Community input is important and will be instrumental in helping us to improve what we do. Your time is valuable and so are your thoughts. Please help us do the best we can by completing this survey and returning it to the Bill Harrington, director, Center for Human Development, 528 E. Main, Suite W, John Day ,OR, 97845, or faxing to 575-1411. Please return surveys by Jan. 31.

- Bill Harrington

Knowledge

(Please answer this section with yes or no)

1. Do you know what the Center for Human Development is and what services it offers the community?

2. Mental health services are only for mentally ill people.---------

3. Everyone can use help with their mental health.

4. People can get over their mental problems on their own if they want to.

5.-It is normal and OK to have problems in life.

6.-Mental health services are only for drug users and alcoholics.

7. The counselors give people advice on how to live.

8.-I go only to Christian counselors.

9.-My pastor counsels me and my family.

Services

1. Please list the services that you are aware of that are provided at the Center for Human Development.

2. Have you or anyone you know received or are receiving service at the Center for Human Development?

3. Did that individual benefit from the service?

4.Was there anything that person did not like? If yes, please explain.

5. Was their life made better?

6. Was there anything that needed to be changed in the way the service was provided or in the actual service?

7. I do OK, but someone else is causing me problems, would a mental health counselor help me?

8. I don't want others to know about my private life.

9. Do you worry about confidentiality?

10. Do you think other people in the community would find out about your private life if you came for service at the Center for Human Development?

11. How would those other people find out?

12. Do you think that mental health services can help you with marriage or other family problems?

13. Do you think that the Center for Human Development can help you with worries that you may have about your kids?

14. How can the Center for Human Development help you and your family or friends?

15. Do you think that mental and emotional health is important to physical health?

16. How does your family feel about seeking services from the Center for Human Development?

17. How do your friends feel about seeking services from the Center for Human Development?

18. What do you think community members need with regard to social services, specifically mental health, alcohol and substance abuse and developmental disabilities?

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