Item # | Screening, Pre, or Post | Item | Response options | Note |
0 | Screening | Are you the person whose name was included in the email invitation for this survey? | If users select YES, they will proceed. If users select NO, the survey will be terminated. | |
1 | Screening | Do you currently or have you previously served in the United States military? | 1) No; 2) Yes, I am currently on full-time active duty. (Active duty includes serving in the United States Armed Forces as well as activation from the National Guard or Reserve.); 3) Yes, I am in the National Guard or Reserve but am not activated.; 4) Yes, I have previously served in the United States military or am a veteran. | |
2 | Screening | (If respond 2 to Q2) Are you currently an active duty service member or an activated member of the National Guard or Reserve? | 1) Active duty service member; 2)Activated National Guard or Reserve member | |
3 | Screening | (If respond 4 to Q2) Please indicate your current military status. | 1) Retired (medical); 2) Retired (non-medical); 3) Separated or discharged | |
3a | Screening | (If respond 4 to Q1) Please indicate the eras in which you served. | 1) OEF/OIF/OND (2001 - present); 2) Desert (1990 - 2000); 3) Post-Vietnam War (1976-1989); 4) Vietnam War (1960-1975); 5) Post-Korean War (1954-1959); 6) WWII through Korean War (1941-1953) | |
3b | Screening | (If respond 3 to Q3) What is your discharge status? | 1) honorable discharge; 2) general discharge (under honorable conditions; 3) other than honorable discharge; 4) entry-level separation; 5) bad conduct discharge; 6) dismissal; 7) dishonorable discharge | |
4 | Screening | In what branch of service are you or have you served? (If you have served in more than one branch, please select the one you served in for the longest period of time.) | 1) Air Force 2) Army 3) Coast Guard 4) Marine Corps 5) Navy | |
5 | Screening | What was [is] your highest military pay grade? (only if in service member or veteran conditions) | E1-E4, E5-E8, W1-W5, O1-O3, O4 and above | |
6 | Screening | Do you have an immediate family member who is currently serving in the United States military? Immediate family members include spouse, domestic partner, cohabitant, child, stepchild, grandchild, parent, stepparent, mother-in-law, father-in-law, son-in-law, daughter-in-law, grandparent, great grandparent, brother, sister, half-brother, half-sister, stepsibling, brother-in-law, sister-in-law, aunt, uncle, niece, nephew, or first cousin (that is, a child of an aunt or uncle). | 1) No 2) Yes | |
6a | Screening | Do you have an immediate family member who previously served in the United States military or is a veteran? Immediate family members include spouse, domestic partner, cohabitant, child, stepchild, grandchild, parent, stepparent, mother-in-law, father-in-law, son-in-law, daughter-in-law, grandparent, great grandparent, brother, sister, half-brother, half-sister, stepsibling, brother-in-law, sister-in-law, aunt, uncle, niece, nephew, or first cousin (that is, a child of an aunt or uncle). | 1) No 2) Yes | |
7a | Screening | Are you close friends with someone who previously served in the U.S. military (active duty, National Guard, or Reserve) or is a veteran? A close friend is someone with whom one can really communicate and confide about feelings and personal problems. |
1) No 2) Yes | |
7b | Screening | Have you used health care provided by the Veterans Health Administration (VA)?. | 1) No 2) Yes | |
7c | Screening | (If respond 2 to Q7a) When was the last time you received health care provided by the Veterans Health Administration (VA)? | 1) In the past 6 months; 2)6 months to 1 year ago; 3) More than one year ago | |
8 | Pre & Post | Thinking about the average person with a mental health problem, how willing or unwilling would you be to do the following? Move next door to someone who has a mental health problem | Definitely unwilling, probably un willing, probably willing, definitely willing | |
8a | Pre & Post | Spend an evening socializing with someone who has a mental health problem | Definitely unwilling, probably un willing, probably willing, definitely willing | |
8b | Pre & Post | Start working closely on a job with someone who has a mental health problem | Definitely unwilling, probably un willing, probably willing, definitely willing | |
9 | Pre & Post | In general, would you say that your physical health is… | Excellent, very good, good, fair, or poor | |
10 | Pre & Post | In general, would you say that your mental health is… | Excellent, very good, good, fair, or poor | |
10a | Pre & Post | In general, would you say that your overall health is… | Excellent, very good, good, fair, or poor | |
11 | Pre & Post | In general, do you think it would damage a person's military career if the person were to seek counseling or mental health treatment through the military, regardless of the reason for seeking help? | No, Yes | |
12 | Pre & Post | A person with a mental health condition is a danger to others | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
13 | Pre & Post | People who have had a mental health condition are never going to be able to contribute much to society. | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
14 | Pre & Post | Imagine that you had a problem that needed to be treated by a mental health professional. Which of the following would you do? Would go for professional help for a serious emotional problem |
Definitely not go, Probably not go, Probably go, Definitely go | |
15 | Pre & Post | Would put off seeking treatment for fear of letting others know about your mental health problem | Definitely would not, Probably would not, Probable would, Definitely would | |
16 | Pre & Post | Would delay seeking treatment for fear of being told that you have a serious mental health problem | Definitely would not, Probably would not, Probable would, Definitely would | |
17 | Pre & Post | Would try to hide your mental health problem from family or friends | Definitely would not, Probably would not, Probable would, Definitely would | |
18 | Pre & Post | Would try to hide your mental health problem from co-workers or classmates | Definitely would not, Probably would not, Probable would, Definitely would | |
19 | Pre & Post | I know how I could be supportive of people with a mental health problem | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
20 | Pre & Post | I plan to take action to prevent discrimination against people with mental health problems | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
20a | Pre & Post | I am confident that I could seek help for a mental health concern if I had one. | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
21 | Pre & Post | If I believed I was having a mental health problem or crisis, my first inclination would be to get professional attention. | Agree, partly agree, partly disagree, disagree | |
22 | Pre & Post | The idea of talking about problems with a psychologist strikes me as a poor way to get rid of emotional conflicts. | Agree, partly agree, partly disagree, disagree | |
23 | Pre & Post | If I were experiencing a serious emotional crisis at this point in my life, I would be confident that I could find relief in psychotherapy (such as counseling). | Agree, partly agree, partly disagree, disagree | |
24 | Pre & Post | There is something admirable in the attitude of a person who is willing to cope with his or her conflicts and fears without resorting to professional help. | Agree, partly agree, partly disagree, disagree | |
25 | Pre & Post | I would want to get psychological help if I were worried or upset for a long period of time. | Agree, partly agree, partly disagree, disagree | |
26 | Pre & Post | I want to have psychological counseling in the future. | Agree, partly agree, partly disagree, disagree | |
27 | Pre & Post | A person with an emotional problem is not likely to solve it alone; he or she is likely to solve it with professional help. | Agree, partly agree, partly disagree, disagree | |
28 | Pre & Post | Considering the time and expense involved in psychotherapy (such as counseling), it would have doubtful value for a person like me. | Agree, partly agree, partly disagree, disagree | |
29 | Pre & Post | A person should work out his or her own problems; getting psychological counseling would be a last resort. | Agree, partly agree, partly disagree, disagree | |
30 | Pre & Post | Personal and emotional troubles, like many things, tend to work out by themselves. | Agree, partly agree, partly disagree, disagree | |
31 | Pre & Post | If you [a friend or family member that is in the military or is a veteran] wanted help for an emotional problem, which of the following would make it difficult?” a. Family or friends would be more helpful than a mental health professional. | Yes/No | |
32 | Pre & Post | It could harm [my/my friend or family member's] career. | Yes/No | |
33 | Pre & Post | My [friend or family member's] co-workers would have less confidence in me [him/her] if they found out. | Yes/No | |
34 | Pre & Post | My [friend or family' members] commander or supervisor might respect me [him/her] less. | Yes/No | |
35 | Pre & Post | [My/My friend or family member's] treatment would be kept confidential. | Yes/No | |
36 | Pre & Post | [I/My friend or family member] would not know where to get help or whom to see. | Yes/No | |
37 | Pre & Post | Even good mental health care is not very effective. | Yes/No | |
38 | Pre & Post | Religious counseling would be more helpful than mental health treatment. | Yes/No | |
38a | Pre & Post | If you were having a personal or emotional problem, how likely is it that you would seek help from the following people? Intimate partner (e.g., girlfriend, boyfriend, husband, wife, domestic partner) | Extremely unlikely, unlikely, likely, extremely likely | |
38b | Pre & Post | Friend (not related to you) | Extremely unlikely, unlikely, likely, extremely likely | |
38c | Pre & Post | Parent | Extremely unlikely, unlikely, likely, extremely likely | |
38d | Pre & Post | Other relative/family member | Extremely unlikely, unlikely, likely, extremely likely | |
38e | Pre & Post | Mental health professional (e.g., psychiatrist, psychologist, social worker, counselor, etc.) | Extremely unlikely, unlikely, likely, extremely likely | |
38f | Pre & Post | Phone helpline (e.g., National Suicide Prevention Lifeline, Veterans Crisis Line) | Extremely unlikely, unlikely, likely, extremely likely | |
38g | Pre & Post | Doctor/primary care physician | Extremely unlikely, unlikely, likely, extremely likely | |
38h | Pre & Post | Minister or religious leader (e.g., priest, rabbi, chaplain) | Extremely unlikely, unlikely, likely, extremely likely | |
38i | Pre & Post | I would not seek help from anyone. | Extremely unlikely, unlikely, likely, extremely likely | |
38j | Pre & Post | I would seek help from another source not listed above. | Extremely unlikely, unlikely, likely, extremely likely | |
38k | Pre & Post | (if respond likely or unlikely) What source? | Open-ended | |
39 | Pre & Post | Thinking about the average person with human immunodeficiency virus (HIV), how willing or unwilling would you be to do the following? Move next door to someone who is diagnosed as HIV positive. | Definitely unwilling, probably un willing, probably willing, definitely willing | |
40 | Pre & Post | Spend an evening socializing with someone who is diagnosed as HIV positive | Definitely unwilling, probably un willing, probably willing, definitely willing | |
41 | Pre & Post | Start working closely on a job with someone who is diagnosed as HIV positive | Definitely unwilling, probably un willing, probably willing, definitely willing | |
42 | Pre & Post | Would go for professional help if you thought you might be HIV positive. | Definitely not go, Probably not go, Probably go, Definitely go | |
43 | Pre & Post | Would put off getting tested for HIV for fear of letting others know. | Definitely would not, Probably would not, Probable would, Definitely would | |
44 | Pre & Post | Would delay getting tested for HIV for fear of being told that you have HIV . | Definitely would not, Probably would not, Probable would, Definitely would | |
45 | Pre & Post | A person diagnosed as HIV positive is a danger to others. | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
46 | Pre & Post | People diagnosed as HIV positive are never going to be able to contribute much to society. | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
47 | Pre & Post | Would try to hide your positive HIV status from family or friends | Definitely would not, Probably would not, Probable would, Definitely would | |
48 | Pre & Post | Would try to hide your positive HIV status from co-workers or classmates | Definitely would not, Probably would not, Probable would, Definitely would | |
49 | Pre & Post | I know how I could be supportive of people diagnosed as HIV positive if I wanted to be . | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
50 | Pre & Post | I plan to take action to prevent discrimination against people diagnosed as HIV positive. | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
51 | Pre & Post | During the past 12 months, was there any time when you needed mental health treatment or counseling for yourself but didn't get it? | No, Yes | |
52 | Pre & Post | During the past 12 months, was there any time when you needed treatment or counseling for yourself for drug or alcohol use (not counting cigarettes) but didn’t get it? | No, Yes | |
53 | Pre & Post | I feel confident that I can... Recognize the signs that someone may be dealing with a mental health problem or crisis. | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
54 | Pre & Post | Reach out to someone who may be dealing with a mental health problem or crisis. | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
55 | Pre & Post | Ask a person whether he/she is considering taking his/her life. | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
56 | Pre & Post | Actively and compassionately listen to someone in distress. | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
57 | Pre & Post | Offer a distressed person basic information and reassurance about mental health problems | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
58 | Pre & Post | Assist a person who may be dealing with a mental health problem or crisis to seek professional help. | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
59 | Pre & Post | Assist a person who may be dealing with a mental health problem or crisis to connect with community, peer, and personal supports. | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
60 | Pre & Post | Be aware of my own views and feelings about mental health problems and disorders. | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
61 | Pre & Post | Recognize and correct misconceptions about mental health problems as I encounter them. | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
Pre & Post | If you are in crisis or know someone who is, confidential support can be found at: National Suicide Prevention Lifeline Phone Number: 1-800-273-8255 (TALK) Website: https://suicidepreventionlifeline.org/ Military and Veterans Crisis Line Phone Number: 1-800-273-8255 (Press 1) Website: https://www.veteranscrisisline.net/ Additional resources can be found here: MentalHealth.gov: https://www.mentalhealth.gov/ Military OneSource: http://www.militaryonesource.mil/mental-health-resources More information on the campaigns referenced in this survey can be found here: Real Warriors: www.realwarriors.net Make the Connection: www.maketheconnection.net National Recovery Month: www.samhsa.gov |
No response necessary | ||
62 | Post | These campaign materials are worth remembering | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
63 | Post | These campaign materials grabbed my attention | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
64 | Post | These campaign materials were powerful | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
65 | Post | These campaign materials were informative | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
66 | Post | These campaign materials were meaningful | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
67 | Post | These campaign materials were convincing | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
67a | Post | If a family member or friend were dealing with an emotional or personal problem, I would share these campaign materials with them. | Strongly disagree, Moderately disagree, Neither agree nor disagree, moderately agree, strongly agree | |
67b | Post | Prior to participating in this study, have you seen, read, or heard any messages or advertising for getting service members or veterans help for mental health problems? | Yes, No | |
67c | Post | [If yes to Q67a] What were the names of the campaign or campaigns that you have heard? | Open-ended | |
68 | Post | Prior to participating in this study, had you ever seen, read, or heard anything about [CAMPAIGN NAME]? | Not at all; Once; 2 to 4 times; 5 to 10 times; More than 10 times; Don't know | |
69 | Post | In recent months, how many times have you ever seen, read, or heard any of the [CAMPAIGN NAME] materials you viewed today? | Not at all; Once; 2 to 4 times; 5 to 10 times; More than 10 times | |
69a | Post | How likely are you to seek more information about mental health? | Extremely unlikely, unlikely, likely, extremely likely | |
70 | Post | Have you ever had a mental health problem? | No, Yes | |
70a | Post | Have you ever had a substance use problem? | No, Yes | |
71 | Post | (If yes to 70), have you ever sought treatment for a mental health problem? | No, Yes | |
71a | Post | (If yes to 70a), have you ever sought treatment or counseling for your use of alcohol or any drug, not counting cigarettes? | No, Yes | |
72 | Post | Do you have a family member who has or has had a mental health problem? | No, Yes | |
72a | Post | Do you have a family member who has gotten treatment or counseling for his or her use of alcohol or any drug, not counting cigarettes? | No, Yes | |
73 | Post | During the past 30 days, how often did you feel: nervous | None of the time, a little of the time, some of the time, most of the time, all of the time | |
74 | Post | Hopeless | None of the time, a little of the time, some of the time, most of the time, all of the time | |
75 | Post | Restless or fidgety | None of the time, a little of the time, some of the time, most of the time, all of the time | |
76 | Post | So depressed that nothing could cheer you up | None of the time, a little of the time, some of the time, most of the time, all of the time | |
77 | Post | That everything was an effort | None of the time, a little of the time, some of the time, most of the time, all of the time | |
78 | Post | Worthless | None of the time, a little of the time, some of the time, most of the time, all of the time | |
79 | Post | The last six questions asked about feelings that might have occurred during the past 30 days. Taking them altogether, did these feelings occur… | Less often than usual, about the the same as usual, more often in the past 30 days than is usual for you | |
80 | Post | The next few questions are about how these feelings may have affected you in the past 30 days. You need not answer any questions if you answered "none of the time" to all six questions about your feelings. During the past 30 days, how many days out of 30 were you totally unable to work or carry out your normal activities because of these feelings? | Open-ended | |
81 | Post | Not counting the days you reported in response to the previous question, how many days in the past 30 were you able to do only half or less of what you would normally have been able to do, because of these feelings? | Open-ended | |
82 | Post | During the past 30 days, how many times did you see a doctor or other health professional about these feelings? | Open-ended | |
83 | Post | During the past 30 days, how often have physical health problems been the main cause of these feelings? | None of the time, a little of the time, some of the time, most of the time, all of the time | |
84 | Post | If you have additional thoughts on the materials you viewed or the survey, please write them in the box below. | Open-ended |
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File Modified | 0000-00-00 |
File Created | 0000-00-00 |