Peer Support Groups Question Title * 1. Where in Bucks are you located ? South Bucks Chiltern District Wycombe District Aylesbury Vale Other Question Title * 2. Have you been diagnosed with or consider yourself to have a mental health condition ? Never Anxiety Depression Bi-polar Eating disorder Prefer not to say Other please state Other (please specify) Question Title * 3. Are you aware of the Peer Support Groups in Bucks, yes or no ? No Yes ( please tick ) Mind the Gap OCD self-help Chesham Bi-Polar Support Group B-Eat Hearing Voices Prefer not to say Other (please specify) Question Title * 4. How did you find out about mental health services in your area ? Internet search Social Media GP referrals Community medical professionals Word of mouth Bucks Mind Other please state Other (please specify) Question Title * 5. If Bucks Mind were to set-up a peer support self-help group would you access the service ? Friendship Support Network Like Minded people Social isolation Non-judgemental environment Structure Empowerment Learning Activities Increased self- esteem Other Other (please specify) Question Title * 6. If a Peer Support group was run for people with anxiety and depression how often would you attend ? Everyday Twice a week Once a week Once a month Evening and Weekend only Don’t know Question Title * 7. Would you be happy to pay a yearly membership fee to help sustain and run the group ? Yes No Other (please specify) Question Title * 8. If you would NOT attend a group what would your barriers be ? Language Access to transportation Financial Time restraints Anxiety in groups Ability to be outside in a group environment Doesn’t interest me Other please state reason Other (please specify) Question Title * 9. If you were to join a peer support group what would be important to you? (For example – activities provided, frequency of activities, location, cost, structure, friendship ) PLEASE STATE Question Title * 10. Gender Male Female Question Title * 11. Age 18 – 24 25 – 34 35 – 44 45 – 54 55 – 64 65 – 74 75+ Question Title * 12. Ethnic group English / Welsh / Scottish / Northern Irish / British Irish Gypsy or Irish Traveller Any other White background White and Black Caribbean White and Black African White and Asian Asian/British Asian Indian Pakistani Bangladeshi Chinese Any other Asian background African Caribbean Any other Black / African / Caribbean background Arab Any other ethnic group Question Title * 13. Marital status Married Single Divorced Widow Separated Co-habiting Question Title * 14. Employment status Full time employment Part time employment Homemaker Retired Unemployed Question Title * 15. Are you in receipt of any benefits ? No Tax credits Job seekers allowance Housing benefits Child benefits Carers and disability benefit Other Done