<p> Improving Adult Community Mental Health Services in Manchester Thank you for taking the time to read the Manchester Mental Health and Social Care engagement document. Trust Chorlton House We are keen to hear what you think about our 70 Manchester Road proposals for more effective community Chorlton-cum-Hardy services. You can: Manchester, M21 9UN. </p><p>Write to: Cath Gormally, Associate Director of We welcome your comments and Community Services and Social Care and th Inclusion, Manchester Mental Health and views by Friday 27 July 2012. Social Care Trust, 11th Floor, Hexagon Tower, If you have any questions about the M9 8GQ engagement document or filling in this form, please email the Trust’s Communications Or e mail to: [email protected] or Team at: [email protected] [email protected] or Or complete this Feedback Form. You can telephone 0161 882 1124. Please feel free to hand it in at one or our office or hospital continue your responses on another sheet of locations or post it to: paper.</p><p>Freepost RSCY-XTEK-JGXK All responses are confidential. Communications Team (Public)</p><p>2</p><p>V05 June 2012 Thank you. ______Question 1: Do the planned improvements to community mental health services affect you? YES / NO (Please circle as appropriate) If yes, please let us know in what way (eg. as a service user/carer/referrer etc.)?</p><p>Question 2: What concerns do you have regarding the proposed changes?</p><p>Question 3: What could the Trust do to address any concerns you may have?</p><p>Finally if you have any further comments that you would like us to consider, please indicate these in the box below.</p><p>About you Are you? The Trust monitors diversity and equality in all its Male Female processes. Please complete this section to help us ensure we have feedback from a wide range of Do you consider yourself to have a disability? people. Yes No Please select one of the answers in each question by putting ticking the box. What is your ethnic group? (please tick)</p><p>What is your age group? Asian/Asian British, Bangladeshi Asian/ Asian British, Indian Under 21 21 – 44 Asian/Asian British, Pakistani 45 – 64 65 and over Asian, other 3</p><p>V05 June 2012 Black /Black British, African ______Black /Black British, Caribbean Black/Black British, other Chinese Please note that you can find a full list of open Mixed, White & Asian meetings and presentations planned to Mixed, White & Black African encourage feedback on these proposals on Mixed, White & Black Caribbean our website: www.mhsc.nhs.uk. Mixed, other White British White Irish White, other Other Ethnic background Unknown/Not declared</p><p>What is the first part of your postcode (e.g. M21)? ______</p><p>Do you consider yourself to be a user of mental health services in Manchester?</p><p>Yes No</p><p>Do you have a caring responsibility for someone who uses mental health services in Manchester?</p><p>Yes No</p><p>Do you represent a local community group or interest group?</p><p>Yes No</p><p>If yes, which one?</p><p>Would you like to be involved in other opportunities/communications about this review and other mental health service improvement projects?</p><p>Yes No</p><p>If yes, please provide your contact details (these will only be used for the purposes of contacting you regarding this particular project):</p><p>______</p><p>______</p><p>4</p><p>V05 June 2012</p>