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Eating Disorders - Tell us your views

We are interested in finding out your views and experiences of eating disorder services in Dorset, and to identify any gaps in services. This questionnaire asks about your experiences, what works well, what needs improving and any changes you would like to see.

The consultation period will run from the 1st December 2011 to 1st March 2012, your views really will help shape future services.

Please complete the questionnaire below:

1: Are you (please tick all that apply)?

A person with lived experience (sufferer)
A carer and/or supporter
A parent
A friend or relative
A Healthcare Professional
Other (please specify)

2: Have you or the person you know ever accessed an eating disorder service?

Yes No If No, go to Question 8.

3: Which service or services did you or the person you know use (please tick all that apply)?

In patient unit
Day treatment services
Specialist ED community service
Children & Adolescents Mental Health Services (CAMHS)
Community Mental Health Teams (CMHT)
Charity & Voluntary Organisations
Private sector provider
Other (please specify)

4: What was helpful about the services you or the person you know accessed?

5: What was unhelpful about the services you or the person you know accessed?

6: How far do/did you or the person you know have to travel to access eating disorder services?

0-10 miles
11-20 miles
21-30 miles
31-40 miles
41-50 miles
51-60 miles
Further than 60 miles

7: What were the reasons for the travel? Please tell us your views about this.

8: Ideally, what do you consider to be the important factors from a service in sustaining long term recovery (from crisis point through all stages to full wellness)?

9: Is there anything else you want to tell us about eating disorder services or other support you, or the person you know, receive or would like to receive?

Please provide as much detail as possible - including your views on any gaps in services and suggestions for changes or improvements.

10: About you.

What gender are you?

Male
Female
Prefer not to answer

How old are you?

Under 18
18-25
26-30
31-40
41-50
51-60
61-70
71 plus
Prefer not to answer

How would you describe your ethnic origin?

White	Asian or Asian British
British Irish Any other White background	Bangladeshi Indian Pakistani Any other Asian background

Black or Black British	Mixed
African Caribbean Any other Black Background	White & Asian White & Black African White & Black Caribbean Any other mixed background

Other Ethnic Group
Chinese Other ethnic group (please specify)

I do not wish to disclose my ethnic origin.

Please enter the beginning of your postcode (this enables us to make sure we have got a good geographic spread of respondents).

We are looking to establish a network of people who access eating disorder services, and/or have experience of an eating disorder. If you would like to be part of this and be contacted with further information, please provide your contact details below.

Name:
E-mail:
Street Address:
Town/City:
County:
Post Code:	Preferred method of contact:
Phone Number:	Email Posted Mail Phone

Survey Results

Following the end of the consultation period, a summary of the results will be made available on the Forum website.

Your views are valuable and will help shape future service provision.