Ephesus Church Fostering & Strengthening Healthy Faith Community Assessment Survey

Mental Health Assessment Survey – April 2021

Thank you for participating in our survey. Your feedback is important.

This assessment tool is designed to inform us about the mental health and substance use issues that face our local congregations.

The information you provide will be completely confidential and will help us determine the training needs of our community and measure the value of the training(s) received. We appreciate your time.

Please answer every question to the best of your ability.

Question Title

* 1. Position of Person Completing Survey (if you belong to more than one, select the most discernible role)

Clergy

Other Congregation Staff

Member of Congregation

Associate Member (i.e. An active participant in one Congregation but hold membership in a different Congregation)

Visitor

Not Identified

The following definitions apply to the survey as a whole:

Substance Use Disorders (i.e. dependence upon meth, marijuana, cocaine, heroin, etc.)

Anxiety Disorders (i.e. phobia, obsessive-compulsive disorder, generalized anxiety disorder, etc.)

Abuse Issues (physical or emotional)

Post-Traumatic Stress (a mental health condition that is triggered by a terrifying event — either experiencing it or witnessing it)

Severe Personality Disorders (a type of mental disorder in which one has a rigid and unhealthy pattern of thinking, functioning, and behaving)

Bipolar Disorders (a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks) or Schizophrenia (chronic and severe mental disorder that affects how a person thinks, feels, and behaves; people with schizophrenia may seem like they have lost touch with reality)

Behavior Problems of Children (child’s behavior or emotional difficulties lasting for more than a few weeks and are the cause of problems at school, at home, or with friends)

Gender Identity (an individual's personal sense of having a particular gender, which may correlate or differ from the individual's assigned sex)

Mental health advocate (an individual who shares their stories and help those who are struggling and take risks and show their vulnerability by telling their truth in hopes of encouraging someone else)

Professional counselors help clients identify goals and potential solutions to problems that cause emotional turmoil; seek to improve communication and coping skills; strengthen self-esteem; and promote behavior change and optimal mental health)

Question Title

* 2. In your own words, can you define Mental Health? If yes, please write in the box below.

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* 3. What are your beliefs about Mental Health?

Question Title

* 4. Is your understanding of Mental Health influenced by your spiritual or religious background?

Yes

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* 5. Do you feel safe when present at your place of worship?

Always

Most Times

Sometimes

Never

Never really thought of my safety

Question Title

* 6. How comfortable are you with discussing the topic of Mental Health in your communal place of worship?

Extremely Comfortable

Comfortable

Somewhat Comfortable

Extremely Uncomfortable

Not sure

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* 7. Do you feel like the people in your Faith community are safe to talk to if you were to be in some type of distress?

Always

Most Times

Sometimes

Never

Not sure

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* 8. How often would you like to meet or partner with a mental health advocate on a monthly basis?

1 Time

At least 3 times

More than 8 times

Never

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* 9. Are you satisfied with how Mental Health is addressed within your spiritual or religious community?

Extremely

Satisfied

Unsatisfied

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* 10. The culture I grew up in had an open dialog about Mental Health.

Yes

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* 11. Are you aware of the Mental Health Resources in your immediate community that could aid you or someone you know who might be having a Mental Health crisis outside of calling 911?

Absolutely

Somewhat

I am not aware of any local resources outside of calling 911

The following questions are designed to help understand the perceived importance of certain issues in the lives of yourself, your family and your congregation.

Question Title

* 12. Is the following issue present in your life, family or congregation?

	Never	Rarely	Sometimes	Often
Alcoholism/Excessive Drinking	Alcoholism/Excessive Drinking Never	Alcoholism/Excessive Drinking Rarely	Alcoholism/Excessive Drinking Sometimes	Alcoholism/Excessive Drinking Often
Drug Use/Substance Use	Drug Use/Substance Use Never	Drug Use/Substance Use Rarely	Drug Use/Substance Use Sometimes	Drug Use/Substance Use Often
Anxiety	Anxiety Never	Anxiety Rarely	Anxiety Sometimes	Anxiety Often
Post-Trauma or Abuse	Post-Trauma or Abuse Never	Post-Trauma or Abuse Rarely	Post-Trauma or Abuse Sometimes	Post-Trauma or Abuse Often
Severe Personality Problems	Severe Personality Problems Never	Severe Personality Problems Rarely	Severe Personality Problems Sometimes	Severe Personality Problems Often
Depression	Depression Never	Depression Rarely	Depression Sometimes	Depression Often
Severe Mental Illness (ex. bipolar disorder, schizophrenia, etc.)	Severe Mental Illness (ex. bipolar disorder, schizophrenia, etc.) Never	Severe Mental Illness (ex. bipolar disorder, schizophrenia, etc.) Rarely	Severe Mental Illness (ex. bipolar disorder, schizophrenia, etc.) Sometimes	Severe Mental Illness (ex. bipolar disorder, schizophrenia, etc.) Often
Children's Behavior Problems	Children's Behavior Problems Never	Children's Behavior Problems Rarely	Children's Behavior Problems Sometimes	Children's Behavior Problems Often
Runaway or Homeless Youth	Runaway or Homeless Youth Never	Runaway or Homeless Youth Rarely	Runaway or Homeless Youth Sometimes	Runaway or Homeless Youth Often
Military Veterans with Mental Health Issues	Military Veterans with Mental Health Issues Never	Military Veterans with Mental Health Issues Rarely	Military Veterans with Mental Health Issues Sometimes	Military Veterans with Mental Health Issues Often
Distinguishing Sin or Willful Behavior from Mental Health Challenges	Distinguishing Sin or Willful Behavior from Mental Health Challenges Never	Distinguishing Sin or Willful Behavior from Mental Health Challenges Rarely	Distinguishing Sin or Willful Behavior from Mental Health Challenges Sometimes	Distinguishing Sin or Willful Behavior from Mental Health Challenges Often
Uncertainty on how to support families with Mental Health Challenges	Uncertainty on how to support families with Mental Health Challenges Never	Uncertainty on how to support families with Mental Health Challenges Rarely	Uncertainty on how to support families with Mental Health Challenges Sometimes	Uncertainty on how to support families with Mental Health Challenges Often
Not being sure when/where to refer someone for treatment	Not being sure when/where to refer someone for treatment Never	Not being sure when/where to refer someone for treatment Rarely	Not being sure when/where to refer someone for treatment Sometimes	Not being sure when/where to refer someone for treatment Often
Unavailability of Housing	Unavailability of Housing Never	Unavailability of Housing Rarely	Unavailability of Housing Sometimes	Unavailability of Housing Often

Question Title

* 13. Are you or your family dealing with any of the following challenging life events?

	No	Yes
Family/Friend in a Nursing Home or Assisted Living	Family/Friend in a Nursing Home or Assisted Living No	Family/Friend in a Nursing Home or Assisted Living Yes
Family/Friend with Dementia or Alzheimer's	Family/Friend with Dementia or Alzheimer's No	Family/Friend with Dementia or Alzheimer's Yes
Chronic or Severe Physical Health Problem	Chronic or Severe Physical Health Problem No	Chronic or Severe Physical Health Problem Yes
Chronic or Severe Mental Health Problem	Chronic or Severe Mental Health Problem No	Chronic or Severe Mental Health Problem Yes
Food Insecurity	Food Insecurity No	Food Insecurity Yes
Loss of Job	Loss of Job No	Loss of Job Yes
Financial Distress	Financial Distress No	Financial Distress Yes

Question Title

* 14. What is your degree of comfort and confidence in engaging with people in the following scenarios?

The following are training programs and descriptions for your reference:

All Training Programs can be offered Virtually.
All 101 Training Programs can be offered via Zoom or Pre-Recorded.

Mental Health 101 - A brief 1-2 hour introduction to mental health and mental illness.

Mental Health First Aid (Adult) - A thorough 8-hour training over one day that teaches you how to identify, understand and respond to signs of mental illnesses and substance use disorders in adults. Offered in English and Spanish.

Mental Health First Aid (Youth) - A thorough 8-hour training over one day that teaches you how to identify, understand and respond to signs of mental illnesses and substance use disorders in youth. Offered in English and Spanish.

Children's Mental Health 101 - A brief 1-2 hour introduction to children's mental health and mental illness.

Education for families coping with Mental Health challenges - One-Time or Ongoing Training Options on a variety of relevant topics. Some resources offered in Spanish.

Companionship Workshop - An engaging 4-hour workshop teaching a relational, community-based model supportive of healing and recovery. Communities learn how to be an active listener when people present their experiences with mental health challenges and share their first-hand accounts. The virtual workshop can be taught via Zoom in one 4-hour session, over two 2-hour sessions, or over three 1.5-hour sessions.

Substance Use Disorder 101 - A brief 1-2 hour introduction to substance use and dependence.

Setting up a Mental Health and Substance Use Disorder Ministry - One-Time or Ongoing Virtual Training Options to discuss the logistics, process, challenges, and models in developing a congregational mental health or substance use disorder ministry. Some resources offered in Spanish.

Becoming a Trauma-Informed Congregation - A One-Time or Ongoing Virtual Training that teaching congregation members the widespread impact of trauma, how to recognize the signs and symptoms of trauma, how to integrate this new knowledge of trauma, and ways to avoid the re-traumatization of individuals. Some resources offered in Spanish.

Question Title

* 15. Please indicate which of the following trainings would be useful for the congregation.

	No	Somewhat	Very
Mental Health 101	Mental Health 101 No	Mental Health 101 Somewhat	Mental Health 101 Very
Mental Health First Aid (Adult)	Mental Health First Aid (Adult) No	Mental Health First Aid (Adult) Somewhat	Mental Health First Aid (Adult) Very
Mental Health First Aid (Youth)	Mental Health First Aid (Youth) No	Mental Health First Aid (Youth) Somewhat	Mental Health First Aid (Youth) Very
Children's Mental Health 101	Children's Mental Health 101 No	Children's Mental Health 101 Somewhat	Children's Mental Health 101 Very
Education for families coping with Mental Health challenges	Education for families coping with Mental Health challenges No	Education for families coping with Mental Health challenges Somewhat	Education for families coping with Mental Health challenges Very
Companionship Workshop	Companionship Workshop No	Companionship Workshop Somewhat	Companionship Workshop Very
Substance Use Disorder 101	Substance Use Disorder 101 No	Substance Use Disorder 101 Somewhat	Substance Use Disorder 101 Very
Setting up a Mental Health and Substance Use Disorder Ministry	Setting up a Mental Health and Substance Use Disorder Ministry No	Setting up a Mental Health and Substance Use Disorder Ministry Somewhat	Setting up a Mental Health and Substance Use Disorder Ministry Very
Becoming a Trauma-Informed Congregation	Becoming a Trauma-Informed Congregation No	Becoming a Trauma-Informed Congregation Somewhat	Becoming a Trauma-Informed Congregation Very

Question Title

* 16. Would you be interested in participating in any of the following trainings?

	No	Yes
Mental Health 101	Mental Health 101 No	Mental Health 101 Yes
Mental Health First Aid (Adult)	Mental Health First Aid (Adult) No	Mental Health First Aid (Adult) Yes
Mental Health First Aid (Youth)	Mental Health First Aid (Youth) No	Mental Health First Aid (Youth) Yes
Children's Mental Health 101	Children's Mental Health 101 No	Children's Mental Health 101 Yes
Education for families coping with mental Health challenges	Education for families coping with mental Health challenges No	Education for families coping with mental Health challenges Yes
Companionship Workshop	Companionship Workshop No	Companionship Workshop Yes
Substance Use Disorder 101	Substance Use Disorder 101 No	Substance Use Disorder 101 Yes
Setting up a Mental Health and Substance Use Disorder Ministry	Setting up a Mental Health and Substance Use Disorder Ministry No	Setting up a Mental Health and Substance Use Disorder Ministry Yes
Becoming a Trauma-Informed Congregation	Becoming a Trauma-Informed Congregation No	Becoming a Trauma-Informed Congregation Yes

Question Title

* 17. If you would like to learn more about mental health let us know by completing the information below.

Name

City

State

Phone number

	None (don't want to get involved)	Low (want to; unsure how)	Medium (I think I might be able)	High (confident)
Responding if someone approaches you and asks you for money?	Responding if someone approaches you and asks you for money? None (don't want to get involved)	Responding if someone approaches you and asks you for money? Low (want to; unsure how)	Responding if someone approaches you and asks you for money? Medium (I think I might be able)	Responding if someone approaches you and asks you for money? High (confident)
Responding if you see somebody sleeping nearby as you are walking down the street?	Responding if you see somebody sleeping nearby as you are walking down the street? None (don't want to get involved)	Responding if you see somebody sleeping nearby as you are walking down the street? Low (want to; unsure how)	Responding if you see somebody sleeping nearby as you are walking down the street? Medium (I think I might be able)	Responding if you see somebody sleeping nearby as you are walking down the street? High (confident)
Approaching someone close to you pushing a shopping cart with personal belongings while in a parking lot?	Approaching someone close to you pushing a shopping cart with personal belongings while in a parking lot? None (don't want to get involved)	Approaching someone close to you pushing a shopping cart with personal belongings while in a parking lot? Low (want to; unsure how)	Approaching someone close to you pushing a shopping cart with personal belongings while in a parking lot? Medium (I think I might be able)	Approaching someone close to you pushing a shopping cart with personal belongings while in a parking lot? High (confident)
Helping someone you hear loudly talking to themselves near a street corner?	Helping someone you hear loudly talking to themselves near a street corner? None (don't want to get involved)	Helping someone you hear loudly talking to themselves near a street corner? Low (want to; unsure how)	Helping someone you hear loudly talking to themselves near a street corner? Medium (I think I might be able)	Helping someone you hear loudly talking to themselves near a street corner? High (confident)
Showing hospitality to someone who is homeless and walks into your business or church service?	Showing hospitality to someone who is homeless and walks into your business or church service? None (don't want to get involved)	Showing hospitality to someone who is homeless and walks into your business or church service? Low (want to; unsure how)	Showing hospitality to someone who is homeless and walks into your business or church service? Medium (I think I might be able)	Showing hospitality to someone who is homeless and walks into your business or church service? High (confident)
Talking to someone whose breath smells of alcohol?	Talking to someone whose breath smells of alcohol? None (don't want to get involved)	Talking to someone whose breath smells of alcohol? Low (want to; unsure how)	Talking to someone whose breath smells of alcohol? Medium (I think I might be able)	Talking to someone whose breath smells of alcohol? High (confident)
Assisting an adult or child who tells you they are being abused by a relative?	Assisting an adult or child who tells you they are being abused by a relative? None (don't want to get involved)	Assisting an adult or child who tells you they are being abused by a relative? Low (want to; unsure how)	Assisting an adult or child who tells you they are being abused by a relative? Medium (I think I might be able)	Assisting an adult or child who tells you they are being abused by a relative? High (confident)
Explaining mental illness to a neighbor that tells you that mental illness is caused by demon possession?	Explaining mental illness to a neighbor that tells you that mental illness is caused by demon possession? None (don't want to get involved)	Explaining mental illness to a neighbor that tells you that mental illness is caused by demon possession? Low (want to; unsure how)	Explaining mental illness to a neighbor that tells you that mental illness is caused by demon possession? Medium (I think I might be able)	Explaining mental illness to a neighbor that tells you that mental illness is caused by demon possession? High (confident)
Assisting a person (i.e. co- worker, relative, neighbor, classmate, etc.) who tells you they are thinking about suicide?	Assisting a person (i.e. co- worker, relative, neighbor, classmate, etc.) who tells you they are thinking about suicide? None (don't want to get involved)	Assisting a person (i.e. co- worker, relative, neighbor, classmate, etc.) who tells you they are thinking about suicide? Low (want to; unsure how)	Assisting a person (i.e. co- worker, relative, neighbor, classmate, etc.) who tells you they are thinking about suicide? Medium (I think I might be able)	Assisting a person (i.e. co- worker, relative, neighbor, classmate, etc.) who tells you they are thinking about suicide? High (confident)
Helping a family member who seems to be sleeping a lot more lately and does not want to leave the house?	Helping a family member who seems to be sleeping a lot more lately and does not want to leave the house? None (don't want to get involved)	Helping a family member who seems to be sleeping a lot more lately and does not want to leave the house? Low (want to; unsure how)	Helping a family member who seems to be sleeping a lot more lately and does not want to leave the house? Medium (I think I might be able)	Helping a family member who seems to be sleeping a lot more lately and does not want to leave the house? High (confident)
Providing support for a family dealing with Mental Health challenges or Substance Use?	Providing support for a family dealing with Mental Health challenges or Substance Use? None (don't want to get involved)	Providing support for a family dealing with Mental Health challenges or Substance Use? Low (want to; unsure how)	Providing support for a family dealing with Mental Health challenges or Substance Use? Medium (I think I might be able)	Providing support for a family dealing with Mental Health challenges or Substance Use? High (confident)
Providing a referral for a member of your congregation to get counseling or therapy?	Providing a referral for a member of your congregation to get counseling or therapy? None (don't want to get involved)	Providing a referral for a member of your congregation to get counseling or therapy? Low (want to; unsure how)	Providing a referral for a member of your congregation to get counseling or therapy? Medium (I think I might be able)	Providing a referral for a member of your congregation to get counseling or therapy? High (confident)
Assisting a member of your extended family who is evicted and needs a place to stay for a short time?	Assisting a member of your extended family who is evicted and needs a place to stay for a short time? None (don't want to get involved)	Assisting a member of your extended family who is evicted and needs a place to stay for a short time? Low (want to; unsure how)	Assisting a member of your extended family who is evicted and needs a place to stay for a short time? Medium (I think I might be able)	Assisting a member of your extended family who is evicted and needs a place to stay for a short time? High (confident)
Interacting respectfully with someone you suspect is high on drugs?	Interacting respectfully with someone you suspect is high on drugs? None (don't want to get involved)	Interacting respectfully with someone you suspect is high on drugs? Low (want to; unsure how)	Interacting respectfully with someone you suspect is high on drugs? Medium (I think I might be able)	Interacting respectfully with someone you suspect is high on drugs? High (confident)

Ephesus Church Fostering & Strengthening Healthy Faith Community Assessment Survey

Mental Health Assessment Survey – April 2021

Question Title

* 1. Position of Person Completing Survey (if you belong to more than one, select the most discernible role)

Question Title

* 2. In your own words, can you define Mental Health? If yes, please write in the box below.

Question Title

* 3. What are your beliefs about Mental Health?

Question Title

* 4. Is your understanding of Mental Health influenced by your spiritual or religious background?

Question Title

* 5. Do you feel safe when present at your place of worship?

Question Title

* 6. How comfortable are you with discussing the topic of Mental Health in your communal place of worship?

Question Title

* 7. Do you feel like the people in your Faith community are safe to talk to if you were to be in some type of distress?

Question Title

* 8. How often would you like to meet or partner with a mental health advocate on a monthly basis?

Question Title

* 9. Are you satisfied with how Mental Health is addressed within your spiritual or religious community?

Question Title

* 10. The culture I grew up in had an open dialog about Mental Health.

Question Title

* 11. Are you aware of the Mental Health Resources in your immediate community that could aid you or someone you know who might be having a Mental Health crisis outside of calling 911?

Question Title

* 12. Is the following issue present in your life, family or congregation?

Question Title

* 13. Are you or your family dealing with any of the following challenging life events?

Question Title

* 14. What is your degree of comfort and confidence in engaging with people in the following scenarios?

Question Title

* 15. Please indicate which of the following trainings would be useful for the congregation.

Question Title

* 16. Would you be interested in participating in any of the following trainings?

Question Title

* 17. If you would like to learn more about mental health let us know by completing the information below.

Question Title

* 18. Do you have any other comments, questions, or concerns?