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Attitudes Towards Mental Illness - Fall 2009

 

Introduction and Instructions

The DBSA Consumer and Family Survey Center is seeking input from consumers and their families.  Please complete the brief survey below. The first section asks for general information about you, and all answers are strictly confidential. The survey results will be posted at www.DBSAlliance.org/surveycenter. The second section has three questions. Please select the answer that best represents your opinion. If a question does not apply to you or you are uncomfortable answering it, please skip that question. If you would like to receive notifications about future DBSA surveys, please click on the link at the end of the survey. Thank you for your participation!

 
  Demographic Information
 
Question - Not Required - Please select one:


 
Question - Not Required - Gender:


   


 
Question - Not Required - Veteran:


 
Question - Not Required - Primary Diagnosis:




   


 

Question 1: Living with mood disorders

Please indicate how much you agree or disagree with each of the following statements:
 
Question - Not Required - I have come to terms with living with my mental illness.




 
Question - Not Required - It is a struggle to manage my illness.




 
Question - Not Required - I feel confident that I will manage my illness well throughout my life.




 
Question - Not Required - I worry that my medications will stop working.




 
Question - Not Required - I am angry that I have a mental illness.




 
Question - Not Required - I feel ashamed/embarrassed because of my illness.




 
Question - Not Required - I believe that I will have a mental illness the rest of my life.




 

Question 2: The impact of your illness on your family and lifestyle

Please rate the overall impact of your illness on your family and lifestyle by indicating how much you agree or disagree with each of the following statements:
 
Question - Not Required - My relationship with my family is good.




 
Question - Not Required - Most of my family members do not believe that my illness has had permanent damaging effects on our relationships.




 
Question - Not Required - I have difficulty maintaining long- term intimate relationships (including marriage) due to my illness.




 
Question - Not Required - Most of my friends/family know about my illness.




 
Question - Not Required - Most of my friends/family have a good understanding of what it means to have a mental illness.




 
Question - Not Required - I have difficulty maintaining long- term friendships due to my illness.




 
Question - Not Required - My illness has had a negative effect on my relationship with my children.




 
Question - Not Required - In general, my illness has decreased my family's expectations for my success.




 
Question - Not Required - I am able to work or go to school on a regular basis.




 
Question - Not Required - I am able to talk to my employer about my mental illness.




  Question 3: Your treatment

Please indicate how much you agree or disagree with each of the following statements about your treatment:
 
Question - Not Required - I have worked closely with my provider to develop the goals for my treatment.




 
Question - Not Required - My treatment plan includes goals for both my mental and physical health.




 
Question - Not Required - I am confident that my clinician is knowledgeable about my illness.




 
Question - Not Required - I am confident that my clinician can help me with my problems.




 
Question - Not Required - My family has always been involved in my treatment.




 
Question - Not Required - I am able to get as much treatment as I need.




 

Thank you for helping us make the voice of the consumer community heard. If you would like to share this survey with a friend, please click here.

 
 
Question - Not Required - Opt-in to the mailing list to receive the results of this survey and participate in additional surveys.


  If you would like to stay in touch with DBSA, please include your email address.

 

 

 

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