Mental Health and Wellness Survey

The Mental Health Ministry invites you to fill out the survey in the bulletin or from the additional survey sheets found in the Wellness Ministry information rack on the corner table in the narthex/gathering area or you may copy the survey form below.

Drop it off in the marked survey box in the narthex/gathering area after the masses next weekend or mail it back to the rectory.

For the ministry to be successful, it is important to first understand our parish’s mental health needs so we can tailor our program to provide the best possible support.  Thank you for filling them out.

Please circle the dot to your answers.

What is your preferred learning environment?

  • In-person events
  • Virtual events
  • Handouts to read at home

What topics would you be interested in for talks or support groups?  Select all that apply.

  • Understanding the difference between Mental Health and Mental Illness
  • Spirituality and Mental Health
  • Coping with Anxiety
  • Suicide
  • Coping with Depression 
  • Improving Mental Wellness.
  • Coping with Psychosis
  • Mental Illness during Covid 
  • Coping with Loneliness
  • Addiction and Mental Illness
  • Alcoholism 
  • Drug Abuse
  • Parenting and Stress
  • Family and Stress
  • Caretaker Stress
  • Managing Stress
  • Stress and Aging 
  • Family Dealing with Mental Illness
  • Family Dealing with Addiction
  • Living with Adult Children with Mental Illness
  • Having Power and Control Over Your Life
  • Dealing with Behavioral Problems at Home
  • Post-Traumatic Stress
  • Improving Communication Skills
  • Practicing Self-Care to Reduce Stress and Promote Mental Health

Please check all the activities below you may be interested to participate in.

  • Spiritual Prayer Group for those with mental illness and mental health issues
  • Spiritual Prayer Group for those with Family Members or friends with mental illness and mental health issues
  • Educational talks on mental health illness
  • Educational talks on mental health issues
  • Educational talks on how to maintain a good mental health 
  • Day Retreat focused on mental well-being
  • Day Retreat focused on mental illness
  • Mass for those with Depression, Anxiety, or other mental health challenges

Would you be interested in learning about mental health?

  • Yes
  • It depends on the subject matter
  • No

This is an optional section to answer.  Please place a checkmark in the Õ symbol if it applies to you.  Have you or a member of your family in the past or present ever dealt with the following?

Õ  AnxietyÕ  Past    Õ  Present     Õ  Self       Õ  Family Member
Õ  DepressionÕ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  Manic Depression      Õ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  Suicidal Thoughts  Õ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  SuicideÕ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  Post Traumatic Stress (PTSD)Õ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  Drug Abuse  Õ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  Alcohol AbuseÕ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  Anger ManagementÕ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  Childhood Mental Health IssuesÕ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  Teenage Mental Health IssuesÕ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  Compulsive Thoughts (OCD)Õ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  Self Harm Thoughts or ActionsÕ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  Negative Self Thoughts Õ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  SchizophreniaÕ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  Personality DisorderÕ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  Ongoing StressÕ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  Eating Disorder Type: ________Õ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  Disruptive Behavior/Dissocial DisorderÕ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  Dementia / Alzheimer’s DiseaseÕ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  AutismÕ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  PsychosisÕ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  ParanoiaÕ  PastÕ  PresentÕ  SelfÕ  Family Member
Õ  Loneliness leading to depressionÕ  PastÕ  PresentÕ  SelfÕ  Family Member

Is there anything not stated above that you would think would be beneficial when it comes to addressing mental health in the parish?  __________________________________________________________________________________________________________________________________________________________________________________________________________________

If you would like someone from Saint James the Apostle Catholic Church Mental Health Ministry to contact you, please provide your contact information below.

Name: ____________________________________________   Phone: _____________________________________________

Email address: _____________________________________   Preferred method of contact: _________________________

Thank You!  The Mental Health Ministry

NOTE: Programs, events and support provided by the Mental Health Ministry are strictly spiritual and educational in nature. Members of the ministry are volunteers only, not mental health professionals, and do not provide medical advice or clinical diagnoses of any kind. If you need immediate help, contact a medical professional, a suicide prevention hotline, or call 9-8-8.

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