Survey: What Makes a Good Day? Survey QuestionsOptional Questions NameThis field is for validation purposes and should be left unchanged.We want to know what it means for you personally to have a good day. Your answers will help us promote strategies to help us all have more good days.For you, what makes a good day?How many "good days" do you have per week? Zero 1 or 2 3 or 4 5 or 6 7 What are some things you do to improve your mood when you've been having a bad day?Sometimes both good and bad things happen in the same day, but our brain only notices the bad things.Think of a "bad day" you had recently. What is one good thing that happened that day—even if it's something very small? Please take a moment to answer the following optional questions. Your answers are totally anonymous—we won't be able to identify you based on this information. Your answers help us provide better information and support for people like you. You can answer as many or as few questions as you would like. When you are done, scroll to the bottom of the survey and click "submit" to receive your screening results.Have you already answered these optional questions on our website today? Yes No Okay! We'll skip them this time.About YouAge Range8-1011-1314-1516-1718-2425-3435-4445-5455-6465+Gender Female Male Non-Binary Do you identify as transgender? Yes No How would you describe your gender?Race/EthnicityAmerican Indian or Alaska NativeAsianBlack or African American (non-Hispanic)Hispanic or LatinoMiddle Eastern or North AfricanNative Hawaiian or other Pacific IslanderWhite (non-Hispanic)More than one of the aboveOtherHousehold IncomeLess than $20,000$20,000 - $39,999$40,000 - $59,999$60,000 - $79,999$80,000 - $99,999$100,000 - $149,999$150,000+Do you live in the United States or another country? I live in the United States I live in another country StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingI live in a U.S. TerritoryWhat country do you live in?AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsZip/Postal CodeWhich of the following populations describes you?Select all that apply. Veteran or active-duty military Caregiver of someone living with emotional or physical illness LGBTQ+ Student Trauma survivor New or expecting parent Healthcare worker Are you caring for someone with a mental or physical health condition? Mental health condition Physical health condition Both mental and physical health conditions Which of the following best describes your sexual orientation?Lesbian or GayBisexualQueerPansexualAsexualStraightOther...What is your sexual orientation?Which of the following describe your experience of trauma? Child abuse/violence Intimate partner violence Sexual assault/violence Serious illness/injury/assault Family conflict (identity acceptance/separation/divorce) Traumatic event (natural disaster, accident, witnessing violence, etc.) Death of a loved one Other and/or tell us more about your trauma Please tell us more about your experience of trauma:About Your Mental HealthHave you ever received treatment/support for a mental health problem? Yes No Are you receiving treatment/support now? Yes No What has prevented you from seeking treatment in the past?Choose up to 3. I wanted to handle my mental health on my own I didn’t know how or where to start I thought it would cost too much I didn’t have time I didn’t think it would help me I didn't feel ready to start treatment I was worried about what people would think or say if I got treatment I was afraid of being forced into a hospital or forced to take medication I tried, but couldn’t find available treatment (no openings, wouldn’t take insurance, etc.) My parent(s) or guardian wouldn't let me, or I didn't want to ask Other... What else has prevented you from seeking treatment in the past?Think about your mental health test. What are the main things contributing to your mental health problems right now?Choose up to 3. Abuse or violence Relationship problems (friends, family, or significant other) Body image Low self-esteem or self-image School or work problems Financial problems Loneliness or isolation Grief or loss of someone or something Experiencing hate/bullying (including racism, homophobia, transphobia, or discrimination) State of the world (war, climate, politics, immigration) I don’t know (something just feels wrong) Other... What else is contributing to your mental health problems right now?What about the state of the world is affecting you the most?About Your HealthDo you currently have health insurance? Yes No I don't know Do you have any of the following physical health conditions?Select all that apply. Heart disease Reproductive health concerns (PCOS, endometriosis, infertility, etc.) Diabetes Cancer Arthritis or other chronic pain Asthma, COPD or other lung conditions Movement Disorders (involuntary tics, tardive dyskinesia, etc.) Digestive problems (Crohn’s, colitis, IBS, etc.) Neurological conditions (epilepsy, etc.) or traumatic brain injury (TBI) Other... What other physical health conditions do you have?Do you have a pet that supports your mental health? Yes No Are you interested in having a pet that supports your mental health? Yes No
