AJ Questionnaire - Ananth Jeevan Life in its fullness

Mental Health Needs Assessment Questionnaire

Dear Pastor / Leader / Teacher,

Greetings from Ananth Jeevan. We are working in the area of Mind Health. We would love to understand the mental health needs of your institution and assess your readiness to implement mental health services. We would like to offer services such as helpline counseling, training, awareness programs, e-learning, support groups, and activity centers. Your responses will help us design tailored programs to support your community.

Please note that all responses will remain confidential and be used solely to inform our service offerings.

Instructions:

Please complete this questionnaire on behalf of your institution (university, hospital, orphanage, old age home, or religious institution).
Respond as accurately as possible, considering the needs of all stakeholders (e.g., staff, students, residents, members).
The survey should take approximately 10-15 minutes to complete.
For any questions, contact Ananth Jeevan via email or phone.

Questionnaire

1. Name of the Institution *

4. Location(City/State): *

5. Approximate Number of Individuals Served:

5.a. Staff/Employees

5.b. Beneficiaries (e.g., students, residents, members)

6. What are the most common mental health challenges observed in your institution? (Select all that apply and provide details if possible):

7. Which groups within your institution are most affected by mental health challenges?(Rank from 1 = most affected to 5 = least affected):

Pastors

Health Workers

Caregivers:

Lecturers

Students

Church Members

Orphans

Seniors

8. Does your institution currently offer any mental health support services? *

Yes
No
Not sure

9. Which of the following mental health services would be most beneficial for your institution? (Rank from 1 = most beneficial to 6 = least beneficial):

Helpline Counseling:

Training (e.g., mental health first aid for staff)

Awareness Workshops:

E-learning (e.g., online mental health courses):

Support Groups (e.g., peer-led groups)

Activity Centers (e.g., art therapy, music sessions):

10. How feasible is it for your institution to implement the following services? (Rate each from 1 = very feasible to 5 = not feasible):

Helpline Counseling:

Training:

Awareness Workshops:

E-learning:

Support Groups:

Activity Centers:

11. What resources are currently available at your institution to support mental health programs? *

Dedicated staff (e.g., counselors, social workers)
Physical space for workshops or activities
Internet access for e-learning or tele-counseling
Funding for mental health initiatives
Community leaders (e.g., pastors, lecturers) willing to be trained
Other (please specify):

12.What technological infrastructure is available for digital mental health services? (Select all that apply): *

Smartphones (widely accessible to staff/beneficiaries)
Computers with internet access
Reliable internet connectivity
Limited or no access to digital tools
Other (please specify):

13. What barriers prevent your institution from addressing mental health needs? (Select all that apply): *

Lack of funding
Lack of trained staff
Stigma around mental health
Limited awareness of mental health issues
Lack of access to resources (e.g., counselors, materials)
Other (please specify):

14. How does your institution view mental health within the context of faith or culture?

Mental health is openly discussed and supported
Mental health is stigmatized or misunderstood
Mental health is addressed through faith-based practices (e.g., prayer)
Other (please describe):

15. Would integrating Christian values (e.g., prayer, biblical teachings) into mental health programs increase acceptance among your community?

Yes, significantly
Yes, somewhat
No
Not sure

17. For Helpline Counseling:

18. For Training:

Preferred training format:

Preferred Training format

In-person
Online
Hybrid

19. For Awareness Workshops:

What topics would be most relevant? (e.g., stress management, burnout prevention, stigma reduction)

In-person workshops

Community events
Church-based sessions
Other

20. For E-learning:

Do staff or beneficiaries have access to devices for e-learning?

Yes, widely available
Limited access
No access

Preferred content:

Self-paced courses
Video tutorials
Interactive modules
Other

21. For Support Groups:

Preferred format:

In-person
Online (e.g., WhatsApp groups)
Hybrid

22. For Activity Centers:

Do you have space available for an activity center?

Yes
No
Not sure

23. What specific mental health challenges or needs would you like our organization to prioritize?

24. Are there any existing mental health programs or partnerships we should be aware of to avoid duplication?

25. What support would your institution need to successfully implement mental health programs? (e.g., funding, training, materials)

26. Any additional comments or suggestions for our mental health initiatives?

Submission Instructions

Please return the completed questionnaire ASAP to Ananth Jeevan by emailing at raj@ananthjeevan.in or vijay@ananthjeevan.in
For assistance, message 7661951444
Thank you for your time and collaboration in building a mentally healthy community!