City Voices Survey
If
you are a consumer of mental health services, then please answer this survey.
It is anonymous. Please fill it out and mail it to City Voices, Inc., PO Box 310368,
Brooklyn, NY 11231. We believe that the results of this survey will help the mental
health establishment better serve mental health consumers. Thank you.
Definition of Quality of Care: the responsiveness of mental health care providers such as psychiatrists, social workers, nurses or others to your individual needs as a consumer, patient or client of mental health care services.
1. Are you happy overall with the quality of care you have received from your mental health providers? (Circle one)yes no not sure
2. What concerns have you had in the past six months with the
quality of care you received from your care providers (Check all that apply):
___rude treatment
___unresponsiveness to questions
___misdiagnosis
___medication that did more harm than good
___other (please explain) ___________________________________________
___no concerns
3. Do you always voice your concerns with the quality of care provided to you? (Circle one)
yes no
4. Have problems with the quality of care you received ever caused you to change your care provider or care facility? (Circle one)
yes no