Back Home Campaign
Thank you for completing a quick survey to report advocacy with federal and state elected officials.
The Back Home Campaign encourages MHA affiliates to track interactions with legislative representatives in their home districts and it helps policymakers become familiar with their local MHA affiliate(s).
Should you need assistance with this form or your advocacy efforts, please do not hesitate to reach out to your Regional Policy Council (RPC) Representative: Ben Harrington, Barb Johnston, Moe Keller, or Shannah Mulvihill. You may also reach out to MHA National Staff at
Name of elected official
Type of advocacy interaction
(Which best describes the type of interaction with your elected official?)
Conducted in-person tour/visit of affiliate facility or program
Participated in an in-person or virtual sit-down (includes advocacy day at the capitol)
Attended a public affiliate event (i.e., candidate forum) or town hall
Telephone call with official or their staffperson
Direct email with official or their staffperson
Signed a coalition letter to official
Signed a petition or sent a form letter to official
Messaged or tagged official via Facebook or Twitter
Designed an action alert for advocates to send to their officials
Provide any additional detail about this interaction including date, issue(s), asks, outcome(s)
i.e. On advocacy day we coordinated visits with 13 legislators. Our action alert was emailed to 176 legislators and the governor. We invited Congresswoman Napolitano to join our next open house. We asked 38 legislators for support on model parity legislation.
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This form was created inside of Mental Health America.