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MC PEI Outreach Training Survey

Provider

Please answer the questions below about the services you received from this program. Your honest answers will help make the program better. You may skip any questions you do not want to answer or that do not apply to you. All of your answers will be kept private. Your answers will not affect the services you receive. Do not write your name on this survey. Thank you!

INSTRUCTIONS: When responding to question 1, please reflect back to how you felt BEFORE attending this training/class.

1. Before attending this training/class:

Space Cell	Yes	No	I don't know
I knew where to go for mental health services near me.	I knew where to go for mental health services near me.: Yes	I knew where to go for mental health services near me.: No	I knew where to go for mental health services near me.: I don't know
I knew a lot about the topic of this training/class.	I knew a lot about the topic of this training/class. : Yes	I knew a lot about the topic of this training/class. : No	I knew a lot about the topic of this training/class. : I don't know
I was able to recognize early signs of mental illness.	I was able to recognize early signs of mental illness.: Yes	I was able to recognize early signs of mental illness.: No	I was able to recognize early signs of mental illness.: I don't know
I felt able to respond effectively to early signs of mental illness.	I felt able to respond effectively to early signs of mental illness.: Yes	I felt able to respond effectively to early signs of mental illness.: No	I felt able to respond effectively to early signs of mental illness.: I don't know
I was likely to assist someone with a mental illness who needed help.	I was likely to assist someone with a mental illness who needed help.: Yes	I was likely to assist someone with a mental illness who needed help.: No	I was likely to assist someone with a mental illness who needed help.: I don't know

INSTRUCTIONS: When responding to question 2, think about how you feel now, AFTER the training/class.

2. Now that I have attended this training/class:

Space Cell	Yes	No	I don't know
I know where to go for mental health services near me.	I know where to go for mental health services near me.: Yes	I know where to go for mental health services near me.: No	I know where to go for mental health services near me.: I don't know
I know a lot about the topic of this training/class.	I know a lot about the topic of this training/class. : Yes	I know a lot about the topic of this training/class. : No	I know a lot about the topic of this training/class. : I don't know
I feel able to recognize early signs of mental illness.	I feel able to recognize early signs of mental illness.: Yes	I feel able to recognize early signs of mental illness.: No	I feel able to recognize early signs of mental illness.: I don't know
I feel able to respond effectively to early signs of mental illness.	I feel able to respond effectively to early signs of mental illness.: Yes	I feel able to respond effectively to early signs of mental illness.: No	I feel able to respond effectively to early signs of mental illness.: I don't know
I am likely to assist someone with a mental illness who needed help.	I am likely to assist someone with a mental illness who needed help.: Yes	I am likely to assist someone with a mental illness who needed help.: No	I am likely to assist someone with a mental illness who needed help.: I don't know

INSTRUCTIONS: When responding to question 3, think about your experience at the training/class.

3. Please choose the box that matches how much you disagree or agree with each sentence below:

Space Cell	Strongly Disagree	Disagree	Agree	Strongly Agree
Staff respected my culture and background (such as my ethnicity, beliefs, identity, etc.).	Staff respected my culture and background (such as my ethnicity, beliefs, identity, etc.).: Strongly Disagree	Staff respected my culture and background (such as my ethnicity, beliefs, identity, etc.).: Disagree	Staff respected my culture and background (such as my ethnicity, beliefs, identity, etc.).: Agree	Staff respected my culture and background (such as my ethnicity, beliefs, identity, etc.).: Strongly Agree
The program had services in the language that I speak best.	The program had services in the language that I speak best.: Strongly Disagree	The program had services in the language that I speak best.: Disagree	The program had services in the language that I speak best.: Agree	The program had services in the language that I speak best.: Strongly Agree
Materials provided were useful.	Materials provided were useful.: Strongly Disagree	Materials provided were useful.: Disagree	Materials provided were useful.: Agree	Materials provided were useful.: Strongly Agree
The training/course was practical and useful.	The training/course was practical and useful.: Strongly Disagree	The training/course was practical and useful.: Disagree	The training/course was practical and useful.: Agree	The training/course was practical and useful.: Strongly Agree
I would recommend this training/course to others.	I would recommend this training/course to others.: Strongly Disagree	I would recommend this training/course to others.: Disagree	I would recommend this training/course to others.: Agree	I would recommend this training/course to others.: Strongly Agree