Pandemic Mental Health Survey
Help us understand the impact of the pandemic on mental health and well-being. Your responses are confidential and will be used for research and support purposes.
Please provide your full name.
*
First Name
Last Name
What is your age?
*
What is your gender?
*
Female
Male
Non-binary / Third gender
Prefer not to say
Other
How would you rate your overall mental health during the pandemic?
*
1
2
3
4
5
During the past two weeks, how often have you experienced the following?
*
Rows
Never
Rarely
Sometimes
Often
Always
Feeling anxious or nervous
1
2
3
4
5
Feeling down, depressed, or hopeless
6
7
8
9
10
Trouble sleeping
11
12
13
14
15
Difficulty concentrating
16
17
18
19
20
Feeling lonely
21
22
23
24
25
Since the pandemic began, how have the following areas of your life changed?
*
Rows
Much Worse
Somewhat Worse
No Change
Somewhat Improved
Much Improved
Social connections
26
27
28
29
30
Physical activity
31
32
33
34
35
Sleep quality
36
37
38
39
40
Work or school performance
41
42
43
44
45
Access to support
46
47
48
49
50
Which of the following coping strategies have you used during the pandemic? (Select all that apply)
*
Talking with friends or family
Physical exercise
Meditation or mindfulness
Professional counseling or therapy
Online support groups
Hobbies or creative activities
Other
Have you sought professional support for your mental health during the pandemic?
*
Yes
No
How confident are you in your ability to manage stress related to the pandemic?
*
Not confident at all
1
2
3
4
Very confident
5
1 is Not confident at all, 5 is Very confident
Please share any additional comments or experiences related to your mental health during the pandemic.
Submit Survey
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