Mental Health Survey Question Title * 1. Your consent. Survey responses are anonymous, and may be shared with partners. Do you give your consent? Yes (continue with survey) No (go to end of survey) Question Title * 2. How would you rate your current mental health? Excellent Good Fair Poor Very bad Prefer not to say Question Title * 3. Have you suffered from any of the following mental health conditions in the past 12 months? (Tick as many as apply to you)? Depression Anxiety Insomnia Post-Traumatic Stress Disorder (PTSD) Phobias Obsessive Compulsive Disorder Bipolar Schizophrenia Other Prefer not to say Question Title * 4. If you have suffered from any of the above, do you know what triggered you to have this condition? (e.g. Covid, loneliness, financial issues, poor health, social isolation) Yes No Prefer not to say Question Title * 5. If YES, please give details: Question Title * 6. Do you feel comfortable discussing your mental health with others? Yes No Prefer not to say Question Title * 7. If NO, why not? Question Title * 8. If YES who do you discuss it with? Question Title * 9. Have you ever discussed your mental health with your GP? Yes No Prefer not to say Question Title * 10. If YES – What support did your GP offer you? How helpful did you find the discussion? Question Title * 11. If NO – Why not? Question Title * 12. Have you ever had counselling via Talking Therapies, the NHS Counselling Service? Yes No Prefer not to say Question Title * 13. If YES – How was your experience of this service? Question Title * 14. Have you ever been referred to Mental Health Services? (to see a psychiatrist etc.) Yes No Prefer not to say Question Title * 15. If YES – How was your experience of using these services? Question Title * 16. Are you aware of any local charities who support people with mental health issues? Yes No Prefer not to say Question Title * 17. If YES – please specify below which ones Question Title * 18. Have you ever received support for your mental health from a charity? Yes No Prefer not to say Question Title * 19. If YES – how did you find the experience of using their services? Question Title * 20. Do you do anything to look after your mental health? Yes No Prefer not to say Question Title * 21. If YES – Please give details below. Question Title * 22. Do you care for anyone who suffers with their mental health? Yes No Prefer not to say Question Title * 23. If YES Please give details of the support you provide. Question Title * 24. If YES – do you receive any support to carry out your caring role? Yes No Prefer not to say Question Title * 25. If YES – Please give details below Question Title * 26. Do you have any other comments on mental health and mental health services? Question Title * 27. If you have any suggestions for future topics for our questionnaires, please list below: Question Title * 28. Your Gender? Male Female Other Prefer not to say Question Title * 29. Your Age? Under 50 50 - 64 65 - 74 75 - 89 90 or over Prefer not to say Question Title * 30. Household Just you 2 people 3 or 3 plus Prefer not to say Question Title * 31. Physical health Good Fair Poor Prefer not to say Question Title * 32. Mental Health Good Fair Poor Prefer not to say Question Title * 33. Your Ethnicity White British White Irish White Other Asian Indian Asian Pakistani Asian British Asian Other Black Caribbean Black African Black British Black Other Mixed Other Prefer not to say Done