Information Collection Request

2014-16 National Mental Health Services Survey (N-MHSS)

ICR 201311-0930-002 · OMB 0930-0119 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 2014 N-MHSS (Full- Facilities Universe in 2014 and 2016 Form and Instruction Modified Repair queued
Form 2015 N-MHSS-Locato Locator Survey 2015 Form and Instruction New Repair queued
Form 2015 N-MHSS-Locato New Facilities 2014-16 Form and Instruction Modified Available
2014 N-MHSS_OMB SS-B_112513.docx Supporting Statement B Uploaded 2013-11-25 Available
Attachment A12 - List of Expert Panel Members_Nov 2011.docx Supplementary Document Uploaded 2013-11-25 Repair queued
Attachment A11 - 2014 N-MHSS Online Information Site Materials_Page 1.docx Supplementary Document Uploaded 2013-11-25 Available
Attachment A11 - 2014 N-MHSS Online Information Site Materials_FAQs.docx Supplementary Document Uploaded 2013-11-25 Available
Attachment A10 - 2014 N-MHSS Thank You Notification for Completed Surveys.docx Supplementary Document Uploaded 2013-11-25 Repair queued
Attachment A9 - 2014 N-MHSS Cover Letter (Second Mailing) and Online Questionnaire Access Instructions_Pg 2.docx Supplementary Document Uploaded 2013-11-25 Repair queued
Attachment A9 - 2014 N-MHSS Cover Letter (Second Mailing) and Online Questionnaire Access Instructions_Pg 1.docx Supplementary Document Uploaded 2013-11-25 Available
Attachment A8 - 2014 N-MHSS Second Thank You-Reminder Letter.docx Supplementary Document Uploaded 2013-11-25 Repair queued
Attachment A7 - 2014 N-MHSS First Thank You-Reminder Letter.docx Supplementary Document Uploaded 2013-11-25 Repair queued
Attachment A6 - 2014 N-MHSS Cover Letter (First Mailing) and Online Questionnaire Access Instructions_Pg 2.docx Supplementary Document Uploaded 2013-11-25 Repair queued
Attachment A6 - 2014 N-MHSS Cover Letter (First Mailing) and Online Questionnaire Access Instructions_Pg 1.doc Supplementary Document Uploaded 2013-11-25 Available
Attachment A5 - 2014 N-MHSS Advance Letter.docx Supplementary Document Uploaded 2013-11-25 Available
Attachment A3 - 2014 N-MHSS Web Screens for Online Questionnaire.docx Supplementary Document Uploaded 2013-11-25 Available
Attachment A4 - 2014 N-MHSS CATI Questionnaire.docx Supplementary Document Uploaded 2013-11-25 Available
2014 N-MHSS_OMB SS-A_112513.docx Supporting Statement A Uploaded 2013-11-25 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
7528 Facilities Universe in 2014 and 2016 Form and Instruction Modified
209518 Locator Survey 2015 Form and Instruction New
202152 New Facilities 2014-16 Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2017 36 Months From Approved 06/30/2015
20,400 0 16,500
20,604 0 6,930
0 0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Facilities Universe in 2014 and 2016 2014 N-MHSS (Full-Scale) Paper Questionnaire 2014 N-MHSS (Full-Scale) Paper Questionnaire
New Facilities 2014-16 2015 N-MHSS-Locator Survey Paper Questionnaire 2015 N-MHSS-Locator Survey Paper Questionnaire
Locator Survey 2015 2015 N-MHSS-Locator Survey Paper Questionnaire 2015 N-MHSS-Locator Survey Paper Questionnaire

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 20,400 16,500 0 3,900 0 0
Annual Time Burden (Hours) 20,604 6,930 0 13,674 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No