Rural Community Engagement Survey

Welcome!

The purpose of this survey is to find out how rural community members feel about behavioral health. The results of this survey will be used to advise state- and local-level programming and policies regarding substance misuse and mental illness.

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* 1. What is your county of residence

Carson City

Churchill County

Clark County

Douglas County

Elko County

Esmeralda County

Eureka County

Humboldt County

Lander County

Lincoln County

Lyon County

Mineral County

Nye County

Pershing County

Storey County

Washoe County

White Pine County

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* 2. What is your gender?

Male

Female

Transgender

Non-binary

I prefer not to say

Other (please specify)

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* 3. Are you a member of the LGTBQ+ community?

Yes

I prefer not to say

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* 4. How old are you?

14 and under

15-18

19-29

30-49

50-64

65 or older

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* 5. What is your race? Please check all that apply.

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Other (please specify)

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* 6. What is your ethnicity?

Hispanic

Non-Hispanic

I prefer not to say

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* 7. If you or someone you care about was feeling a lot of stress, anxiety, depression, or experiencing a crisis or tragedy, would you know where to go for help?

Yes

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* 8. If yes, where would you go for help? Please select all that apply.

Friends and family

A doctor

A mental health professional

Church, pastor, or a religious leader

Hospital or clinic

A hotline

School or school counselor/staff

911

A community agency

Other (please specify)

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* 9. Do you feel enough support exists within your county to help people dealing with mental illness or emotional pain?

Yes

I don't know if adequate support exists

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* 10. Are you satisfied with the quality of the care or support?

Yes

Comments

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* 11. Do you feel that enough support exists within your county to assist those dealing with substance misuse? (For example, drinking too much, taking more pain medication than they should, using other people’s medications, using drugs, or any type of addiction to a substance.)

Yes

I don't know if adequate support exists

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* 12. What do you feel are the biggest factors keeping people from help? Please select all that apply.

Not having insurance

Not having the right insurance

Stigma or judgement

Fear of legal consequences (Child protective services, red flag or gun laws, etc.)

No transportation to services

Only telehealth/no in-person services available

No internet, phone service, or technology to connect with services

Lack of knowledge of what resources are available

Wait times are too long to be seen for services

Don’t like or trust the providers available

Worried about confidentiality

Other (please specify)

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* 13. Where do you believe the local and/or state government should focus its energy and money in support of those with longer-term distress, mental illness or substance misuse? Please select all that apply.

Provide services to those who can't afford treatment or don't have insurance

Connect community members who are struggling to the right community resources (local treatment, non-profits, etc.)

Raising community awareness and reducing stigma or judgement

The government should not play a role in providing support for these individuals

I don't know

Other (please specify)

Rural Community Engagement Survey

Welcome!

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* 1. What is your county of residence

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* 2. What is your gender?

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* 3. Are you a member of the LGTBQ+ community?

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* 4. How old are you?

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* 5. What is your race? Please check all that apply.

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* 6. What is your ethnicity?

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* 7. If you or someone you care about was feeling a lot of stress, anxiety, depression, or experiencing a crisis or tragedy, would you know where to go for help?

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* 8. If yes, where would you go for help? Please select all that apply.

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* 9. Do you feel enough support exists within your county to help people dealing with mental illness or emotional pain?

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* 10. Are you satisfied with the quality of the care or support?

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* 11. Do you feel that enough support exists within your county to assist those dealing with substance misuse? (For example, drinking too much, taking more pain medication than they should, using other people’s medications, using drugs, or any type of addiction to a substance.)

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* 12. What do you feel are the biggest factors keeping people from help? Please select all that apply.

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* 13. Where do you believe the local and/or state government should focus its energy and money in support of those with longer-term distress, mental illness or substance misuse? Please select all that apply.

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* 14. Other suggestions or comments: