Mental Health Survey – Better Without It

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Living Better Without It
BWI Locations
- BWI Kentucky
- Central Florida
Partnership Opportunities
- Partner with BWI
- Order BWI Products

BWI-ShareOpinion

BWI-ShareOpinion

SHARE YOUR OPINION

What mental health habits help you feel your best? Which drugs have an impact on mental health? We want to hear from you.

Step 1 of 6

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Your Mind Is Better Without It

Your Mental State.

Every day you're surrounded by messages telling you that life is better when you try this product - this activity - this drink - this drug. Being your best self is knowing when you're #BetterWithoutIt. Your mind is the most powerful tool you have, so it's important to take care of it. Answer the survey questions below to share your opinions about mental health and how drugs or alcohol affect your sense of well-being. This survey will take approximately 5-10 minutes.

1. Within the last month, how often have you experienced these emotions?(Required)

	Never	Once in a while	Some of the time	Most of the time	Always
Calm and peaceful
Happy
Energetic
Bleh/Neutral
Gloomy
Sad
Angry

2. Within the last month, how often have you felt stress about the following areas of your life?(Required)

	Never	Once in a while	Some of the time	Most of the time	Always
Housing Stability
Physical Health
Family
Friends
Partner/Significant Other
Social Life
Studies/School
Discrimination, Bullying, or Harassment

Your Habits

The next few questions deal with habits that have all been shown to have a positive impact on mental health.

3. On average, how many hours do you sleep per night?(Required)

More than 10 hours

8-9 hours

6-7 hours

4-5 hours

Fewer than 4 hours

4. On average, how much water do you drink per day?(Required)

Equivalent of 4 water bottles or more

Equivalent of 2-3 water bottles

Equivalent of 1 water bottle

I don't know

5. Describe your typical eating habits. (Choose all that apply)

I always/almost always eat breakfast

I always/almost always eat lunch

I always/almost always eat dinner

I eat balanced meals: fruits, vegetables, proteins, and starches

I eat a few snacks throughout the day

I snack a lot at night

Almost all my "meals" are snacks

Other (please specify)

Managing Stress and Anxiety

6. Have you used any of these techniques to self-manage anxious feelings or stress?

	Never	Rarely	Sometimes	Frequently	Daily
Meditation/Yoga
Exercise
Deep Breathing
Relaxation Exercises
Listening to Music
Positive Thinking/Affirmations
Engaging in Hobbies (e.g. photography)

Other (Please tell us more about the stress and anxiety management techniques that you use!)

7. How helpful are these stress management techniques? Rank them in order of MOST helpful (#1) to least helpful (#7).

Meditation / Yoga
Exercise
Deep Breathing
Relaxation Exercises
Listening to Music
Positive Thinking / Affirmations
Engaging in Hobbies (e.g. photography, arts, games, etc.)
Other Techniques

8. Do you feel that it is okay to self-medicate for stress or anxiety?(Required)

Always - you're in the driver's seat

Sometimes - it depends

Never - it's important to talk to a professional first

Other (Please specify)

Please Specify

9. If you responded "yes" -- to what extent is it okay to self-medicate?

10. Have you ever used any prescription or non-prescription drugs to manage stress or anxiety?

I don't feel any difficulty with stress or anxiety

I feel stress or anxiety but don't use any substances to manage it

I have used anxiety management medications as prescribed by my doctor

Occasionally I blow off steam by drinking or using another drug in a social setting

I regularly use drugs or drink to manage my stress or anxiety, but they've never been prescribed to me

I'd rather not answer

Other (please specify)

Please Specify

Substances and Mental Health

11. Do you believe the following substances have a positive or negative impact on mental health?(Required)

	No Impact	Strong Negative Impact	Weak Negative Impact	Neutral Impact	Weak Positive Impact	Strong Positive Impact
Tobacco
Cannabis
Alcohol
Kratom
Xanax
Codeine/Hydrocodone/Oxycodone/Percocet
Dextromethorphan (DMX)
Amphetamines/Adderall/Ritalin
Ecstacy/MDMA
Cocaine/Crack
Crystal Meth
LSD
Heroin
Mushrooms
Inhalants

12. Please elaborate on any of your answers.

About You

13. What is your age?(Required)

Under 18

18-24

25-34

35-44

45-54

55-64

65+

14. Would you be interested in more information about leadership opportunities with the Better Without It campaign?(Required)

I'd like to join an advisory committee on preventing substance misuse

I'm interested in appearing in videos and other content for social media, ads, and the website

I'm not interested in these opportunities

Your Mind Is Better Without It

15. Thank you for your interest in becoming a leader with the Better Without It campaign! Please share your contact information and we will get in touch soon.

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email

Phone

ABOUT BETTER WITHOUT IT

Every day you're surrounded by messages telling you that life is better when you try this product - this activity - this drink - this drug.

Being your best self is knowing when you're #BetterWithoutIt.

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