Survey on COVID-19 and Mental Health - Cycle 2
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For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
Table of Contents
- Household information (DEM)
- Household information (AGE)
- Household information (GDR)
- Household information (DHH)
- Introduction (INT)
- Mental health (MH)
- Mental health (IM)
- Mental health (DIS)
- Mental health (BH)
- Mental health (MPC)
- Mental health (ANX)
- Mental health (DEP)
- Mental health (PTS)
- Mental health (SUI)
- Mental health (MHS)
- Alcohol (ALC)
- Cannabis (CAN)
- Parenting (PS)
- Household violence (HV)
- Labour market activities (LM)
- Indigenous identity (IS)
- Sociodemographic characteristics (PG)
- Place of birth, immigration and citizenship (DEM1)
- Marital status (MS)
- Education (ED)
- Total household income (THI)
- Future surveys (UCE)
- Data sharing agreements (DSA)
Household information (DEM)
Household information (DEM) - Question identifier:DEM_Q05
Including yourself, how many people live in your 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?
- 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 (AGE)
Household information (AGE) - Question identifier:AGE_Q02
What is your age?
Min = 0; Max = 999
Household information (GDR)
Household information (GDR) - Question identifier:GDR_Q10
What is your gender?
- 1: Male
- 2: Female
- 3: Or please specify
Household information (GDR) - Question identifier:GDR_R15
Please verify that all of the information is correct.
Your information
Gender: [Male/Female/^GDR_S10/Information not provided]
Household information (DHH)
Household information (DHH) - Question identifier:DHH_Q25
To determine which geographic region you live in, please provide your postal code.
Long Answer Length = 6
Introduction (INT)
Introduction (INT) - Question identifier:INT_R05
This survey covers various topics related to mental health and well-being. It may appear that some questions are similar but each set of questions helps to assess different information needs.
Mental health (MH)
Mental health (MH) - Question identifier:MH_R05
The following questions are about health, including your mental and social well-being.
Mental health (MH) - Question identifier:MH_Q05
In general, how is your mental health?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
Mental health (MH) - Question identifier:MH_Q10
Compared to before the COVID-19 pandemic, how would you say your mental health is now?
- 1: Much better now
- 2: Somewhat better now
- 3: About the same
- 4: Somewhat worse now
- 5: Much worse now
Mental health (MH) - Question identifier:MH_Q15
Using a scale of 0 to 10 where 0 means "Very dissatisfied" and 10 means "Very satisfied", how do you feel about your life as a whole right now?
- 00: 0 - Very dissatisfied
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10 - Very satisfied
Mental health (MH) - Question identifier:MH_Q20
How would you describe your sense of belonging to your local community?
- 1: Very strong
- 2: Somewhat strong
- 3: Somewhat weak
- 4: Very weak
Mental health (IM)
Mental health (IM) - Question identifier:IM_Q05
Have you or anyone you know been diagnosed with COVID-19?
- 1: Yes
- 2: No
Mental health (IM) - Question identifier:IM_Q05A
Who has been diagnosed with COVID-19?
- 1: Yourself
- 2: Another household member
- 3: A close friend or family member outside of your household
- 4: A co-worker or colleague
- 5: Someone else with whom you interact with in your community (e.g., neighbour, grocery store worker, babysitter)
- 6: Other
Mental health (IM) - Question identifier:IM_Q10
Have you experienced any of the following impacts due to the COVID-19 pandemic?
- 01: Loss of job or income
- 02: Difficulty meeting financial obligations or essential needs (e.g., such as rent or mortgage payments, utilities and groceries)
- 03: Death of a family member, friend or colleague
- 04: Feelings of loneliness or isolation
- 05: Emotional distress (e.g., grief, anger, worry, etc.)
- 06: Physical health problems (e.g., weight gain or loss, high blood pressure, headaches, sleep problems, etc.)
- 07: Challenges in personal relationships with members of your household (e.g., children, spouse, parent, grandparents, etc.)
- 08: Other
- 09: None of the above
Mental health (DIS)
Mental health (DIS) - Question identifier:DIS_R01
The following questions deal with feelings you may have had during the past month.
Mental health (DIS) - Question identifier:DIS_Q01A
During the past month, how often did you feel:
Tired out for no good reason
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
Mental health (DIS) - Question identifier:DIS_Q01B
During the past month, how often did you feel:
Nervous
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
Mental health (DIS) - Question identifier:DIS_Q01C
During the past month, how often did you feel:
So nervous that nothing could calm you down
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
Mental health (DIS) - Question identifier:DIS_Q01D
During the past month, how often did you feel:
Hopeless
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
Mental health (DIS) - Question identifier:DIS_Q01E
During the past month, how often did you feel:
Restless or fidgety
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
Mental health (DIS) - Question identifier:DIS_Q01F
During the past month, how often did you feel:
So restless you could not sit still
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
Mental health (DIS) - Question identifier:DIS_Q01G
During the past month, how often did you feel:
Sad or depressed
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
Mental health (DIS) - Question identifier:DIS_Q01H
During the past month, how often did you feel:
So depressed that nothing could cheer you up
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
Mental health (DIS) - Question identifier:DIS_Q01I
During the past month, how often did you feel:
That everything was an effort
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
Mental health (DIS) - Question identifier:DIS_Q01J
During the past month, how often did you feel:
Worthless
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
Mental health (DIS) - Question identifier:DIS_Q01K
The previous questions were about feelings that occurred to different degrees during the past month.
Taking them altogether, did these feelings occur more often in the past month than before the pandemic, less often than before the pandemic or about the same as before the pandemic?
- 1: More often
- 2: Less often
- 3: About the same
- 4: Never have had any
Mental health (DIS) - Question identifier:DIS_Q01L
Is that a lot more, somewhat more or only a little more often than usual?
- 1: A lot
- 2: Somewhat
- 3: A little
Mental health (DIS) - Question identifier:DIS_Q01M
Is that a lot less, somewhat less or only a little less often than usual?
- 1: A lot
- 2: Somewhat
- 3: A little
Mental health (DIS) - Question identifier:DIS_Q01N
During the past month, how much did these feelings usually interfere with your life or activities?
- 1: A lot
- 2: Some
- 3: A little
- 4: Not at all
- 5: Don't know
Mental health (BH)
Mental health (BH) - Question identifier:BH_Q35A
Are you currently doing any of the following activities for your health?
Communicating with friends and family
- 1: Yes, for my mental health
- 2: Yes, for my physical health
- 3: Yes, for both my mental and physical health
- 4: No
Mental health (BH) - Question identifier:BH_Q35B
Are you currently doing any of the following activities for your health?
Communicating with a professional
- 1: Yes, for my mental health
- 2: Yes, for my physical health
- 3: Yes, for both my mental and physical health
- 4: No
Mental health (BH) - Question identifier:BH_Q35C
Are you currently doing any of the following activities for your health?
Meditating
- 1: Yes, for my mental health
- 2: Yes, for my physical health
- 3: Yes, for both my mental and physical health
- 4: No
Mental health (BH) - Question identifier:BH_Q35D
Are you currently doing any of the following activities for your health?
Praying or seeking spiritual guidance
- 1: Yes, for my mental health
- 2: Yes, for my physical health
- 3: Yes, for both my mental and physical health
- 4: No
Mental health (BH) - Question identifier:BH_Q35E
Are you currently doing any of the following activities for your health?
Exercising outdoors
- 1: Yes, for my mental health
- 2: Yes, for my physical health
- 3: Yes, for both my mental and physical health
- 4: No
Mental health (BH) - Question identifier:BH_Q35F
Are you currently doing any of the following activities for your health?
Exercising indoors
- 1: Yes, for my mental health
- 2: Yes, for my physical health
- 3: Yes, for both my mental and physical health
- 4: No
Mental health (BH) - Question identifier:BH_Q35G
Are you currently doing any of the following activities for your health?
Changing food choices
- 1: Yes, for my mental health
- 2: Yes, for my physical health
- 3: Yes, for both my mental and physical health
- 4: No
Mental health (BH) - Question identifier:BH_Q35H
Are you currently doing any of the following activities for your health?
Participating in hobbies
- 1: Yes, for my mental health
- 2: Yes, for my physical health
- 3: Yes, for both my mental and physical health
- 4: No
Mental health (BH) - Question identifier:BH_Q35I
Are you currently doing any of the following activities for your health?
Changing sleep patterns
- 1: Yes, for my mental health
- 2: Yes, for my physical health
- 3: Yes, for both my mental and physical health
- 4: No
Mental health (MPC)
Mental health (MPC) - Question identifier:MPC_R05
The following is a series of statements that people might use to describe themselves.
Mental health (MPC) - Question identifier:MPC_Q05A
Please indicate to what extent you agree with each statement.
You have little control over the things that happen to you
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
Mental health (MPC) - Question identifier:MPC_Q05B
Please indicate to what extent you agree with each statement.
There is really no way you can solve some of the problems you have
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
Mental health (MPC) - Question identifier:MPC_Q05C
Please indicate to what extent you agree with each statement.
There is little you can do to change many of the important things in your life
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
Mental health (MPC) - Question identifier:MPC_Q05D
Please indicate to what extent you agree with each statement.
You often feel helpless in dealing with problems of life
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
Mental health (MPC) - Question identifier:MPC_Q05E
Please indicate to what extent you agree with each statement.
Sometimes you feel that you are being pushed around in life
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
Mental health (MPC) - Question identifier:MPC_Q05F
Please indicate to what extent you agree with each statement.
What happens to you in the future mostly depends on you
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
Mental health (MPC) - Question identifier:MPC_Q05G
Please indicate to what extent you agree with each statement.
You can do just about anything you really set your mind to
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
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 (ANX) - Question identifier:ANX_Q05C
Over the last 2 weeks, how often have you been bothered by the following problems?
Worrying too much about different things
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (ANX) - Question identifier:ANX_Q05D
Over the last 2 weeks, how often have you been bothered by the following problems?
Trouble relaxing
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (ANX) - Question identifier:ANX_Q05E
Over the last 2 weeks, how often have you been bothered by the following problems?
Being so restless that it is hard to sit still
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (ANX) - Question identifier:ANX_Q05F
Over the last 2 weeks, how often have you been bothered by the following problems?
Becoming easily annoyed or irritable
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (ANX) - Question identifier:ANX_Q05G
Over the last 2 weeks, how often have you been bothered by the following problems?
Feeling afraid as if something awful might happen
- 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_Q005
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_Q010
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
Mental health (DEP) - Question identifier:DEP_Q015
Over the last 2 weeks, how often have you been bothered by the following problems?
Had trouble falling or staying asleep, or sleeping too much
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP) - Question identifier:DEP_Q020
Over the last 2 weeks, how often have you been bothered by the following problems?
Felt tired or having little energy
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP) - Question identifier:DEP_Q025
Over the last 2 weeks, how often have you been bothered by the following problems?
Had poor appetite or overate
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP) - Question identifier:DEP_Q030
Over the last 2 weeks, how often have you been bothered by the following problems?
Felt bad about yourself - or that you are a failure or have let yourself or your family down
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP) - Question identifier:DEP_Q035
Over the last 2 weeks, how often have you been bothered by the following problems?
Had trouble concentrating on things, such as reading the newspaper or watching television
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP) - Question identifier:DEP_Q040
Over the last 2 weeks, how often have you been bothered by the following problems?
Been moving or speaking so slowly that other people could have noticed? Or the opposite, being so fidgety or restless that you have been moving around a lot more than usual
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP) - Question identifier:DEP_Q045
Over the last 2 weeks, how often have you been bothered by the following problems?
Had thoughts that you would be better off dead or of hurting yourself in some way
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP) - Question identifier:DEP_Q050
How difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?
- 1: Not difficult at all
- 2: Somewhat difficult
- 3: Very difficult
- 4: Extremely difficult
Mental health (PTS)
Mental health (PTS) - Question identifier:PTS_R05
Throughout life, sometimes things happen to people that are unusually or especially frightening, stressful, or traumatic. For example: 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.
Mental health (PTS) - Question identifier:PTS_Q05
Have you ever experienced a highly stressful or traumatic event during your life?
- 1: Yes
- 2: No
Mental health (PTS) - Question identifier:PTS_Q10
Was the worst or most stressful traumatic event that you have ever experienced related to any of the following?
- 1: Related to the COVID-19 pandemic (e.g., death of someone close to you from COVID-19, major stressful life changes due to COVID-19, etc.)
- 2: Related to any other serious illness
- 3: Any other type of traumatic experience
Mental health (PTS) - Question identifier:PTS_Q15A
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
Mental health (PTS) - Question identifier:PTS_Q15B
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
Mental health (PTS) - Question identifier:PTS_Q15C
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
Mental health (PTS) - Question identifier:PTS_Q15D
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
Mental health (PTS) - Question identifier:PTS_Q15E
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
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Mental health (PTS) - Question identifier:PTS_Q15F
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
Mental health (PTS) - Question identifier:PTS_Q15G
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
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Mental health (PTS) - Question identifier:PTS_Q15H
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
Mental health (PTS) - Question identifier:PTS_Q15I
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
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Mental health (PTS) - Question identifier:PTS_Q15J
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
Mental health (PTS) - Question identifier:PTS_Q15K
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
Mental health (PTS) - Question identifier:PTS_Q15L
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
Mental health (PTS) - Question identifier:PTS_Q15M
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
Mental health (PTS) - Question identifier:PTS_Q15N
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Trouble experiencing positive feelings
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Mental health (PTS) - Question identifier:PTS_Q15O
Keeping your worst event in mind, over the past month, how much have you been bothered by the following problems?
Irritable behaviour, angry outbursts, or acting aggressively
- 1: Not at all
- 2: A little bit
- 3: Moderately
- 4: Quite a bit
- 5: Extremely
Mental health (PTS) - Question identifier:PTS_Q15P
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
Mental health (PTS) - Question identifier:PTS_Q15Q
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
Mental health (PTS) - Question identifier:PTS_Q15R
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
Mental health (PTS) - Question identifier:PTS_Q15S
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
Mental health (PTS) - Question identifier:PTS_Q15T
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_Q010
Have you seriously contemplated suicide since the COVID-19 pandemic began?
- 1: Yes
- 2: No
Mental health (SUI) - Question identifier:SUI_Q015
How old were you the last time you seriously contemplated suicide?
Min = 0; Max = 999
Mental health (MHS)
Mental health (MHS) - Question identifier:MHS_Q05
Have you accessed any resources (on the internet, via phone or in person) to help manage your emotions, mental health or use of alcohol or drugs during the COVID-19 pandemic?
- 1: Yes
- 2: No
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?
Min = 0; Max = 99
Alcohol (ALC) - Question identifier:ALC_Q15
During the past 30 days, how often have you had ^BINGE 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
Alcohol (ALC) - Question identifier:ALC_Q20
On average, over the course of the COVID-19 pandemic, how has your alcohol consumption changed when comparing to before the pandemic?
- 1: Increased
- 2: Decreased
- 3: No change
Alcohol (ALC) - Question identifier:ALC_Q25
Which of the following reasons have contributed to your increased consumption of alcohol since before the COVID-19 pandemic?
- 1: Stress (e.g., as a result of family or work obligations, financial impacts, job uncertainty, etc.)
- 2: Boredom
- 3: Loneliness
- 4: Convenience (e.g., lack of regular schedule, at home more often, accessibility to alcohol, etc.)
- 5: Other
- 6: No particular reason
- 7: I don't know
Alcohol (ALC) - Question identifier:ALC_Q30
Which of the following reasons have contributed to your decreased consumption of alcohol since before the COVID-19 pandemic?
- 1: Cost
- 2: Personal responsibilities (e.g., family or work obligations, too busy, etc.)
- 3: Personal choice (e.g., weight control, health concerns, dislike the effects of alcohol, etc.)
- 4: Decreased opportunities for socialization (e.g., gatherings with friends and family, dine-in at restaurants, etc.)
- 5: Other
- 6: No particular reason
- 7: I don't know
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
On average, over the course of the COVID-19 pandemic, how has your use of cannabis changed when comparing to before the pandemic?
- 1: Increased
- 2: Decreased
- 3: No change
Cannabis (CAN) - Question identifier:CAN_Q15
Which of the following reasons have contributed to your increased use of cannabis since before the COVID-19 pandemic?
- 1: Stress (e.g., as a result of family or work obligations, financial impacts, job uncertainty, etc.)
- 2: Boredom
- 3: Loneliness
- 4: Convenience (e.g., lack of regular schedule, at home more often, accessibility to cannabis, etc.)
- 5: Other
- 6: No particular reason
- 7: I don't know
Cannabis (CAN) - Question identifier:CAN_Q20
Which of the following reasons have contributed to your decreased use of cannabis since before the COVID-19 pandemic?
- 1: Cost
- 2: Personal responsibilities (e.g., family or work obligations, too busy, etc.)
- 3: Personal choice (e.g., weight control, health concerns, dislike the effects of cannabis, etc.)
- 4: Decreased opportunities for socialization (ee.g., gatherings with friends and family, etc.)
- 5: Other
- 6: No particular reason
- 7: I don't know
Parenting (PS)
Parenting (PS) - Question identifier:PS_Q05
Are you a parent or legal guardian of a child (or children) under the age of 18?
- 1: Yes
- 2: No
Parenting (PS) - Question identifier:PS_Q10A
Please indicate the number of children under 18 months in your home.
- 00: 0
- 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
Parenting (PS) - Question identifier:PS_Q10B
Please indicate the number of children in your home between the ages of 18 months and 17 years.
- 00: 0
- 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
Parenting (PS) - Question identifier:PS_R15
When answering the following questions, please think about the child between the ages of 18 months and 17 years who had the most recent birthday.
Parenting (PS) - Question identifier:PS_Q15A
How old is the child who had the most recent birthday?
- 01: 18-23 months
- 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
Parenting (PS) - Question identifier:PS_Q20
What is the gender of this child?
- 1: Male
- 2: Female
- 3: Or please specify
Parenting (PS) - Question identifier:PS_R25A
At one time or another, all children misbehave or do things that parents don't like. Parents have many ways or styles of dealing with these types of problems. Each item will have two statements associated with it that will describe differences in parenting style on a scale between 1 and 7. For each item, please indicate where you fit between the statements that best describes your style of parenting during the past two months.
If you have more than one child, please refer to the child between the ages of 18 months and 17 years who had the most recent birthday when answering the following questions.
Parenting (PS) - Question identifier:PS_Q25A
When I'm upset or under stress:
- 1: 1 - I am not more picky than usual
- 2: 2
- 3: 3
- 4: 4
- 5: 5
- 6: 6
- 7: 7 - I am picky and on my child's back
Parenting (PS) - Question identifier:PS_Q25B
When my child misbehaves:
- 1: 1 - I don't get into an argument
- 2: 2
- 3: 3
- 4: 4
- 5: 5
- 6: 6
- 7: 7 - I usually get into a long argument with my child
Parenting (PS) - Question identifier:PS_Q25C
When my child misbehaves:
- 1: 1 - I keep my talks short and to the point
- 2: 2
- 3: 3
- 4: 4
- 5: 5
- 6: 6
- 7: 7 - I give my child a long lecture
Parenting (PS) - Question identifier:PS_R25B
Remember, please indicate where you fit between the statements that best describes your style of parenting during the past two months for the child who had the most recent birthday.
Parenting (PS) - Question identifier:PS_Q25D
When my child misbehaves:
- 1: 1 - I speak to my child calmly
- 2: 2
- 3: 3
- 4: 4
- 5: 5
- 6: 6
- 7: 7 - I raise my voice or yell
Parenting (PS) - Question identifier:PS_Q25E
After there's been a problem with my child:
- 1: 1 - Things get back to normal quickly
- 2: 2
- 3: 3
- 4: 4
- 5: 5
- 6: 6
- 7: 7 - I often hold a grudge
Parenting (PS) - Question identifier:PS_Q25F
When there is a problem with my child:
- 1: 1- Things don't get out of hand
- 2: 2
- 3: 3
- 4: 4
- 5: 5
- 6: 6
- 7: 7 -Things build up and I do things I don't mean to do
Parenting (PS) - Question identifier:PS_Q25G
When my child misbehaves I spank, slap, grab, or hit my child:
- 1: 1 - Never or rarely
- 2: 2
- 3: 3
- 4: 4
- 5: 5
- 6: 6
- 7: 7 - Most of the time
Parenting (PS) - Question identifier:PS_R25C
Remember, please indicate where you fit between the statements that best describes your style of parenting during the past two months for the child who had the most recent birthday.
Parenting (PS) - Question identifier:PS_Q25H
When my child misbehaves:
- 1: 1 - I handle it without getting upset
- 2: 2
- 3: 3
- 4: 4
- 5: 5
- 6: 6
- 7: 7 - I get so frustrated or angry that my child can see I'm upset
Parenting (PS) - Question identifier:PS_Q25I
When my child misbehaves:
- 1: 1 - I rarely use bad language or curse
- 2: 2
- 3: 3
- 4: 4
- 5: 5
- 6: 6
- 7: 7 - I almost always use bad language
Parenting (PS) - Question identifier:PS_Q25J
When my child does something I don't like, I insult my child, say mean things, or call my child names:
- 1: 1 - Never or rarely
- 2: 2
- 3: 3
- 4: 4
- 5: 5
- 6: 6
- 7: 7 - Most of the time
Household violence (HV)
Household violence (HV) - Question identifier:HV_R05
The next questions concern the serious problem of violence in the home. Your responses are important whether or not you have had any of these experiences. Remember that all information provided is strictly confidential.
Household violence (HV) - Question identifier:HV_Q05
How concerned are you about violence in your home?
- 1: Not at all
- 2: Somewhat
- 3: Very
- 4: Extremely
Household violence (HV) - Question identifier:HV_Q10
Whom in your household are you concerned about being a target of violence?
- 1: Yourself
- 2: Another adult or other adults in the household
- 3: Child or children
Labour market activities (LM)
Labour market activities (LM) - Question identifier:LM_R05
The following questions concern your activities during the week of [Display the system date - 7] to [Display the system date - 1].
Labour market activities (LM) - Question identifier:LM_Q05
During that week, did you work at a job or business?
- 1: Yes
- 2: No
Labour market activities (LM) - Question identifier:LM_Q10
During that week, did you have a job or business from which you were absent?
- 1: Yes
- 2: No
Labour market activities (LM) - Question identifier:LM_Q15
What was the main reason you were absent from work that week?
- 1: Planned absence not related to COVID-19 (e.g., vacation, work schedule, maternity or parental leave, seasonal job or business)
- 2: Unplanned absence not related to COVID-19 (e.g., illness or disability other than COVID-19, caring for children or elder relative for non-COVID-19 reasons, labour dispute (strike or lockout))
- 3: Business closure or layoff related to COVID-19
- 4: Personal circumstances related to COVID-19 (e.g., personal safety, own or household member's diagnosis, self-isolation after recent travel, taking care of children due to school closure)
Labour market activities (LM) - Question identifier:LM_Q20
Which of the following best describes your usual place of work at your main job or business, before the pandemic?
- 1: Work at a fixed location outside the home
- 2: Work outside the home with no fixed location (e.g., driving, making sales calls)
- 3: Work at home
Labour market activities (LM) - Question identifier:LM_Q25
During the week of [Display the system date - 7] to [Display the system date - 1], in which of these locations did you work the most hours?
- 1: At a fixed location outside the home
- 2: Outside the home with no fixed location (e.g., driving, making sales calls)
- 3: At home
- 4: Absent from work
Labour market activities (LM) - Question identifier:LM_Q30
During the week of [Display the system date - 7] to [Display the system date - 1], were you considered an "essential worker"?
- 1: Yes
- 2: No
- 3: Don't know
Labour market activities (LM) - Question identifier:LM_Q35
Were you considered a "frontline worker"?
- 1: Yes
- 2: No
- 3: Don't know
Indigenous identity (IS)
Indigenous identity (IS) - Question identifier:IS_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.
Are you:
- 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?
Min = 0; Max = 9999
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)
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: Trades 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, 2019?
Min = -99999999; Max = 99999999
Total household income (THI) - Question identifier:THI_Q10
How has your total amount of household income changed due to the COVID-19 pandemic?
- 1: Increased
- 2: Decreased
- 3: No change
Future surveys (UCE)
Future surveys (UCE) - Question identifier:UCE_Q01
Statistics Canada is planning future surveys on mental health, including a potential follow-up to this survey.
Would you like to sign-up for future surveys?
- 1: Yes
- 2: No
Future surveys (UCE) - Question identifier:UCE_Q05B
Please provide the following information so we can email you to participate in a follow-up survey or future mental health surveys.
Email address
Long Answer Length = 80
Data sharing agreements (DSA)
Data sharing agreements (DSA) - Question identifier:DSA_R01
To avoid duplication of surveys, Statistics Canada may enter into agreements to share the data from this survey, including postal code, with provincial and territorial ministries of health, [the Institut de la statistique du Québec,/BLANK] Health Canada and the Public Health Agency of Canada. [The Institut de la statistique du Québec and provincial ministries/Provincial ministries] of health may make the data available to local health authorities. Only organizations that have agreed to keep your information confidential and use it only for statistical purposes will receive the data.
Data sharing agreements (DSA) - Question identifier:DSA_Q01
Do you agree to share your information with provincial and territorial ministries of health, [the Institut de la statistique du Québec,/BLANK] Health Canada and the Public Health Agency of Canada?
- 1: Yes
- 2: No
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