Survey on Mental Health and Stressful Events
For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
Table of Contents
- Household information (DEM)
- Age (AGE)
- Gender (GDR)
- Postal code (DHH)
- Labour market activities (LMA)
- Introduction (INT)
- General health (GEN)
- Chronic conditions (CCC)
- Healthy behaviours (BH)
- Mental health services (MHS)
- Mental health (ANX)
- Mental health (DEP)
- Stressful events (PTS)
- Mental health (SUI)
- Social impacts of stressful events (SIP)
- Mental health services - contact with health professionals (SR1)
- Alcohol (ALC)
- Cannabis (CAN)
- Social provisions (SPS)
- Indigenous identity (ABM)
- Sociodemographic characteristics (PG)
- Place of birth, immigration and citizenship (DEM1)
- Disability (LTC)
- Marital status (MS)
- Sexual orientation (SOR)
- Education (ED)
- Total household income (THI)
Household information (DEM)
Household information (DEM) - Question identifier:DEM_Q05
Including yourself, how many people live in your household?
Number of people in household
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20 or more
Household information (DEM) - Question identifier:DEM_Q10
Including yourself, how many of these people are 18 years of age or more?
Number of people in household 18 years of age or more
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20 or more
Age (AGE)
Age (AGE) - Question identifier:AGE_Q02
What is your age?
Age in years
Min = 0; Max = 121
Gender (GDR)
Gender (GDR) - Question identifier:GDR_R05
The following questions are about sex at birth and gender.
Gender (GDR) - Question identifier:GDR_Q05
What was your sex at birth?
- 1: Male
- 2: Female
Gender (GDR) - Question identifier:GDR_Q10
What is your gender?
Is it:
- 1: Male
- 2: Female
- 3: Or please specify
Gender (GDR) - Question identifier:GDR_R15
Please verify that all of the information is correct.
Your information:
Sex assigned at birth: ^DT_SEX_E
Gender: [Male/Female/^GDR_S10/Information not provided]
Postal code (DHH)
Postal code (DHH) - Question identifier:DHH_Q25
To determine which geographic region you live in, please provide your postal code.
Postal code
Long Answer Length = 6
Labour market activities (LMA)
Labour market activities (LMA) - Question identifier:LMA_Q05A
Have you ever been a member of the Canadian Armed Forces, a public safety worker, or a health care provider?
- 1: Yes, a member of the Canadian Armed Forces (e.g., Regular or Reserve force members, including veterans)
- 2: Yes, a public safety worker (e.g., a police officer, firefighter, paramedic, correctional officer, coast guard employee, border services officer, Indigenous emergency manager, or 9-1-1 dispatcher or operator)
- 3: Yes, a health care provider (e.g., a nurse, physician, psychologist, social worker, or other health care provider)
- 4: No
Labour market activities (LMA) - Question identifier:LMA_Q05B
Are you currently a member of the Canadian Armed Forces, a public safety worker, or a health care provider?
- 1: Yes, a member of the Canadian Armed Forces (e.g., Regular or Reserve force members, including veterans)
- 2: Yes, a public safety worker (e.g., a police officer, firefighter, paramedic, correctional officer, coast guard employee, border services officer, Indigenous emergency manager, or 9-1-1 dispatcher or operator)
- 3: Yes, a health care provider (e.g., a nurse, physician, psychologist, social worker, or other health care provider)
- 4: No
Labour market activities (LMA) - Question identifier:LMA_Q10
Did you work at a job or a business at any time in the past three months?
- 1: Yes
- 2: No
Labour market activities (LMA) - Question identifier:LMA_Q10A
What is the main reason that you have not worked at a job or business in the past three months?
- 01: Chronic physical or mental health condition diagnosed by a health professional
- 02: Own injury such as broken bone, bad cut, burn or sprain
- 03: Own infectious disease such as a cold, flu or stomach flu
- 04: Other reason related to physical or mental health
- 05: Caring for own children
- 06: Caring for elderly relatives
- 07: Maternity, paternity or parental leave
- 08: Education, training or school
- 09: Temporary lay-off
- 10: Strike or lockout
- 11: Retired
- 12: Other
Labour market activities (LMA) - Question identifier:LMA_Q15
In the past three months, on average, how many hours did you usually work per week?
Number of hours
Min = 0; Max = 168
Labour market activities (LMA) - Question identifier:LMA_R20
The next questions are about how your health might have affected your work productivity.
Labour market activities (LMA) - Question identifier:LMA_Q20
In the past three months, how many days in total have you been absent from work because of your own physical, mental or emotional health?
Number of days
Min = 0; Max = 99
Labour market activities (LMA) - Question identifier:LMA_Q25
Have you reduced your planned work hours in the past three months because of your own physical, mental, or emotional health?
- 1: Yes
- 2: No
Labour market activities (LMA) - Question identifier:LMA_Q25A
Prior to any reductions in your work hours in the past three months, how many hours were you usually working per week?
Min = 0; Max = 168
Labour market activities (LMA) - Question identifier:LMA_Q25B
Following any reductions in your work hours in the past three months, how many hours were you usually working per week?
Number of hours
Min = 0; Max = 168
Labour market activities (LMA) - Question identifier:LMA_Q30
In the past three months, how much has your own physical, mental or emotional health reduced the amount or the kind of activity you can do at work?
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Labour market activities (LMA) - Question identifier:LMA_Q35
In the past three months, did you apply for or receive short-term or long-term disability benefits?
- 1: Yes
- 2: No
Labour market activities (LMA) - Question identifier:LMA_Q40
In the past three months, did you apply for or receive employment insurance benefits?
- 1: Yes
- 2: No
Introduction (INT)
Introduction (INT) - Question identifier:INT_R05
This survey covers various topics related to mental health and well-being. It is important to keep in mind that the time frame of these questions will vary throughout the survey. When applicable, please pay attention to the time frames in the questions.
General health (GEN)
General health (GEN) - Question identifier:GEN_R05
The following questions are about health. By health, we mean not only the absence of disease or injury but also physical, mental and social well-being.
General health (GEN) - Question identifier:GEN_Q05
In general, how is your health?
Would you say:
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
General health (GEN) - Question identifier:GEN_Q10
In general, how is your mental health?
Would you say:
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
Chronic conditions (CCC)
Chronic conditions (CCC) - Question identifier:CCC_R05
The following questions are about some "long-term health conditions" which are expected to last or have already lasted 6 months or more and that have been diagnosed by a health professional.
Chronic conditions (CCC) - Question identifier:CCC_Q05
Do you have a mood disorder such as depression, bipolar disorder, mania or dysthymia?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q10
Do you have an anxiety disorder such as a phobia, obsessive-compulsive disorder or a panic disorder?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q15
Do you have post-traumatic stress disorder?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q15A
Do you currently experience symptoms of post-traumatic stress disorder?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q15B
Have you ever been diagnosed with post-traumatic stress disorder?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q20
Do you have any other chronic mental health problem or condition?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q25
Do you have a chronic physical health condition such as high blood pressure, arthritis, osteoporosis, diabetes, asthma, chronic obstructive pulmonary disease or heart disease?
- 1: Yes
- 2: No
Healthy behaviours (BH)
Healthy behaviours (BH) - Question identifier:BH_Q35
Are you currently doing any of the following activities to maintain or improve your health?
Are you:
- 01: Communicating with friends or family
- 02: Communicating with health professionals (e.g., counsellor or therapist)
- 03: Communicating through social media
- 04: Meditating or seeking spiritual guidance
- 05: Exercising
- 06: Participating in hobbies (e.g., gardening, journaling or crafts)
- 07: Ensuring adequate sleep (e.g., avoiding screen time before sleep, avoiding caffeinated drinks or maintaining regular sleep cycle)
- 08: Other
- 09: None of the above
Mental health services (MHS)
Mental health services (MHS) - Question identifier:MHS_R05
The following questions are about the use of help and health care services related to problems with emotions, mental health or use of alcohol or drugs.
Mental health services (MHS) - Question identifier:MHS_Q05
Have you ever accessed any resources (on the internet, via phone or in person) to help manage your emotions, mental health or use of alcohol or drugs?
- 1: Yes
- 2: No
Mental health services (MHS) - Question identifier:MHS_Q10
During the past 12 months, did you receive the following kinds of help because of problems with your emotions, mental health or use of alcohol or drugs?
Did you receive:
- 1: Information about these problems, treatments or available services
- 2: Medication
- 3: Counselling, therapy, or help for problems with personal relationships (Include support groups such as Alcoholics Anonymous (AA), Narcotics Anonymous.)
- 4: None
Mental health services (MHS) - Question identifier:MHS_Q15
During the past 12 months, was there ever a time when you felt that you needed help for problems with your emotions, mental health or use of alcohol or drugs, but you didn't receive it?
- 1: Yes
- 2: No
Mental health services (MHS) - Question identifier:MHS_Q20
Why didn't you receive the help you needed (during the past 12 months)?
Was it because:
- 01: You preferred to manage yourself
- 02: You didn't know how or where to get this kind of help
- 03: You haven't gotten around to it (e.g., too busy)
- 04: Your job interfered (e.g., workload, hours of work or no cooperation from supervisor)
- 05: Access to care was limited (e.g., help was not readily available)
- 06: You didn't have confidence in the health care system or social services
- 07: You couldn't afford to pay
- 08: Insurance did not cover
- 09: You were afraid of what others would think of you
- 10: Language problems
- 11: Other
Mental health (ANX)
Mental health (ANX) - Question identifier:ANX_Q05A
Over the last 2 weeks, how often have you been bothered by the following problems?
Feeling nervous, anxious or on edge
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (ANX) - Question identifier:ANX_Q05B
Over the last 2 weeks, how often have you been bothered by the following problems?
Not being able to stop or control worrying
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP)
Mental health (DEP) - Question identifier:DEP_Q05A
Over the last 2 weeks, how often have you been bothered by the following problems?
Had little interest or pleasure in doing things
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP) - Question identifier:DEP_Q05B
Over the last 2 weeks, how often have you been bothered by the following problems?
Felt down, depressed, or hopeless
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Stressful events (PTS)
Stressful events (PTS) - Question identifier:PTS_R05
Throughout life, sometimes things happen to people that are unusually or especially frightening, stressful or traumatic. Examples include experiencing sudden loss of someone close, witnessing or experiencing actual or threatened serious injury or illness, a serious accident or fire, exposure to violence, etc.
The following questions may be sensitive to some people, but we have to ask the same questions of everyone.
Stressful events (PTS) - Question identifier:PTS_Q05
Have you ever experienced any of the following highly stressful or traumatic events during your life?
- 01: Natural disaster (e.g., flood, hurricane, tornado, earthquake)
- 02: Fire or explosion
- 03: Transportation accident (e.g., car accident, boat accident, train wreck, plane crash)
- 04: Serious accident at work, home, or during recreational activity
- 05: Exposure to toxic substance (e.g., dangerous chemicals, radiation)
- 06: Physical assault (e.g., being attacked, hit, slapped, kicked, beaten up)
- 07: Assault with a weapon (e.g., being shot, stabbed, threatened with a knife, gun, bomb)
- 08: Sexual assault (e.g., rape, attempted rape, made to perform any type of sexual act through force or threat of harm)
- 09: Other unwanted or uncomfortable sexual experience
- 10: Combat or exposure to a war-zone (in the military or as a civilian)
- 11: Captivity (e.g., being kidnapped, abducted, held hostage, prisoner of war)
- 12: Life-threatening illness or injury
- 13: Severe human suffering
- 14: Sudden violent death (e.g., homicide, suicide)
- 15: Sudden accidental death
- 16: Serious injury, harm, or death you caused to someone else
- 17: Any other very stressful event or experience
- 18: None of the above
Stressful events (PTS) - Question identifier:PTS_R10
For the following questions, the event that caused you the most reactions will be referred as your worst event.
Stressful events (PTS) - Question identifier:PTS_Q10
What was the worst event that you experienced?
- 01: Natural disaster
- 02: Fire or explosion
- 03: Transportation accident
- 04: Serious accident at work, home, or during recreational activity
- 05: Exposure to toxic substance
- 06: Physical assault
- 07: Assault with a weapon
- 08: Sexual assault
- 09: Other unwanted or uncomfortable sexual experience
- 10: Combat or exposure to a war-zone (in the military or as a civilian)
- 11: Captivity
- 12: Life-threatening illness or injury
- 13: Severe human suffering
- 14: Sudden violent death
- 15: Sudden accidental death
- 16: Serious injury, harm, or death you caused to someone else
- 17: Any other very stressful event or experience
Stressful events (PTS) - Question identifier:PTS_Q15
How did you experience this event?
Would you say:
- 1: It happened to me directly
- 2: I witnessed it
- 3: I learned about it happening to a close family member or a close friend
- 4: I was repeatedly exposed to details about it as part of my job (e.g., paramedic, police, military, or other first responder)
Stressful events (PTS) - Question identifier:PTS_Q20
How old were you when the worst event happened, or first happened?
Age in years
Min = 0; Max = 121
Stressful events (PTS) - Question identifier:PTS_Q21
Did the worst event you experienced involve actual or threatened death, serious injury, or sexual violence?
- 1: Yes
- 2: No
Stressful events (PTS) - Question identifier:PTS_Q22
Did your worst event involve the death of a close family member or close friend?
- 1: Yes
- 2: No
Stressful events (PTS) - Question identifier:PTS_Q22A
What was their cause of death?
- 1: Accident or violence
- 2: Natural causes
Stressful events (PTS) - Question identifier:PTS_Q25A
Was your worst event related to something that happened while you were at work?
- 1: Yes, related to current occupation
- 2: Yes, related to past occupation
- 3: No
Stressful events (PTS) - Question identifier:PTS_Q25D
Was your past occupation as a member of the Canadian Armed Forces, a public safety worker, or a health care provider?
- 1: Yes, a member of the Canadian Armed Forces (e.g., Regular or Reserve force members, including veterans)
- 2: Yes, a public safety worker (e.g., a police officer, firefighter, paramedic, correctional officer, coast guard employee, border services officer, Indigenous emergency manager, or 9-1-1 dispatcher
or operator) - 3: Yes, a health care provider (e.g., a nurse, physician, psychologist, social worker, or other health care provider)
- 4: No
Stressful events (PTS) - Question identifier:PTS_Q30
Was the worst event that you have ever experienced related to the COVID-19 pandemic?
- 1: Yes
- 2: No
Stressful events (PTS) - Question identifier:PTS_Q35A
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Repeated, disturbing, and unwanted memories of the stressful experience
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35B
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Repeated, disturbing dreams of the stressful experience
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35C
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Suddenly feeling or acting as if the stressful experience were actually happening again, as if you were actually back there reliving it
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35D
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Feeling very upset when something reminded you of the stressful experience
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35E
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Having strong physical reactions when something reminded you of the stressful experience
e.g., heart pounding, trouble breathing, sweating
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35F
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Avoiding memories, thoughts, or feelings related to the stressful experience
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35G
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Avoiding external reminders of the stressful experience
e.g., people, places, conversations, activities, objects, or situations.
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35H
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Trouble remembering important parts of the stressful experience
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35I
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Having strong negative beliefs about yourself, other people, or the world
e.g., having thoughts such as: I am bad, there is something seriously wrong with me, no one can be trusted, the world is completely dangerous
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35J
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Blaming yourself or someone else for the stressful experience or what happened after it
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35K
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Having strong negative feelings such as fear, horror, anger, guilt, or shame
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35L
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Loss of interest in activities that you used to enjoy
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35M
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Feeling distant or cut off from other people
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35N
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Trouble experiencing positive feelings
e.g., being unable to feel happiness or have loving feelings for people close to you
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35O
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Irritable behavior, angry outbursts, or acting aggressively
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35P
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Taking too many risks or doing things that could cause you harm
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35Q
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Being "superalert" or watchful or on guard
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35R
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Feeling jumpy or easily startled
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35S
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Having difficulty concentrating
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Stressful events (PTS) - Question identifier:PTS_Q35T
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Trouble falling or staying asleep
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Mental health (SUI)
Mental health (SUI) - Question identifier:SUI_R005
The following questions may be sensitive to some people, but we have to ask the same questions of everyone.
Mental health (SUI) - Question identifier:SUI_Q005
Have you ever seriously contemplated suicide?
- 1: Yes
- 2: No
Mental health (SUI) - Question identifier:SUI_Q007
Has this happened in the past 12 months?
- 1: Yes
- 2: No
Mental health (SUI) - Question identifier:SUI_Q010
Have you ever seriously contemplated suicide as a result of the worst event that you have ever experienced?
- 1: Yes
- 2: No
Mental health (SUI) - Question identifier:SUI_Q020
Have you ever made a plan to seriously attempt suicide?
- 1: Yes
- 2: No
Mental health (SUI) - Question identifier:SUI_Q025
Has this happened in the past 12 months?
- 1: Yes
- 2: No
Mental health (SUI) - Question identifier:SUI_Q030
Have you ever seriously attempted suicide?
- 1: Yes
- 2: No
Mental health (SUI) - Question identifier:SUI_Q040
Did this happen in the past 12 months?
- 1: Yes
- 2: No
Mental health (SUI) - Question identifier:SUI_Q045
How many times did you seriously attempt suicide in your lifetime?
Enter a number
Min = 0; Max = 99
Social impacts of stressful events (SIP)
Social impacts of stressful events (SIP) - Question identifier:SIP_Q05
In the past 12 months, have problems related to your worst event affected any of the following aspects of your life?
Would you say:
- 1: Your home responsibilities, like cleaning, shopping and taking care of the house or apartment
- 2: Your ability to attend school
- 3: Your ability to work at a job
- 4: Your family life (e.g., relationship with spouse or dependents)
- 5: Your ability to form or maintain close relationships with other people
- 6: Your social life
- 7: None of the above
Mental health services - contact with health professionals (SR1)
Mental health services - contact with health professionals (SR1) - Question identifier:SR1_Q05A_01
During the past 12 months, have you talked to any of the following people about problems related to your worst event?
Did you talk to:
- 1: Psychiatrist
- 2: Family doctor or general practitioner
- 3: Psychologist
- 4: Nurse
- 5: Social worker, counsellor, or psychotherapist
- 6: Another health professional
- 7: None of the above
Mental health services - contact with health professionals (SR1) - Question identifier:SR1_Q05A
How many times did you talk to a psychiatrist about problems related to your worst event?
Number of consultations
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
- 21: 21
- 22: 22
- 23: 23
- 24: 24
- 25: 25 or more
Mental health services - contact with health professionals (SR1) - Question identifier:SR1_Q05B
How many times did you talk to a family doctor or general practitioner about problems related to your worst event?
Number of consultations
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
- 21: 21
- 22: 22
- 23: 23
- 24: 24
- 25: 25 or more
Mental health services - contact with health professionals (SR1) - Question identifier:SR1_Q05C
How many times did you talk to a psychologist about problems related to your worst event?
Number of consultations
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
- 21: 21
- 22: 22
- 23: 23
- 24: 24
- 25: 25 or more
Mental health services - contact with health professionals (SR1) - Question identifier:SR1_Q05D
How many times did you talk to a nurse about problems related to your worst event?
Number of consultations
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
- 21: 21
- 22: 22
- 23: 23
- 24: 24
- 25: 25 or more
Mental health services - contact with health professionals (SR1) - Question identifier:SR1_Q05E
How many times did you talk to a social worker, counsellor, or psychotherapist about problems related to your worst event?
Number of consultations
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
- 21: 21
- 22: 22
- 23: 23
- 24: 24
- 25: 25 or more
Mental health services - contact with health professionals (SR1) - Question identifier:SR1_Q05F
How many times did you talk to another health professional about problems related to your worst event?
Number of consultations
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
- 21: 21
- 22: 22
- 23: 23
- 24: 24
- 25: 25 or more
Mental health services - contact with health professionals (SR1) - Question identifier:SR1_Q10A
Did you experience any of the following problems with the scheduling of your appointments?
Would you say:
- 1: One or more of your appointments was cancelled, rescheduled or delayed due to the COVID-19 pandemic
- 2: One or more of your appointments was cancelled, rescheduled or delayed due to other reasons (Exclude any reason related to the COVID-19 pandemic.)
- 3: One or more of your appointments has not been scheduled yet
- 4: Did not experience any problems with the scheduling of your appointments
Mental health services - contact with health professionals (SR1) - Question identifier:SR1_Q15A
Did you experience any other difficulties getting the health care service you needed?
- 01: Difficulty getting a referral
- 02: Waited too long between booking appointment and visit
- 03: Service not available in your area
- 04: Transportation (e.g., travel restrictions, lack of public transportation)
- 05: Cost
- 06: Quarantine rules or office closures
- 07: Service not available in the official language of your choice
- 08: Lack of availability of culturally appropriate health services
- 09: Lack of First Nations, Métis or Inuit traditional medicines, healing or wellness practices
- 10: Other
- 11: None of the above
Alcohol (ALC)
Alcohol (ALC) - Question identifier:ALC_R05
The following questions are about your alcohol consumption.
Alcohol (ALC) - Question identifier:ALC_Q05
During the past 30 days, did you have a drink of beer, wine, liquor or any other alcoholic beverage?
- 1: Yes
- 2: No
Alcohol (ALC) - Question identifier:ALC_Q10
During the past 30 days, on those days when you drank alcoholic beverages, how many drinks did you usually have?
Number of drinks
Min = 0; Max = 99
Alcohol (ALC) - Question identifier:ALC_Q15
During the past 30 days, how often have you had [5/4] or more drinks on one occasion?
- 1: Daily or almost daily
- 2: 2 to 5 times a week
- 3: Once a week
- 4: 2 to 3 times in the past 30 days
- 5: Once in the past 30 days
- 6: Not in the past 30 days
Cannabis (CAN)
Cannabis (CAN) - Question identifier:CAN_R05
The following questions are about your cannabis consumption.
Cannabis (CAN) - Question identifier:CAN_Q05
In the past 30 days, how often did you use cannabis?
- 01: Never used cannabis
- 02: Used previously but not in the past 30 days
- 03: 1 day in the past 30 days
- 04: 2 or 3 days in the past 30 days
- 05: 1 or 2 days per week
- 06: 3 or 4 days per week
- 07: 5 or 6 days per week
- 08: Daily
Cannabis (CAN) - Question identifier:CAN_Q10
What is the main reason you use cannabis?
- 1: Medical use with a medical document
- 2: Medical use without a medical document
- 3: Non-medical use
- 4: Both medical use and non-medical use
Social provisions (SPS)
Social provisions (SPS) - Question identifier:SPS_R05
The following questions are about your current relationships with friends, family members, co-workers, community members, and so on.
Social provisions (SPS) - Question identifier:SPS_Q05A
Please indicate to what extent each statement describes your current relationships with other people.
There are people I can depend on to help me if I really need it
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
Social provisions (SPS) - Question identifier:SPS_Q05B
Please indicate to what extent each statement describes your current relationships with other people.
There are people who enjoy the same social activities I do
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
Social provisions (SPS) - Question identifier:SPS_Q05C
Please indicate to what extent each statement describes your current relationships with other people.
I have close relationships that provide me with a sense of emotional security and well-being
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
Social provisions (SPS) - Question identifier:SPS_Q05D
Please indicate to what extent each statement describes your current relationships with other people.
There is someone I could talk to about important decisions in my life
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
Social provisions (SPS) - Question identifier:SPS_Q05E
Please indicate to what extent each statement describes your current relationships with other people.
I have relationships where my competence and skill are recognized
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
Social provisions (SPS) - Question identifier:SPS_Q05F
Please indicate to what extent each statement describes your current relationships with other people.
There is a trustworthy person I could turn to for advice if I were having problems
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
Social provisions (SPS) - Question identifier:SPS_Q05G
Please indicate to what extent each statement describes your current relationships with other people.
I feel part of a group of people who share my attitudes and beliefs
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
Social provisions (SPS) - Question identifier:SPS_Q05H
Please indicate to what extent each statement describes your current relationships with other people.
I feel a strong emotional bond with at least one other person
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
Social provisions (SPS) - Question identifier:SPS_Q05I
Please indicate to what extent each statement describes your current relationships with other people.
There are people who admire my talents and abilities
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
Social provisions (SPS) - Question identifier:SPS_Q05J
Please indicate to what extent each statement describes your current relationships with other people.
There are people I can count on in an emergency
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
Indigenous identity (ABM)
Indigenous identity (ABM) - Question identifier:ABM_Q01
Are you First Nations, Métis or Inuk (Inuit)?
- 1: No
- 2: Yes, First Nations
- 3: Yes, Métis
- 4: Yes, Inuk (Inuit)
Sociodemographic characteristics (PG)
Sociodemographic characteristics (PG) - Question identifier:PG_Q05
The following question collects information in accordance with the Employment Equity Act and its Regulations and Guidelines to support programs that promote equal opportunity for everyone to share in the social, cultural, and economic life of Canada.
- 01: White
- 02: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
- 03: Chinese
- 04: Black
- 05: Filipino
- 06: Arab
- 07: Latin American
- 08: Southeast Asian (e.g., Vietnamese, Cambodian, Laotian, Thai)
- 09: West Asian (e.g., Iranian, Afghan)
- 10: Korean
- 11: Japanese
- 12: Other
Place of birth, immigration and citizenship (DEM1)
Place of birth, immigration and citizenship (DEM1) - Question identifier:DEM1_Q30A
Where were you born?
- 1: Born in Canada
- 2: Born outside Canada
Place of birth, immigration and citizenship (DEM1) - Question identifier:DEM1_Q30B
Are you a Canadian citizen?
- 1: Yes, a Canadian citizen by birth
- 2: Yes, a Canadian citizen by naturalization (Canadian citizen by naturalization refers to an immigrant who was granted Citizenship of Canada under the Citizenship Act.)
- 3: No, not a Canadian citizen
Place of birth, immigration and citizenship (DEM1) - Question identifier:DEM1_Q30C
Are you a landed immigrant or permanent resident?
- 1: No
- 2: Yes
Place of birth, immigration and citizenship (DEM1) - Question identifier:DEM1_Q35
In what year did you first become a landed immigrant or a permanent resident?
Year of immigration
Min = 1902; Max = 2023
Disability (LTC)
Disability (LTC) - Question identifier:LTC_Q10
Do you identify as a person with a disability?
- 1: Yes
- 2: No
Marital status (MS)
Marital status (MS) - Question identifier:MS_Q01
What is your marital status?
- 1: Married (For Quebec residents only, select the "Married" category if your marital status is "civil union".)
- 2: Living common law (Two people who live together as a couple but who are not legally married to each other.)
- 3: Never married (not living common law)
- 4: Separated (not living common law)
- 5: Divorced (not living common law)
- 6: Widowed (not living common law)
Sexual orientation (SOR)
Sexual orientation (SOR) - Question identifier:SOR_Q01
What is ^DT_YOUR2 sexual orientation?
- 1: Heterosexual
- 2: Lesbian or gay
- 3: Bisexual
- 4: Or please specify
Education (ED)
Education (ED) - Question identifier:ED_Q05
What is the highest certificate, diploma or degree that you have completed?
- 1: Less than high school diploma or its equivalent
- 2: High school diploma or a high school equivalency certificate
- 3: Trade certificate or diploma
- 4: College, CEGEP or other non-university certificate or diploma (other than trades certificates or diplomas)
- 5: University certificate or diploma below the bachelor's level
- 6: Bachelor's degree (e.g., B.A., B.A. (Hons), B.Sc., B.Ed., LL.B)
- 7: University certificate, diploma or degree above the bachelor's level
Total household income (THI)
Total household income (THI) - Question identifier:THI_R01
Now a question about total household income.
Total household income (THI) - Question identifier:THI_Q01
What is your best estimate of your total household income received by all household members, from all sources, before taxes and deductions, during the year ending December 31, 2022?
Rounded to the nearest CAN$
Min = -99999999; Max = 99999999
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