INTERCAMHS MEMBER SURVEY


Please complete the following survey.

(1) Are you signing up to be a new member now?


(2) If you are a current member, what year did you join?


Background and Personal Information

(3) First Name
(4) Last Name
(5) Organization
(6) Organization's Web Address
(7) Degree, University
(8) Title
(9) Salutation
(10) Address 1
(11) Address 2
(12) City
(13) State
(14) Zip
(15) Phone - Work
(16) Phone - Home
(17) Fax
(18) Email


(19) What is your first language?
(20) In what other languages are you fluent?
(21) In what setting do you work (choose all that apply)?




(22) Please indicate in what area you work (choose all that apply):






Based on your answer above, in your daily work:

(23) What are 2 to 3 major problems you are facing?
(24) What are 2 to 3 major projects you are involved in?
(25) What are 2 to 3 of your major interests?
(26) What are 2 to 3 priority (child and adolescent mental health) issues
that need to be addressed in your country?
(27) What professional associations are you a member of? (eg., International
Union of Health Promotion and Education, Australian Health Promoting Schools
Association, International Society of Psychiatric Mental Health Nurses, etc.)
(28) With what other sectors and types of professionals do you work?
(29) What types of professional development would you be interested in pursuing?

Future Direction of Intercamhs

(30) On the mental health continuum from health promotion to the prevention
of disorders, what are the issues that you think INTERCAMHS needs to address in
the next five years?
(31) What role do you think INTERCAMHS could have in addressing these issues?
(32) What are the best conferences globally, regionally, or in your country at
which INTERCAMHS should be present and provide workshops?



(33) Could you personally recruit 3-5 new members for INTERCAMHS
(if so, please list their names)? What information or materials would you need to do this?
(34) What broader recruitment strategies might you suggest?


(35) If we organized task forces for INTERCAMHS’ 8 strategic aims (below),
which aims would you be interested in helping advance? Please rank the order of your top three choices ONLY.

        

        

        

1 2 3
Aim 1: Development of a common language of terms related
to mental health in schools
Aim 2: Build communication mechanisms between people
interested in school-based mental health in different countries;
INTERCAMHS website as best international information resource
Aim 3: Encourage dialogue, lessons learned, collaborative
activities, and mutual support among people and programs
in different countries
Aim 4: Enhance interdisciplinary approaches to school-based
health care
Aim 5: Promote the advancement of strategic research agenda
and collaborative research among people and programs in
different countries
Aim 6: Foster the development of advocacy agendas, coalitions,
and policy improvements to advance mental health in schools
Aim 7: Raise awareness of the mental health needs of youth
and the value of school-based programs
Aim 8: Stimulate increased funding and improved capacity to
provide a full continuum of mental promotion, early intervention
and treatment services in schools.


(36) In pursuit of aim 5, what research ideas would you suggest INTERCAMHS pursue?



(37) What materials, products, ideas, and other information would you like to
see on the INTERCAMHS website?

(38) Have you authored any articles or created any products (i.e. training
materials, curricula, web sites) of particular relevance to INTERCAMHS members?
Please list no more than six.


(39) Please add any other suggestions or comments.

(40) One of the benefits of membership in Intercamhs is the ability to search our secured and private on-line member's database. The database allows you to find colleagues across the globe who are working on issues similar to your own. In order to make the database useful, we would like your permission to include some basic information about you to other members. This information is private and available only to other Intercamhs members.



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