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Mental Health Survey

This survey is part of a design research project on the mental health of female children in elementary and high schools. This survey should take less than 10 minutes to complete. It is completely anonymous and no personal data is collected.


Thank you for your time, it is greatly appreciated!

Q1. What gender does your child(ren) identify with?
Q2. Which age group does your child(ren) fall into?
Q3. What is the highest level of education your child(ren) completed?
Q4. What type of classroom/school is your child in?
Q5. Has your child(ren) been diagnosed with a mental health disorder before?
Q6. What is your child's diagnosis? (select all that apply)
Q7. Is your child(ren) currently taking any medication or treatment?
Q8. How long has your child(ren) been recieving mental health services or treatment?
Q9. Which of the following treatment/intervention did you seek? (Check all that apply)
Q10. Do you or others have significant difficulty managing your child's behaviour?

Q11. How often does your child experience or exhibit the attitude or behaviour below? 

Calm and peaceful




Spend more time alone

Tired easily


Have trouble with teacher

Less interested in school

Fight with other children

Distracted easily

Feel sad or unhappy

Feel hopeless

Have trouble concentrating

Less interested in friends

Absent from school

School grades dropping

Have trouble sleeping

Get hurt frequently

Do not listen to rules

Do not show feelings

Take things that do not belong to him/her

Refuse to share


Physical or verbal aggression

Stopped hanging around with their usual friends

Q12. Which of the following do you think contributes most to mental or emotional health issues in your child?
Q13. Overall, has it been difficult caring for your child(ren) with a mental health issue?
Q14. How much time does your child spend on social media?

Thank you for taking part in this survey. Is there anything you would like to add?

Thanks for submitting!

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