Mental Health & Wellbeing Survey form template
Use this if you require a robust and practical mental health & wellbeing survey form template.
Why this form is necessary
The purpose of this Mental Health & Wellbeing Survey form template is to provide you with a flexible and customisable document to serve as a robust and effective starting point for you.
By using our Mental Health & Wellbeing Survey form template, you can streamline your process, maintain consistency and accuracy, and save time, and it can be easily adapted to fit your specific scenario.
Workflow sequence
Mental health policy
If you want to promote mental health in your workplace, and how you aim to support your employees, this model policy template is essential.
Specifications
5 mins
466 words, 2 pages A4
17 June 2024
Introduction
We value the mental health and wellbeing of our employees. This survey aims to understand your current state of wellbeing, identify areas where we can provide support, and improve our mental health initiatives. Your responses are confidential and will be used to enhance our workplace environment.
Section 1: General Wellbeing
-
How would you rate your overall mental health over the past month?
- Excellent
- Good
- Fair
- Poor
- Very Poor
-
How often have you felt stressed at work in the past month?
- Never
- Rarely
- Sometimes
- Often
- Always
-
How often do you feel you can manage your workload effectively?
- Always
- Most of the time
- Sometimes
- Rarely
- Never
Section 2: Work Environment
-
How supported do you feel by your manager regarding your mental health?
- Very Supported
- Supported
- Neutral
- Unsupported
- Very Unsupported
-
How comfortable do you feel discussing mental health issues with your colleagues?
- Very Comfortable
- Comfortable
- Neutral
- Uncomfortable
- Very Uncomfortable
-
Do you feel that your work environment positively contributes to your mental health?
- Strongly Agree
- Agree
- Neutral
- Disagree
- Strongly Disagree
Section 3: Work-Life Balance
-
How satisfied are you with your work-life balance?
- Very Satisfied
- Satisfied
- Neutral
- Dissatisfied
- Very Dissatisfied
-
How often do you work beyond your regular hours to complete tasks?
- Never
- Rarely
- Sometimes
- Often
- Always
-
Do you have enough time to relax and unwind after work?
- Always
- Most of the time
- Sometimes
- Rarely
- Never
Section 4: Company Resources and Support
-
Are you aware of the mental health resources and support provided by the company?
- Yes
- No
-
Have you ever used any of the mental health resources provided by the company?
- Yes
- No
-
How effective do you find the mental health resources provided by the company?
- Very Effective
- Effective
- Neutral
- Ineffective
- Very Ineffective
Section 5: Personal Reflection and Feedback
-
What aspects of your job positively impact your mental health? (Open-ended)
-
What aspects of your job negatively impact your mental health? (Open-ended)
-
What additional support or resources would you like the company to provide to help improve your mental health and wellbeing? (Open-ended)
-
Any additional comments or suggestions? (Open-ended)
Thank you for taking the time to complete this survey. Your feedback is crucial in helping us create a supportive and healthy work environment. If you need immediate assistance or someone to talk to, please contact [HR/Employee Assistance Program contact information].
Note: Please remember that your responses are confidential, and your honesty is appreciated to help us make meaningful improvements.
Version: [1.0]
Issue date: [date]
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