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BLAC (Black LGBTQ+ Action Coalition) Community Mental Health Survey
In partnership with the Los Angeles County Department of Mental Health, the Black LGBTQ+ Action Coalition (BLAC) centers to discuss and respond to the mental, behavioral, and emotional needs of the Black LGBTQ+ communities in Los Angeles.
What is your gender identity?
*
Male
Female
Transgender woman
Transgender man
Another identity:
Another identity:
What is your race?
*
Black or African American
Asian or Asian American
Native Hawaiian or Pacific Islander
Alaskan Native
White
Native American
Another race or ethnicity
Another race or ethnicity
What is your sexual orientation?
*
Gay
Lesbian
Bisexual
Straight or heterosexual
Pansexual
Intersex
Something else:
Something else:
What is your age range?
*
18-24
25-29
30-34
35-39
40-44
45+
I believe there are enough mental and behavioral health programs for Black people.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
I believe there are enough mental health and behavioral health programs for LGBTQ+ people.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
I believe there are enough mental health and behavioral health programs Black LGBTQ+ people.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
I know where to find mental health services designed for LGBTQ+ people.
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a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
I know where to find mental health services designed for Black people.
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a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
I know where to find mental health services designed for Black LGBTQ+ people.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
There really are not enough adequate mental and behavioral health programs for LGBTQ+ people.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
There really are not enough mental behavioral health programs for Black people.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
I know where to find mental health services for Black LGBTQ+.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
I have difficulty engaging in mental health services.
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a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
I have difficulty finding mental health services for LGBTQ+ people.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
There really are not enough mental and behavioral health programs for Black LGBTQ+ people.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
I really do not know about mental health issues.
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a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
It is challenging to find mental health services for myself.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
I struggle discussing my own mental health concerns.
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a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
I feel knowledgeable about mental health issues.
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a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
I feel comfortable being open about my own mental health concerns and needs.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
I know where to find appropriate mental health services for myself.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
I am experienced in conducting community outreach.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
I am experienced in facilitating meetings.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
I am experienced providing mental health services.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
I am experienced in receiving mental health services.
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a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
The topics discussed within BLAC were helpful.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
BLAC was enjoyable.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
f. I took this survey online.
The BLAC facilitators were knowledgeable.
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a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
f. I took this survey online,
The BLAC facilitators were pleasant.
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a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
f. I took this survey online.
Since participating in BLAC, mental and emotional health stigma for me has:
*
a. Strongly increased
b. Slightly increased
c. Slightly decreased
d. Strongly decreased
e. Did not increase or decrease
f. I took this survey online.
g. Something else:
g. Something else:
Since participating in BLAC, I am more likely to engage in mental health services, (i.e. one-on-one, groups, etc.)
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
f. I took this survey online.
Since participating in BLAC, mental and emotional health knowledge for me has:
*
a. Strongly increased
b. Slightly increased
c. Slightly decreased
d. Strongly decreased
e. Did not increase or decrease
f. I took this survey online.
g. Something else:
g. Something else:
I feel more empowered to educate someone else about mental and emotional health since participating in BLAC.
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a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
f. I took this survey online.
The day of the week of the event worked for me.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
f. I took this survey online.
The time of day for this event worked well for me.
*
a. Strongly agree
b. Agree
c. Neither agree nor disagree
d. Disagree
e. Strongly disagree
f. I took this survey online.
In order to compensate for drawing winners, please provide your CashApp handle. (Note: we are only able to compensate through CashApp.)
*
a. CashApp handle
a. CashApp handle
Please verify CashApp (Note: we are only able to compensate through CashApp.)
*
a. Cash App handle
a. Cash App handle
Who referred you to the survey or program? (If no one, please enter "N/A")
*
Name
Name
If selected as one of our winners, may we announce you on social media?
*
Yes
No, thank you
Type your name here please:
If you are interested in being contacted for other events and opportunities like this, we invite you to leave your email below.
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