Mental Health Mapping Stockton-on-Tees - Page 1 of 3 - Stockton-on-Tees Borough Council

1. Which organisation do you work for?

(Required)

2. What is the name of the service you work for?

(Required)

3. Where is your service delivered? (Tick all that apply)

(Required) Clinical Settings e.g. Hospital / GP Virtual / Online ONLY School / Educational establishment including college/university Teams/Zoom Telephone Community Other

If other please detail

4a. Who funds/commissions the service?

(Required)

4b. When is the service funded until?

6. Does your service support children/adults or both?

(Required)

7. How do people access the service?

(Required) Self Referral Referral from a health professional Both

8a. Please detail the eligibility criteria for the service?

(Required)

8b. Does your service target a specific population?

9a. Does the service operate a waiting list?

(Required) Yes No

9b. If yes what is the current wait time (in weeks)

10a. What is the maximum number of clients/patients you can support at any given time?

(Required)

10b. How often do you reach maximum capacity?

Never Rarely Sometimes Often Always

11. What area does the service cover?

Stockton-on-Tees Teesside North-East National Other

Please specify

12. Is there a cost to the client/patient?

Yes No

Please detail

13a. Please tick which days the service is available?

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

13b. What hours do you operate? please explain any changes for week days/weekends

14. Are the any current organisational pressures that you can share? (e.g. recruitment)

15. Are there any specific groups/populations that you would like to engage more with?

16. Do you think there are any gaps in the service you deliver for mental health?