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(FTNYS Survey) - Service Recipient Voice in Outcomes: What Should Be Measured?

FTNYS Survey

Service Recipient Voice in Outcomes: What Should Be Measured?

Thank you for taking the time participate in this brief survey! The goal of this survey is to better understand how to define outcomes for family support services by asking people who have participated in services, family peer advocates or peer providers, service providers, and others for their perspectives. All responses are confidential and anonymous, and you are free to skip any questions that you do not wish to answer. By completing this survey, you are providing permission for CCSI to use your responses in aggregated (i.e., summarized/averaged), de-identified data analysis. Results of the analysis may be published only if the identity of the individuals who completed the survey remains confidential.

If you have any questions please feel free to contact Briannon O’Connor, PhD (Boconnor@ccsi.org); Joslyn Teter, MSW (Jteter@ccsi.org); or Brian Smith, MSW (Bsmith@ccsi.org).

1. Which describes you best? (*If multiple roles apply to you, please choose the one role that you currently identify with or best describes you)

Please enter an 'other' value for this selection.

2. Have you or a family member ever been a participant in services?

If you answered YES to the above question, are you completing the following set of question as a participant of services or as a family member/caregiver?

3. How long have you or a family member been participating in services?

4. In the last 6 months which services have you/your family member participated in? (Check all that apply)

5. Which services have you/your family member participated in your/their lifetime? (Check all that apply)

6. For the following statements, please rate each according to how true you find each statement to your/your family member's recovery.

Space Cell	Not at All True	Slightly True	Somewhat True	Moderately True	Very Much So True
Engaging socially with others is important to me/my family member	Engaging socially with others is important to me/my family member: Not at All True	Engaging socially with others is important to me/my family member: Slightly True	Engaging socially with others is important to me/my family member: Somewhat True	Engaging socially with others is important to me/my family member: Moderately True	Engaging socially with others is important to me/my family member: Very Much So True
Participating in meaningful activities (volunteering, school, work etc.,) is important to me/my family member	Participating in meaningful activities (volunteering, school, work etc.,) is important to me/my family member: Not at All True	Participating in meaningful activities (volunteering, school, work etc.,) is important to me/my family member: Slightly True	Participating in meaningful activities (volunteering, school, work etc.,) is important to me/my family member: Somewhat True	Participating in meaningful activities (volunteering, school, work etc.,) is important to me/my family member: Moderately True	Participating in meaningful activities (volunteering, school, work etc.,) is important to me/my family member: Very Much So True
Feeling a part of a community is important to me/my family member	Feeling a part of a community is important to me/my family member: Not at All True	Feeling a part of a community is important to me/my family member: Slightly True	Feeling a part of a community is important to me/my family member: Somewhat True	Feeling a part of a community is important to me/my family member: Moderately True	Feeling a part of a community is important to me/my family member: Very Much So True
Developing and/or increasing coping skills is important to me/my family member	Developing and/or increasing coping skills is important to me/my family member: Not at All True	Developing and/or increasing coping skills is important to me/my family member: Slightly True	Developing and/or increasing coping skills is important to me/my family member: Somewhat True	Developing and/or increasing coping skills is important to me/my family member: Moderately True	Developing and/or increasing coping skills is important to me/my family member: Very Much So True
Peer and recovery services help me/my family member reduce or eliminate medications	Peer and recovery services help me/my family member reduce or eliminate medications: Not at All True	Peer and recovery services help me/my family member reduce or eliminate medications: Slightly True	Peer and recovery services help me/my family member reduce or eliminate medications: Somewhat True	Peer and recovery services help me/my family member reduce or eliminate medications: Moderately True	Peer and recovery services help me/my family member reduce or eliminate medications: Very Much So True
The services I or a family member participate in are chosen by me/my family member	The services I or a family member participate in are chosen by me/my family member: Not at All True	The services I or a family member participate in are chosen by me/my family member: Slightly True	The services I or a family member participate in are chosen by me/my family member: Somewhat True	The services I or a family member participate in are chosen by me/my family member: Moderately True	The services I or a family member participate in are chosen by me/my family member: Very Much So True
Increasing my mood is important to me/my family member	Increasing my mood is important to me/my family member: Not at All True	Increasing my mood is important to me/my family member: Slightly True	Increasing my mood is important to me/my family member: Somewhat True	Increasing my mood is important to me/my family member: Moderately True	Increasing my mood is important to me/my family member: Very Much So True
Getting along with others is important to me/my family member	Getting along with others is important to me/my family member: Not at All True	Getting along with others is important to me/my family member: Slightly True	Getting along with others is important to me/my family member: Somewhat True	Getting along with others is important to me/my family member: Moderately True	Getting along with others is important to me/my family member: Very Much So True
Reducing symptoms is the main reason I/my family member participate in services	Reducing symptoms is the main reason I/my family member participate in services: Not at All True	Reducing symptoms is the main reason I/my family member participate in services: Slightly True	Reducing symptoms is the main reason I/my family member participate in services: Somewhat True	Reducing symptoms is the main reason I/my family member participate in services: Moderately True	Reducing symptoms is the main reason I/my family member participate in services: Very Much So True
Peer services have been an important part of my/my family member's recovery	Peer services have been an important part of my/my family member's recovery: Not at All True	Peer services have been an important part of my/my family member's recovery: Slightly True	Peer services have been an important part of my/my family member's recovery: Somewhat True	Peer services have been an important part of my/my family member's recovery: Moderately True	Peer services have been an important part of my/my family member's recovery: Very Much So True
Having a voice in my treatment goals is important to me/my family member	Having a voice in my treatment goals is important to me/my family member: Not at All True	Having a voice in my treatment goals is important to me/my family member: Slightly True	Having a voice in my treatment goals is important to me/my family member: Somewhat True	Having a voice in my treatment goals is important to me/my family member: Moderately True	Having a voice in my treatment goals is important to me/my family member: Very Much So True
Peer and recovery services have helped keep me/my family member from seeking care in an Emergency Department	Peer and recovery services have helped keep me/my family member from seeking care in an Emergency Department: Not at All True	Peer and recovery services have helped keep me/my family member from seeking care in an Emergency Department: Slightly True	Peer and recovery services have helped keep me/my family member from seeking care in an Emergency Department: Somewhat True	Peer and recovery services have helped keep me/my family member from seeking care in an Emergency Department: Moderately True	Peer and recovery services have helped keep me/my family member from seeking care in an Emergency Department: Very Much So True
Being in a relationship is important to me/my family member	Being in a relationship is important to me/my family member: Not at All True	Being in a relationship is important to me/my family member: Slightly True	Being in a relationship is important to me/my family member: Somewhat True	Being in a relationship is important to me/my family member: Moderately True	Being in a relationship is important to me/my family member: Very Much So True
Medication has helped my/my family member's recovery	Medication has helped my/my family member's recovery: Not at All True	Medication has helped my/my family member's recovery: Slightly True	Medication has helped my/my family member's recovery: Somewhat True	Medication has helped my/my family member's recovery: Moderately True	Medication has helped my/my family member's recovery: Very Much So True
Peer services have prevented me/my family member from being hospitalized	Peer services have prevented me/my family member from being hospitalized: Not at All True	Peer services have prevented me/my family member from being hospitalized: Slightly True	Peer services have prevented me/my family member from being hospitalized: Somewhat True	Peer services have prevented me/my family member from being hospitalized: Moderately True	Peer services have prevented me/my family member from being hospitalized: Very Much So True

7. (a) Please check the top 3 statements that you find MOST important to your recovery.

(b) Please check the 3 statements that you find LEAST important to your/your family member's recovery.

8. If you or a family member have participated in services provided by peers (Family Support Services, Family Peer Advocate, Peer-Run Services, etc.), how would you describe the benefit of peer-run/peer-led services compared to any other services you or a family member have received?

9. Would you recommend services provided by peers to others?

Why or why not?

10. How do you define recovery?

11. (a) Is your definition different from other viewpoints (e.g. family, therapist, doctor, etc.)?

(b) If you answered yes, please describe how your definition is different:

(c) If you are a family member of an individual in recovery, do you believe your definition is different than your family member's or others around you (e.g. friends, family not in recovery, therapist, doctor, etc.)?

12. Is there anything this survey did not capture that is relevant to your/your family member's personal health and recovery journey? If so, please describe:

Demographics Section

13. What is your age?

14. What is your gender?

Please enter an 'other' value for this selection.

15. What is your race?

Please enter an 'other' value for this selection.

16. What is your ethnicity?

17. The community I live in is mostly:

18. My current residence is:

Please enter an 'other' value for this selection.