Primary Care Mental Health Liaison Service Questionnaire

From Autumn 2014, Bristol will have new mental health services. The new mental health services have been designed with Service Users and Carers. So that we can tell if the new mental health services are better, we need to know your view on the services you use now.

Your views are very important to us. We don’t need your name or any personal details, just your views and opinions. All of the information that you provide will be kept confidential and will not affect any service you are currently receiving.

What is the Primary Care Mental Health Liaison Service?

The Primary Care Mental Health Liaison Service operates alongside family doctors; the staff are mental health practitioners who decide if someone will benefit from short-term involvement with their team.

The staff delivers patient assessment as well as managing referrals. They operate alongside GPs and other primary care staff to plan treatment and care. The service offers:

  • Advice on books, leaflets and websites which are known to help
  • Referral to other groups, as appropriate, or access to other mental health teams
  • Advice and support to primary care professionals.

For more information please see

Question 1: Are you a patient/service user or carer?

Patient/Service User
Carer

If you are not a patient/service user or carer, what other role do you describe yourself?

Other, please describe

Question 2: How would you rate your satisfaction of the Primary Care Mental Health Liaison Service?

Criteria / Not applicable / Very dissatisfied / Dissatisfied / Neither satisfied or dissatisfied / Satisfied / Very satisfied
How satisfied were you with the time you waited to be seen by this service?
How satisfied were you with the assessment you received from this service?
How satisfied were you with the care and support you received from this service?
How satisfied were you with the staff who you met during your time with this service?
How satisfied were you with the information you received from this service?

Question 3: What would have improved your experience of this service?

______

Question 4: How would you rate your overall satisfaction with the Primary Care Mental Health Liaison service?

Criteria / Not applicable / Very dissatisfied / Dissatisfied / Neither satisfied or dissatisfied / Satisfied / Very satisfied
Waiting times
Accessibility
Assessment
Quality of Information
Level of support
Quality and attitudes of staff
Individual Recovery focus
Other, please describe

Question 5: Does the stigma and discrimination about mental health stop you doing the things you want to do?

Yes
No

Question 6: As a patient/service user, do you feel you have been treated differently due to your mental health problems by the service supporting you?

Yes
No

Question 7: As a carer, do you feel the person you care for has been treated differently due to their mental health problems by the service supporting them?

Yes
No

Question 8: What would you like to see change in the Primary Care Mental Health Liaison service?

______

Question 9: What three things do you would think would most help people who use mental health services in Bristol?

______

Question 10: Do you have any other comments that you think would be helpful for us to know?

Please use this space to comment.

You may wish to:

  • Comment about the quality of mental health services
  • Share your experiences of the services
  • Share your experiences of being treated differently and how this affected you
  • Share the experiences of the person you care for of being treated differently and how this affected them
  • Share your experience of stigma and discrimination and how it affects you
  • Comment on anything else you think would be useful

______

______

______

Thank you very much for taking the time to complete this questionnaire. Your views and opinions will be of value to us.

If you would like to be involved in giving up your views of future mental health services, please fill in your details below:

Name:______

Address:______

______

______

Postcode: ______

Email Address: ______

Once you have filled the survey in, please post to: FAO Sandra Beal, Modernising Mental Health Programme, Bristol CCG, 5th Floor, South Plaza, Marlborough Street, Bristol, BS1 3NX

Equality Monitoring Form

The NHS is committed to promoting Equality of Opportunity, eliminating discrimination and tackling Health Inequalities. Filling out this form is voluntary and would help us to analyse the responses we receive.

Further information on the NHS’ commitment to promoting Equality of Opportunity is at the bottom of this form.

Question 1: Choose one option that best describes your gender identity:

Female
Male
I’d prefer not to say

Question 2: Is your gender identity the same as the gender you were originally assigned to at birth?

Yes
No
I’d prefer not to say

Question 3: Choose one option that best describes your age:

16 – 24
25 – 34
35 – 44
45 – 54
55 – 64
65+
I’d prefer not to say

Question 4: Choose one option that best describes your ethnic group or background

Asian or Asian British:
Indian
Pakistani
Bangladeshi
Chinese
Other Asian, including:
  • East African Asian
  • Vietnamese

Black, African, Caribbean or Black British:
African, including:
  • Somali

Caribbean
Other Black
Mixed/Multiple ethnic group:
White and Black Caribbean
White and Black African
White and Asian
Other Mixed/Multiple ethnic background
Other ethnic group:
Arab
Other ethnic group
White:
English / Welsh / Scottish / Northern Irish / British
Irish
Other White, including:
  • Gypsy or Irish Traveller
  • Roma
  • East European
  • Australian
  • White American

I’d prefer not to say

Questions 5: Choose one option that best describes your religion:

Christian (including Church of England, Catholic, Protestant and all other Christian denominations)
Buddhist
Hindu
Jewish
Muslim
Sikh
Other religion or belief, including:
  • Pagan

Atheist
No religion or belief
I’d prefer not to say

Question 6: Choose one option that best describes your sexual orientation:

Bisexual
Gay
Heterosexual
Lesbian
I’d prefer not to say

Question 7: Do you have a disability? (A disabled person is defined in the Disability Discrimination Act as some with a physical or mental impairment that has a substantial and long term impact on their ability to carry out day-to-day activities)

Yes
No
I’d prefer not to say

Question 8: If you have answered yes to question 7 of the equality monitoring form, please choose one option that best describes your disability:

Physical impairment
Sensory impairment
Learning disability/difficulty
Mental ill health
Long standing illness/long term condition
I’d prefer not to say

Equal Opportunities Statement

The NHS is committed to promoting Equality of Opportunity, eliminating discrimination and tackling Health Inequalities. We want to do this because it makes absolute sense to us. It enables us to provide high quality health care in accordance with the needs of our communities, improves access to our services, and assists us in fulfilling our legal obligations under the Public Sector Equality Duty & the Equality Act 2010"

We hope you will understand why we are seeking this information. However, please be assured that the completion of this part of the survey is voluntary. We would like to thank you for your cooperation in gathering this information, which will help us to ensure the effective monitoring of our equal opportunities policy. It would help us to analyse the responses we receive if you completed the following equality monitoring details.

Once you have filled the survey in, please post to: FAO Sandra Beal, Modernising Mental Health Programme, Bristol CCG, 5th Floor, South Plaza, Marlborough Street, Bristol, BS1 3NX