This survey is designed to be completed by a person living with a mental illness.

Gender Male Female

State/Territory      Select State NSW QLD ACT WA SA NT TAS VIC Overseas

Location      Capital City (eg. Perth/Sydney) Regional (eg. Geelong/Townsville) Remote (eg. Tennant Creek) Other

Age under 16 17-24 25-39 40-49 50-64 65+

Primary diagnosis      Depression Schizophrenia Bipolar Disorder Anxiety Disorder Personality Disorder Other

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1. Are you receiving treatment for your mental illness? Yes No

2. Are you a smoker? Yes No

3. Main source of income? (Choose 1 only) Disability Support Pension Newstart Allowance Employment Other

4. Where do you live (Choose 1 only)      Owner-occupier With parents Supported/group accommodation Private rental accommodation Boarding house Public housing Other

5. How long have you lived in your current home? (Choose 1 only) Less than 1 year 1 to 3 years 3-5 years More than 5 years

6. Are you currently looking for somewhere else to live? Yes No

7. Are you responsible for any children? Yes No

8. Are you on a public housing waiting list? Yes No

9. If you have ever applied, have you had difficulty meeting the criteria for public housing? Yes No

10. Are you concerned about losing your housing/becoming homeless? Not at all A little A lot

11. Have you ever been homeless or without suitable housing? Yes No

12. Has being in hospital ever contributed to a loss of housing? Yes No

13. Has anyone given you any help or support in finding suitable housing? Yes No

14. If yes, who has helped? (Choose 1 only) Family Health Worker Other

15. What types of housing have you tried to find? (choose all appropriate) – To select multiple items: Windows: control/click; Mac: command/click.      Owner-occupier With parents Supported/group accommodation Private rental accommodation Boarding house Public housing Other

16. Do you feel that you have been discriminated in the housing market as a result of your illness? Yes No

17. Do you think that there is less affordable housing now than there has been in the past? Yes No Don't know

18. What do you think would help in finding suitable housing? – To select multiple items: Windows: control/click; Mac: command/click.      More help from workers More low cost accommodation More long-term supported housing All the above Other

Are there any other comments you would like to make about mental illness and housing?