Mental Health Workshop

FemaleMaleNon-binaryPrefer to self-describe (please specify)Prefer not to say

SELECT YOUR ETHNICITY
White BritishWhite IrishAny other White backgroundWhite and Black CaribbeanWhite and Black AfricanWhite and AsianAny other mixed backgroundIndianPakistaniBangladeshiAny other Asian backgroundCaribbeanAfricanAny other black backgroundChineseAny other background

Which of the following best describes how you think of yourself?
BiGay/lesbianHeterosexual/straightPrefer to self-describe (please specify)Prefer not to say

Have you or any member of your family or close friends been employed in any of the following roles?
AdvertisingMarketingFinanceBankingMarket ResearchPublic Relations/MediaJournalismNone of these

How many market research focus groups have you participated in, in the past?
1-3 groups4+ groupsNone

When did you last attend a market research focus group?
In the last 6 monthsOver 6 months agoI have never attended a market research focus group

Working Status
Working (FT)Working (PT)StudentHomemaker etcNot working/unemployed less than 6 monthsUnemployed more than 6 monthsRetired

Have you ever experienced a mental health problem (This does not have to mean diagnosed by a doctor)?
YesNo

How recent is this experience?
CurrentWithin last year1-2 years ago3-4 years ago5-6 years agoOver 6 years ago

What mental health symptoms have experienced? (Please tick ALL that apply)
AngerAnxietyCompulsionsDifficulty sleepingDepressionHallucinations (visual and/or auditory)Irrationallow moodMood swingsObsessionPanicParanoiaPhobiasPsychosisSelf-harmStress (inc. Post Traumatic Stress)Suicidal thoughtsAny other (please specify below)

Have you ever been in direct contact with the mental health charity Mind?
By this we mean have you received support from them or contacted them directly (Viewing/engaging with social media or website is fine).
YesNo

Are you able to attend the full two-day workshop?
YesNo

Do you have any additional needs that would support you in attending the workshop?
YesNo

Do you have any dietary requirements?
YesNo

Would you like to bring anyone with you for support at the workshop?
They would not take part but would wait in a separate room in the same venue to be available for you if you need support. (If yes, inform that one friend/family/carer can attend and their travel expenses will be reimbursed).
YesNo

Will you incur any childcare or other caring costs as a result of attending the workshop?
(If yes, inform that we can reimburse up to £100 towards these costs)
YesNo