Mental Health Carer's Survey

The role of the Mental Health carer is often complex and includes support for more than one medical condition. This survey provides an opportunity to profile the support and roles of the carer.

Your profile - this section helps us to understand the role you undertake

Q1.

Are you:

Q3.

Do you live with the person you care for?

Q3.

What age group you fit into?

Q4.

How long have you been in the caring role?

Q5.

How regularly do you provide support for the caring role?

Q6.

Has the carer role had an impact on any of these areas?

Yes

No

Q6.1.

Less time for yourself

Q6.2.

Stopped paid work

Q6.3.

Reduced personal time

Q6.4.

More stress

Q6.5.

Suffer from depression

Q6.6.

See less of my friends

Q6.7.

Less social life

Q6.8.

More financial constraints

Q6.9.

Change in role

Q7.

How many people do you care for?

Q8.

What tasks do you carry out as a carer?

Yes

No

Q8.1.

Personal care e.g. washing

Q8.2.

Accompany appointments

Q8.3.

Phone calls and mail

Q8.4.

Domestic tasks

Q8.5.

Shopping

Q8.6.

Finance

Q8.7.

Holidays

Q8.8.

Company

Q9.

What other commitments do you have?

Yes

No

Q9.1.

Children

Q9.2.

Working full time

Q9.3.

Caring for others

Q9.4.

Working part time

Q9.5.

Studying

Q9.6.

Voluntary work

Q9.7.

Self-employed

Time away from your caring role

Q10.

Are you aware that you are entitled to an assessment of your own needs as a carer?

Q11.

Do you have any breaks away from your caring role?

Q12.

Did you know that after assessment, you may be entitled to financial help?

Q13.

Would it be useful to have a contact number where emergency care could be arranged?

Q14.

Do you believe you have been given enough information about the services that are available to you?

Q15.

Do you know how to access the support worker service?

Q16.

Have you have had any of these types of contact from you carer worker?

Yes

No

Q16.1.

Telephone

Q16.2.

Visit from home

Q16.3.

Interview away from home

Q16.4.

Attendance at carer's group

Q17.

What are the barriers to you attending a carers group?

Yes

No

Q17.1.

Transport

Q17.2.

Nobody to care for the person I look after

Q17.3.

Venue and location are unsuitable

Q17.4.

Time of group meetings

Q17.5.

Group does not meet my needs

Q17.6.

Group is already established

Q17.7.

Own health issues

Q17.8.

Other people to care for

Q18.

Overall, what do you think of the services you receive?

Created by KeyPoint survey software