In the last 12 months, did you try to get mental health care?
- Yes, I saw a provider
- Yes, I tried but did not get an appointment
- No
- Prefer not to say
Which type(s) of mental health provider did you see in the last 12 months? Select all that apply.
- Psychiatrist (MD/DO)
- Psychologist (PhD/PsyD)
- Therapist/Counselor (e.g., LCSW, LMFT, LPC)
- Primary care clinician
- Psychiatric nurse practitioner
- Clinical social worker
- Group therapy program
- Other
- Not applicable—I did not see a provider
About how many mental health appointments did you have in the last 12 months? (Enter a whole number; enter 0 if none.)
Accepts a numeric value
Whole numbers only
How likely are you to seek mental health care in the next 6 months?
Range: 1 – 10
Min: Very unlikelyMid: Neither likely nor unlikelyMax: Very likely
Attention check: To confirm you are paying attention, please select "Yes".
How well did your provider’s expertise match your needs?
Scale: 10 (star)
Min: Poor matchMax: Excellent match
Please rate your most recent provider on the following:
| Rows | Very poor | Poor | Fair | Good | Excellent |
|---|
| Treated me with respect | • | • | • | • | • |
| Listened carefully | • | • | • | • | • |
| Explained things clearly | • | • | • | • | • |
| Included my goals in care | • | • | • | • | • |
| Cultural sensitivity | • | • | • | • | • |
| Coordinated with my other care | • | • | • | • | • |
In the last 12 months, did you switch mental health providers?
If yes, rank the main reasons you switched (top = most important).
Drag to order (top = most important)
- Poor fit with provider
- Wait times were too long
- Cost or insurance issues
- Schedule didn’t work
- Provider left or changed network
- Preferred telehealth
- Location or transportation
How long did you wait for your most recent new-patient appointment?
- Same week
- 1-2 weeks
- 3-4 weeks
- 1-2 months
- 3+ months
Which barriers, if any, kept you from getting an appointment? Select all that apply.
- No providers taking new patients
- Waitlist too long
- Cost too high or insurance not accepted
- Couldn’t find a provider who fit my needs
- Available times didn’t fit my schedule
- Transportation or distance
- Uncomfortable seeking care
- Technology barriers
- Other
- None of the above
What was the longest wait you encountered when trying to get care?
- Same week
- 1-2 weeks
- 3-4 weeks
- 1-2 months
- 3+ months
- Never got an appointment
What might keep you from seeking care in the next 6 months? Select all that apply.
- I feel fine/no need
- Prefer self-help or informal support
- Privacy or stigma concerns
- Cost or coverage
- Unsure how to get started
- Scheduling or transportation
- Past negative experience
- Don’t trust providers
- Other
- Nothing likely to prevent me
In the last 12 months, did you use telehealth (video or phone) for mental health care?
- Yes, video visits
- Yes, phone calls
- Yes, both
- No
Compared with in-person visits, telehealth was...
| Rows | Much worse | Worse | About the same | Better | Much better |
|---|
| More convenient | • | • | • | • | • |
| Easier to talk openly | • | • | • | • | • |
| Protected my privacy | • | • | • | • | • |
| Helped with scheduling flexibility | • | • | • | • | • |
| Had good audio/video quality | • | • | • | • | • |
How do you usually pay for mental health care?
- Employer-sponsored insurance
- Individual/Marketplace plan
- Medicaid
- Medicare
- Student plan
- Military/VA (e.g., TRICARE)
- Uninsured/self-pay
- Other
- Prefer not to say
About how much did you pay out of pocket for your most recent mental health visit? (USD; enter a whole number)
Accepts a numeric value
Whole numbers only
Overall, my mental health care costs were affordable.
Range: 1 – 10
Min: Strongly disagreeMid: NeutralMax: Strongly agree
Allocate 100 points across the options to show what matters most when matching you with a provider.
Total must equal 100
- Expertise that matches my concerns
- Appointments available soon
- Insurance accepted/low out-of-pocket cost
- Good communication style/rapport
- Cultural or language match
- Telehealth availability
- Location/convenience
Min per option: 0Whole numbers only
What is your age?
- 18-24
- 25-34
- 35-44
- 45-54
- 55-64
- 65+
- Prefer not to say
Which best describes your gender?
- Woman
- Man
- Non-binary or gender diverse
- Prefer not to say
Where do you live?
- United States
- Canada
- United Kingdom
- Australia
- European Union
- Other
What is the highest level of education you have completed?
- Less than high school
- High school or GED
- Some college/Associate degree
- Bachelor’s degree
- Graduate or professional degree
- Prefer not to say
What is your current employment status?
- Full-time
- Part-time
- Self-employed
- Student
- Unemployed
- Homemaker
- Retired
- Unable to work
- Prefer not to say
How do you describe your race or ethnicity? Select all that apply.
- American Indian or Alaska Native
- Asian
- Black or African American
- Hispanic or Latino/a/x
- Middle Eastern or North African
- Native Hawaiian or Other Pacific Islander
- White
- Multiple races/ethnicities
- Other
- Prefer not to say
Any final comments about your experience getting or receiving mental health care?
Max 600 chars
AI Interview: 2 Follow-up Questions on your care experience
AI InterviewLength: 2Personality: Expert InterviewerMode: Fast Thank you for completing the survey! Your feedback helps improve access and provider matching.