Variable Label
1.4
COUNTRY
1.5
ADDRESS
1.6
PHONE
1.7
1.8
DISCIPLINE
IDNUMB
AGE
SEX
Question
Variable Type
Number
Tick one
response only
Response Categories
Male
Female
Psychiatrist
apply
Neurologist
Other Medical Practitioner
Psychologist
Social Scientist
Nurse
Public Health Professional
Other, please specify
1.9
INSTITUTION
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
Tick one
response only
No
National Network
Regional Network
International Network
Both regional and international
networks
1.10.1
NETWORK NAME
Tick one
None
2) Research Experience
2.1
METHODS
2.2
REVIEWER
response only
Tick one
response only
2.3
EDITOR
3.0
RECENT
RESEARCH
EXPERIENCE
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
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
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)
Epidemiology
and Public
Health
Clinical Trials
Social/
Psychological
Science
Methodology
Health
Systems
Basic Science
Clinical
Other, please
specify
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)
Epidemiology
and Public
Health
Clinical Trials
Social/
Psychological
Science
Methodology
Health
Systems
Basic Science
Clinical
Other, please
specify
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)
TRAINING
None
Short courses in mental health research
Masters Programs in mental health research
PhD programs in mental health
4.2
INTERNET
Tick one
response only
No
Yes, but only free websites (e.g. PubMed)
Yes, to paid resources (e.g. PsycInfo)
4.3
LIBRARY
Tick one
response only
4.4
BIOSTATS
None
Yes, in my institution
Yes, from outside institution
Dont need, am sufficiently qualified
4.5
NEUROSCI
None
Yes, in my institution
Yes, from outside institution
Dont need, am sufficiently qualified
4.6
ETHICS
None
Yes, in my institution
Yes, from outside institution
Tick one
response only
CONSUMER
4.8
POLICY
4.9
CONSULTANCY
4.10
FUNDING
5) RESEARCH IMPACT
5.1
PUBL_LOC
Tick one
response only
No
Yes
Tick one
response only
No
Yes
Number
Tick one
response only
5.2
PUBL_INT
Tick one
response only
5.3
JNL_CHOICE
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
PRES_LOC
Tick one
response only
5.5
PRES_INT
Tick one
response only
5.6
PHD_STUD
Tick one
response only
5.7
DISSEM
5.8
IMPACT
Tick one
response only
5.8.1
IMPACT_EG
5.9
NOIMPACT
Tick one
response only
5.9.1
NOIMPACT_EG
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
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
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
PRIOR_POP
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
Ranking of 3
choices
(number
according to
priority)
6.5
PRIOR_CHAL
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
Tick one
response only
No
Yes
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.