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* 1. Have you spent time in a psychiatric facility as a patient, employee or visitor?

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* 2. (For patients) Why were you or they hospitalized? (For Staff) Why did you choose to work in a psychiatric care facility?

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* 3. Describe your experience either as a patient, staff member or visitor.

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* 4. This survey is completely anonymous. Absolutely no personal information is being gathered about you - only your responses to these questions - not even the I.P. address of your computer.

My hope is this freedom will enable you to unload your shame and allow others to see they are not alone. Please come up with a nickname to hide your identity in the event I read your responses on the show. If you are feeling suicidal PLEASE call the Suicide Prevention Hotline 800-273-8255.

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* 5. What sex/gender are you?

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* 6. Are you gay, straight, bisexual or asexual (not interested in either sex)?

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* 7. How old are you?

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* 8. Do you have any comments or suggestions to make the Mental Illness Happy Hour podcast better?

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