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Mental Health
This is a survey used for educational purposes only. Mental health is a crisis in the United States and some questions could trigger emotions.
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* Indicates required question
What is your gender?
*
Male
Female
Other:
What is your age?
18-29
30-42
43-52
53-62
63-72
Over 72
Clear selection
Highest level of education?
GED/HS DIPLOMA
Some College
Associates
Bachelors
Masters
Doctorates
Clear selection
What is your yearly household income?
*
Less than $18,000
$19,000 to $30,000
$31,000 to $50,000
$51,000 to $70,000
$71,000 to $95,000
Over $96,000
What is your race/ethnicity ?
White
Black
Hispanic
Asian
Native American
Native Hawaiian or Pacific Islander
Clear selection
Do you think poverty has an impact on mental health?
Yes
No
Maybe
Clear selection
Do you feel there is access to mental health facilities in your area?
Yes
No
Maybe
Clear selection
Have you ever been diagnosed with a mental health disorder?
Yes
No
Maybe
Clear selection
Does speaking about mental health make you uncomfortable?
Yes
No
Clear selection
Do you think mental health has an impact on drug abuse?
Yes
No
Maybe
Clear selection
Do you think the outbreak of COVID-19 has caused an increase in depression?
Yes
No
Maybe
Clear selection
Do you think there is enough prevention for mental health crisis?
Yes
No
Maybe
Clear selection
Do you think men or women are more affected by mental Illnesses?
Men
Women
Unsure
Clear selection
Do you think society has taken mental health seriously?
Yes
No
Maybe
Clear selection
Do you think social media has caused an increase in depression?
Yes
No
Maybe
Clear selection
Is there a history of mental disorder in your family?
Yes
No
Unsure
Clear selection
Do you think having a support system helps with preventing mental health?
Yes
No
Maybe
Clear selection
Have you seen a therapist in the past 3 years?
Yes
No
Clear selection
How often do you feel depressed?
Always
Often
Sometimes
Rarely
Never
Clear selection
How would you rate your mental health?
Outstanding
Very Good
Good
Fair
Poor
Clear selection
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