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Questionnaire for Researchers; Final Version; February 2005

RESPONDENTS DEMOGRAPHIC PROFILE


Country
Name
Age
Gender
Occupation
Highest Educational Attainment
Address
Phone Number
E-mail
Group/Institutional Affiliation
Years of service at present work
Please make sure that you have answered all the questions. In case you have any question, do not hesitate to contact us.
Number
1) Personal
1.1
1.2
1.3

Variable Label

1.4

COUNTRY

1.5

ADDRESS

1.6

PHONE

1.7

EMAIL

In which country have you spent the


majority of your professional time in the
past five years?
What is your current address (please
provide your full postal address)?
What is your daytime contact telephone
number with regional dialing code?
What is your email address?

1.8

DISCIPLINE

Which of these categories best describes

IDNUMB
AGE
SEX

Question

How old are you (age at last birthday)?


What is your sex?

Variable Type

Number
Tick one
response only

Response Categories

Male
Female

Tick all that

Psychiatrist

Questionnaire for Researchers; Final Version; February 2005


your professional position?

apply

Neurologist
Other Medical Practitioner
Psychologist
Social Scientist
Nurse
Public Health Professional
Other, please specify

1.9

INSTITUTION

Which of these categories best describe the


institution you work with?

Tick all that


apply

NGO
University Department
Research Organization/Institute
Hospital
Government Ministry
Private Sector (for profit)
Not applicable; do not work in an
institution
Other, please specify

1.10

NETWORKS

Are you affiliated to any research network?

Tick one
response only

No
National Network
Regional Network
International Network
Both regional and international
networks

1.10.1

NETWORK NAME

If yes to 1.10, which network/s are you a


member of?

In which of the following research methods


have you received formal training?

Tick all that


apply

Epidemiology, Public Health


Qualitative research methods
Basic Sciences, e.g. neuroimaging,
genetics, statistics
Other, please specify

How many mental health related articles or

Tick one

None

2) Research Experience
2.1
METHODS

2.2

REVIEWER

Questionnaire for Researchers; Final Version; February 2005


grant applications have you reviewed in the
past five years?

response only

Tick one
response only

2.3

EDITOR

How many editorial or advisory boards of


academic journals have you served on in
the past five years?

3.0

RECENT
RESEARCH
EXPERIENCE

Number of mental health related projects in


the past five years; for each project: status,
type of study, mental disorder, funding
source, collaborators, outcome

1 articles/grants
2 - 5 articles/grants
6 - 10 articles/grants
> 10 articles/grants
None
1
2
>2
Please complete this information in the
Table

Questionnaire for Researchers; Final Version; February 2005


LIST THE THREE MOST RECENT MENTAL HEALTH RELATED RESEARCH PROJECTS YOU HAVE BEEN INVOLVED WITH IN THE PAST 5 YEARS

TITLE OF PROJECT 1
1. The theme of the
research (Tick all
that apply)

Epidemiology
and Public
Health
Clinical Trials
Social/
Psychological
Science
Methodology
Health
Systems
Basic Science
Clinical
Other, please
specify

2. The role you


played in this
research
(Tick one response
only)

3. The setting
from where the
subjects in the
research were
sampled (Tick one
response only)

Principal
Investigator
Co- Principal
Investigator
Collaborator
Researcher
Supervisor
Other,please
specify

Community
Primary
Care
General
Hospital
Psychiatric
Hospital
Multiple
Not
applicable
Other,please
specify

4. Were there
collaborations in
your country or
internationally
(Tick all that
apply)

None
National
International
with other
low and
middle
income
countries
International
with high
income
countries

5. The source of
funding for the
research (Tick all
that apply)

6. Which mental
health issue was the
focus? (Tick all that
apply)

7. Was the
association of the
mental health issue
with specific
marginalized groups
included in your
research question/
objectives (Tick all
that apply)

8. The motivation
for pursuing this
research (Tick all

None (own
funds)
Research
Council
Foundation/
NGO
WHO
Drug
Company
University
Ministry
Multiple
Other,please
specify

Psychoses
Depression/
Anxiety
Substance
Use
Childhood
Disorders
Dementia
Epilepsy
Personality
Learning
Disabilities
Eating
Disorders
Suicide
Other,please
specify

Women
Children and
Adolescents
Poverty
Refugees
Minorities
Elderly
persons
Violence/
Trauma
Prisoners
Disabled
persons
Other, please
specify

Burden of
illness/ public
health
Availability of
funds
Collaborator
proposal
Personal
interest
Career
prospects
Policy maker
request
Commissioned
by external
agency
Social
justice/equity
Other, please
specify

that apply)

Questionnaire for Researchers; Final Version; February 2005


TITLE OF PROJECT 2
1. The theme of the
research (Tick all
that apply)

Epidemiology
and Public
Health
Clinical Trials
Social/
Psychological
Science
Methodology
Health
Systems
Basic Science
Clinical
Other, please
specify

2. The role you


played in this
research
(Tick one response
only)

3. The setting
from where the
subjects in the
research were
sampled (Tick one
response only)

Principal
Investigator
Co- Principal
Investigator
Collaborator
Researcher
Supervisor
Other,please
specify

Community
Primary
Care
General
Hospital
Psychiatric
Hospital
Multiple
Not
applicable
Other,please
specify

TITLE OF PROJECT 3

4. Were there
collaborations in
your country or
internationally
(Tick all that
apply)

None
National
International
with other
low and
middle
income
countries
International
with high
income
countries

5. The source of
funding for the
research (Tick all
that apply)

6. Which mental
health issue was the
focus? (Tick all that
apply)

7. Was the
association of the
mental health issue
with specific
marginalized groups
included in your
research question/
objectives (Tick all
that apply)

8. The motivation
for pursuing this
research (Tick all

None (own
funds)
Research
Council
Foundation/
NGO
WHO
Drug
Company
University
Ministry
Multiple
Other,please
specify

Psychoses
Depression/
Anxiety
Substance
Use
Childhood
Disorders
Dementia
Epilepsy
Personality
Learning
Disabilities
Eating
Disorders
Suicide
Other,please
specify

Women
Children and
Adolescents
Poverty
Refugees
Minorities
Elderly
persons
Violence/
Trauma
Prisoners
Disabled
persons
Other, please
specify

Burden of
illness/ public
health
Availability of
funds
Collaborator
proposal
Personal
interest
Career
prospects
Policy maker
request
Commissioned
by external
agency
Social
justice/equity
Other, please
specify

that apply)

Questionnaire for Researchers; Final Version; February 2005

1. The theme of the


research (Tick all
that apply)

Epidemiology
and Public
Health
Clinical Trials
Social/
Psychological
Science
Methodology
Health
Systems
Basic Science
Clinical
Other, please
specify

2. The role you


played in this
research
(Tick one response
only)

3. The setting
from where the
subjects in the
research were
sampled (Tick one
response only)

Principal
Investigator
Co- Principal
Investigator
Collaborator
Researcher
Supervisor
Other,please
specify

Community
Primary
Care
General
Hospital
Psychiatric
Hospital
Multiple
Not
applicable
Other,please
specify

4. Were there
collaborations in
your country or
internationally
(Tick all that
apply)

None
National
International
with other
low and
middle
income
countries
International
with high
income
countries

5. The source of
funding for the
research (Tick all
that apply)

6. Which mental
health issue was the
focus? (Tick all that
apply)

7. Was the
association of the
mental health issue
with specific
marginalized groups
included in your
research question/
objectives (Tick all
that apply)

8. The motivation
for pursuing this
research (Tick all

None (own
funds)
Research
Council
Foundation/
NGO
WHO
Drug
Company
University
Ministry
Multiple
Other,please
specify

Psychoses
Depression/
Anxiety
Substance
Use
Childhood
Disorders
Dementia
Epilepsy
Personality
Learning
Disabilities
Eating
Disorders
Suicide
Other,please
specify

Women
Children and
Adolescents
Poverty
Refugees
Minorities
Elderly
persons
Violence/
Trauma
Prisoners
Disabled
persons
Other, please
specify

Burden of
illness/ public
health
Availability of
funds
Collaborator
proposal
Personal
interest
Career
prospects
Policy maker
request
Commissioned
by external
agency
Social
justice/equity
Other, please
specify

that apply)

Questionnaire for Researchers; Final Version; February 2005


4) Research Resources
4.1

TRAINING

Are you involved with teaching any of the


following training programs?

Tick all that


apply

None
Short courses in mental health research
Masters Programs in mental health research
PhD programs in mental health

4.2

INTERNET

Do you have access to the internet-based


databases of research literature?

Tick one
response only

No
Yes, but only free websites (e.g. PubMed)
Yes, to paid resources (e.g. PsycInfo)

4.3

LIBRARY

How many mental health related journals


does a library you can readily access
subscribe to?

Tick one
response only

None/do not access a library


1 journal
2-3 journals
4-10 journals
>10 journals

4.4

BIOSTATS

Do you have access to the technical support in Tick one


epidemiology and/or biostatistics?
response only

None
Yes, in my institution
Yes, from outside institution
Dont need, am sufficiently qualified

4.5

NEUROSCI

Do you have access to the technical support in Tick one


neurosciences and/or basic sciences research? response only

None
Yes, in my institution
Yes, from outside institution
Dont need, am sufficiently qualified

4.6

ETHICS

Do you have access to an ethical review


board?

None
Yes, in my institution
Yes, from outside institution

Tick one
response only

Questionnaire for Researchers; Final Version; February 2005


4.7

CONSUMER

4.8

POLICY

4.9

CONSULTANCY

4.10

FUNDING

5) RESEARCH IMPACT
5.1
PUBL_LOC

In the past five years, have consumers or


users of mental health services been
involved with your mental health research?
In the past five years, have policy makers
been involved with your mental health
research?
In the past five years, have you had access
to any mental health related research
fellowships or consultancies?

Tick one
response only

No
Yes

Tick one
response only

No
Yes

Approximately how much research funding


have you had access to in the past year?
(Please report the currency you are using to
describe this amount.)

Number

In the past five years, how many


publications have you had in local academic
journals, i.e. ones that mainly or exclusively
publish papers from your country?

Tick one
response only

Tick all that


apply

5.2

PUBL_INT

In the past five years, how many


publications have you had in international
academic journals, i.e. predominately
publishing papers from different countries?

Tick one
response only

5.3

JNL_CHOICE

What is the primary reason for choosing a


particular journal for the last article you
published?

Tick one
response only

No
Yes, from a charitable or public institution
Yes, from a private or corporate institution
(incl. pharmaceutical companies)

None
1 publication
2-5 publications
6-10 publications
>10 publications
None
1 publication
2-5 publications
6-10 publications
>10 publications
Impact factor
Readership
Personal preference for the journal
Better chance of the paper being accepted
No specific reason
Other, specify

Questionnaire for Researchers; Final Version; February 2005


5.4

PRES_LOC

In the past five years, how many


presentations of mental health research have
you made at national conferences, i.e. in
your country?

Tick one
response only

5.5

PRES_INT

In the past five years, how many


presentations of mental health research have
you made at international conferences, i.e.
outside your country?

Tick one
response only

5.6

PHD_STUD

In the past five years, how many students


have you supervised for higher research
degrees (e.g. PhD) having a significant
component related to mental health?

Tick one
response only

5.7

DISSEM

Have your research findings been


disseminated in any of the following ways
in the past five years?

Tick all that


apply

5.8

IMPACT

Tick one
response only

5.8.1

IMPACT_EG

Can you identify any policy, program,


advocacy or practice change that has
resulted from the evidence of your research
findings?
If yes, please give one specific example:

5.9

NOIMPACT

Tick one
response only

5.9.1

NOIMPACT_EG

Can you identify any established research


evidence you have generated that should
have influenced policy, program, advocacy
or practice, but that has not done so?
If yes, please give one specific example:

None
1 presentation
2-5 presentations
6-10 presentations
>10 presentations
None
1 presentation
2-5 presentations
6-10 presentations
>10 presentations
None
1 student
2-5 students
6-10 students
>10 students
TV
Radio
Local newspapers
International newspapers
Leaflets or other concise material
Materials for policy makers
Other, please specify
No
Yes
Dont Know

No
Yes
Dont Know

Questionnaire for Researchers; Final Version; February 2005

6) RESEARCH PRIORITIES
What in your opinion are the most important mental health research priorities in your country, over the next five years? Please rank up to 3
categories for each of the following themes relating to research priorities (1=First Priority ; 2= Second Priority ; 3= Third Priority) :
6.1
PRIOR_TYPE
Over the next five years, what in your
Ranking of 3
Epidemiological studies of burden and risk
opinion are the most important mental
choices
factors
health research priorities in your country?
(number
Clinical trials
according to
Social science research, e.g. illness beliefs,
priority)
measurement
Health systems research, e.g. services
evaluation, policy and economic studies
Basic sciences research, including genetics
and neuroimaging
Other, please specify
6.2

PRIOR_DISORD

Please rank the three most important mental


health issues for your research work:

Ranking of 3
choices
(number
according to
priority)

Psychoses
Depression/Anxiety
Substance Use Disorders
Child and Adolescent Disorders
Dementia
Epilepsy
Personality
Learning Disabilities
Eating Disorders
Suicide
Other, please specify

Questionnaire for Researchers; Final Version; February 2005


6.3

PRIOR_POP

Please rank the three most important


marginalized populations for your research:

Ranking of 3
choices
(number
according to
priority)

Women
Children and Adolescents
Poor
Refugees
Minorities
Elderly persons
Persons exposed to Violence/Trauma
Prisoners
Disabled Persons
Other, please specify

6.4

PRIOR_RSN

Please rank the three most important


reasons for the choices you made, in
response to the previous two questions

Ranking of 3
choices
(number
according to
priority)

Burden of disease in the population


Availability of funds
Personal interest
Policy maker request
Social justice/equity
Other, specify

6.5

PRIOR_CHAL

Please rank the three most important


challenges or obstacles you have faced in
implementing these research priorities.

Ranking of 3
choices
(number
according to
priority)

Lack of funds
Lack of trained researchers
Lack of support from peers
Lack of research culture in institution
Lack of collaborators
Lack of time
Personal conflicts
Other, specify

6.6

CONSENT

Tick one
response only

No
Yes

6.7

PARTICIPATE

Do you consent to having your name and


research experience included in databases of
Mental Health Researchers that may be used
in on-line or print databases?
Would you be interested in being part of a
mental health research network?

Tick one
response only

No
Yes

Questionnaire for Researchers; Final Version; February 2005

Please refer other researchers or stakeholders in your country who are also involve in mental health research and practice:
Name
Mailing Address
Phone/Fax/Mobile
Email
KINDLY ATTACH YOUR CV IF POSSIBLE.

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