfied	Satisfied Not at all	Satisfied Slightly	Satisfied Moderately	Satisfied Very	Satisfied Extremely
Exhausted	Exhausted Not at all	Exhausted Slightly	Exhausted Moderately	Exhausted Very	Exhausted Extremely
Heavy	Heavy Not at all	Heavy Slightly	Heavy Moderately	Heavy Very	Heavy Extremely
Lighter	Lighter Not at all	Lighter Slightly	Lighter Moderately	Lighter Very	Lighter Extremely
Understood	Understood Not at all	Understood Slightly	Understood Moderately	Understood Very	Understood Extremely
Supported	Supported Not at all	Supported Slightly	Supported Moderately	Supported Very	Supported Extremely
Anxious	Anxious Not at all	Anxious Slightly	Anxious Moderately	Anxious Very	Anxious Extremely
Respected	Respected Not at all	Respected Slightly	Respected Moderately	Respected Very	Respected Extremely
Overwhelmed	Overwhelmed Not at all	Overwhelmed Slightly	Overwhelmed Moderately	Overwhelmed Very	Overwhelmed Extremely
Included/Involved	Included/Involved Not at all	Included/Involved Slightly	Included/Involved Moderately	Included/Involved Very	Included/Involved Extremely
Validated	Validated Not at all	Validated Slightly	Validated Moderately	Validated Very	Validated Extremely
Agitated	Agitated Not at all	Agitated Slightly	Agitated Moderately	Agitated Very	Agitated Extremely
Hopeful	Hopeful Not at all	Hopeful Slightly	Hopeful Moderately	Hopeful Very	Hopeful Extremely
Guided	Guided Not at all	Guided Slightly	Guided Moderately	Guided Very	Guided Extremely

Other (please specify)

Question Title

* 7. Based on the above question (Question 6), can you tell me why you selected any stronger emotions?

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* 8. Where would you prefer the assessment to be conducted? Select all that apply.

At home

Via Telehealth (video)

In the community mental health clinic

In the hospital

In a community centre

Other (please specify)

Question Title

* 9. Did you feel comfortable answering questions on this survey

Strongly Agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

HOPE ASSESSMENT Consumer Survey

St Vincent's Hospital, Melbourne: HOPE Enhancement Project

Question Title

* 1. What gender do you identify with?

Question Title

* 2. What is your age?

Question Title

* 3. Do you identify as Aboriginal and/or Torres Strait Islander?

Question Title

* 4. With which ethnic group do you identify?

Question Title

* 5. Do you identify with any religion?

Question Title

* 6. How did you feel when you were completing the assessment through HOPE?Select all that apply.

Question Title

* 7. Based on the above question (Question 6), can you tell me why you selected any stronger emotions?

Question Title

* 8. Where would you prefer the assessment to be conducted? Select all that apply.

Question Title

* 9. Did you feel comfortable answering questions on this survey

Question Title

* 10. Do you think we should include any other questions or is there anything you would like to add?

* 6. How did you feel when you were completing the assessment through HOPE?
Select all that apply.