Mental Health Issue Survey
Arya Pratinidhi Sabha America's AHAM (Arya Hindus for Awareness of Mental Health) Project team is reaching out to the community understand what mental health issues most affect the lives of friends and family around you. This survey is 100% Confidential. No personal identifiable information is collected, shared, sold or distributed. The data collected will be used only to develop mental health awareness programs for the benefit of the community.
Gender
Please Select
Male
Female
N/A
Age
0 - 17
18 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 - 74
75 or more
Education
Less than HS diploma
High school
Some college
Bachelors degree
Graduate degree
Higher education
Type of Employment
Student
Unemployed (looking for a job)
Unemployed (not looking for a job)
Self-employed
Full-time employment
Part-time employment
Marital Status
Single
Married
Divorced
Widowed
Please select three mental health issues most relevant to you.
Depression
Anxiety / Panic
Post Traumatic Stress Disorder
Suicide
Biopolar Disorder
Schizophrenia
Dementia - Alzheimer's Disease /
Alcohol Use Disorder
Cannabis (Marijuana) Use Disorder
LGBTQ Issues
Opioid Use Disorder
Autism
ADHD - attention deficit hyperactivity disorder
OCD - obsessive compulsive disorder
Eating Disorder
Other
Where are you located?
*
Please Select
United States
Canada
Europe
Asia
Submit Survey
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