1. Survey Instructions

The Mental Health Services Act (MHSA) of Alameda County wants your ideas on how to strengthen its mental health and wellness programs to better serve you and your community. What do you think should be a part of our work in the next three years (e.g., more services for youth, more home visits to senior citizens, more housing supports, different mental health treatment options)? Also, what are some new or innovative ideas you’d like Alameda County to try out?

This survey is part of a larger community planning process that also includes community meetings throughout Alameda County from July to September 2017. If you would like information about the meetings, please click HERE.

 There are 15 questions in the survey and it takes about 10 minutes to complete. ALL QUESTIONS ARE OPTIONAL, and you're welcome to leave questions blank if you do not want to respond. Also, the survey is anonymous.

Thank you for your help with this community effort!

Is this your first time providing input and information for our MHSA Community Planning Process?

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* 1. Is this your first time providing input and information for our MHSA Community Planning Process?

Please rank the importance of each Child/Youth/Transition Age Youth's mental health issue listed below by importance (1 being Absolutely Essential through 5 being Not  Important at This Time).

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* 2. Please rank the importance of each Child/Youth/Transition Age Youth's mental health issue listed below by importance (1 being Absolutely Essential through 5 being Not  Important at This Time).

  1=Absolutely Essential 2=Very Important 3=Moderately Important 4=Slightly Important 5=Not Important at This Time
Academic Success
Social Isolation/Feeling Alone
Community Violence and Trauma
Juvenile Justice Involvement
Homelessness
Out-of-home Placement/Foster Care
Suicide
Depression
Family Conflict/Stress
Employment
Substance Use/Abuse
Please rank the importance of each Adult/Older Adult mental health issue listed below by importance (1 being Absolutely Essential through 5 being Not Important at This Time).

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* 3. Please rank the importance of each Adult/Older Adult mental health issue listed below by importance (1 being Absolutely Essential through 5 being Not Important at This Time).

  1=Absolutely Essential 2=Very Important 3=Moderately Important 4=Somewhat Important 5=Not Important at This Time
Homelessness
Social isolation/Feeling Alone
Incarceration of Mentally Ill Adults
Ongoing Multiple Hospitalizations
Suicide
Community Violence and Trauma
Domestic Violence 
Inability to Find Employment
Substance Abuse
Inability to Obtain an Education
Parenting Issues/Family Stress
Chronic Health Issues
Are there any populations or groups of people whom you believe are not being adequately served by the current MHSA programs in Alameda County? Please check all that apply.

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* 4. Are there any populations or groups of people whom you believe are not being adequately served by the current MHSA programs in Alameda County? Please check all that apply.

Based on your answers in question 4, please identify who you feel are the three most under served groups (please be very specific):

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* 5. Based on your answers in question 4, please identify who you feel are the three most under served groups (please be very specific):

What issues make it more challenging for consumers and their families to receive mental health services? Please check all that apply.

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* 6. What issues make it more challenging for consumers and their families to receive mental health services? Please check all that apply.

Please list any suggestions for programs or services that would
enhance consumers' wellness and recovery and better meet the needs of your community.

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* 7. Please list any suggestions for programs or services that would
enhance consumers' wellness and recovery and better meet the needs of your community.

This question is to hear from you on Innovative Ideas to improve and transform our county mental health system.  The goal of the Innovation program is to contribute to learning and improving in three ways:
1. Introduce new mental health practices/approaches including prevention and early intervention
that have never been done before, or
2. Make a change to an existing mental health practice/approach, including adaptation for a new
setting or community, or
3. Introduce a new application to the mental health system of a promising community driven
practice/approach that has been successful in non-mental health contexts or settings.
Please list below any innovative ideas about improving mental health services that you may have:

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* 8. This question is to hear from you on Innovative Ideas to improve and transform our county mental health system.  The goal of the Innovation program is to contribute to learning and improving in three ways:
1. Introduce new mental health practices/approaches including prevention and early intervention
that have never been done before, or
2. Make a change to an existing mental health practice/approach, including adaptation for a new
setting or community, or
3. Introduce a new application to the mental health system of a promising community driven
practice/approach that has been successful in non-mental health contexts or settings.
Please list below any innovative ideas about improving mental health services that you may have:

Which of the following MHSA Service Areas do you feel have been effective in addressing our local mental health concerns and negative outcomes that may result from untreated mental illness?  Please check all that apply.

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* 9. Which of the following MHSA Service Areas do you feel have been effective in addressing our local mental health concerns and negative outcomes that may result from untreated mental illness?  Please check all that apply.

Please tell us about yourself.
My AGE GROUP is:

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* 10. Please tell us about yourself.
My AGE GROUP is:

My GENDER is:

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* 11. My GENDER is:

My RACE/ETHNICITY is:

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* 13. My RACE/ETHNICITY is:

If you marked "ASIAN" under question 13 please tell us about your Nationality/Country of Origin:

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* 14. If you marked "ASIAN" under question 13 please tell us about your Nationality/Country of Origin:

Which of the following groups do you primarily identify with or represent (please only choose one group)?

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* 15. Which of the following groups do you primarily identify with or represent (please only choose one group)?

Thank You for your Time!  
This area is for any additional comments you would like to give us:

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* 16.
Thank You for your Time!  
This area is for any additional comments you would like to give us:

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