Behavioral Health Services Survey for Family Members/Friends
Disability Rights New Mexico (DRNM) is interested in hearing about your family member's or close friend's experiences as they have accessed behavioral/mental health services in New Mexico. This survey will help us to advocate for better services. Your participation is completely optional and your answers will remain anonymous. If you'd like this survey in an alternate format, please call DRNM at 1-800-432-4682. Thank you!
Are you the family member or close friend of a person who has used or tried to access behavioral/mental health services in New Mexico since January 1, 2015?
(If you answered "No," there is no need to proceed further. Thanks!).
What kinds of services did your family member/friend try to access?
Please check all that apply:
Counseling or therapy
Emergency services, such as being taken to the ER for evaluation or treatment
Assertive Community Treatment (ACT)
Medication management services
Substance use treatment
Residential care treatment
Boarding home care
Transitional living services
Behavioral Health Institute (State hospital in Las Vegas, NM)
Adult shelter care
Personal care services
Behavioral Management Services
Representative Payee services
Treatment Guardian services
Care coordination by a Managed Care Organization, such as Presbyterian, United, Molina, or Blue Cross/Blue Shield
Has your family member or friend received services from any of the following agencies?
Please check all that apply.
Open Skies Healthcare
Turquoise Health and Wellness
Valle Del Sol
None of the above
Since January 1, 2015, how many times has your family member/friend gone to the Emergency Room to get behavioral/mental health services?
Since January 1, 2015, how many times has your family member/friend been hospitalized for a behavioral/mental health issue?
(This may include substance use).
Since January 1, 2015, has your family member/friend's need for emergency treatment for behavioral/mental health issues: decreased, stayed the same, or increased?
Please check one.
Decreased (fewer trips to the Emergency Room or hospitalizations).
Stayed the same
Increased (more trips to the Emergency Room or hospitalizations).
Since January 1, 2015, was your family member or friend able to make appointments for behavioral/mental health services?
(In other words, was a clinician available for appointments within 2 weeks of your family member/friend needing it?).
What is your family member/friend's age range?
Age 17 or under
Age 18 - 24 years
Age 25 or older
I'd prefer not to answer
What is your family member/friend's highest level of education?
8th grade or less
Some high school, but didn't graduate
High school graduate or GED
Some college or 2-year degree
4-year college graduate
More than 4-year college graduate
I'd prefer not to answer
What is your family member/friend's race?
White, of Hispanic or Latino origin
White, not of Hispanic or Latino origin
Prefer not to answer.
Is there anything else that you would like to share about your family member/friend's experience with the behavioral health system in New Mexico?
Thank you for your participation in this survey. If you are interested in a longer interview with Disability Rights New Mexico staff, please let us know by providing your name and phone number or email address. Your help is greatly appreciated!
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