Skip survey header

Ottawa Guiding Council on Mental Health and Addictions - PWLLE Reference Group Application

Persons with Lived and Living Experience Reference Group - Application Questions: 

Thank you for your interest in joining the 24/7 Mental Health and Substance Use Crisis Response Strategy Reference Group! Please answer the questions below. At the end of the section, you will be able to upload your résumé, letters of reference or any other relevant information you think would strengthen your application.  

If you prefer to speak to someone on the phone to share this information, please call our Program Coordinator, Trevor Lapointe at, 613 304 8330. 

Personal Information: 
1. Please provide us with the following information: *This question is required.
It is important that the Reference Group for the Guiding Council on Mental Health and Addictions broadly represents various intersecting identities. It is our aim to reflect the diverse population of Ottawa as best as possible. If you are not comfortable disclosing these identities, please select 'Prefer not to say'.

Information will be kept confidential to a small selection committee. 
2. Age:  *This question is required.
4. Race / Ethnicity:
Please select all that apply *This question is required.
5. Other Identifiers: 
Please select all that apply
6. I have lived or living experience of mental illness, mental health problems and/or substance use problems: *This question is required.
7. I am a family caregiver or family member of someone with mental illness, mental health problems or substance use problems: *This question is required.
8.

 

I have experienced the current 24/7 crisis response system (911, 211, 311 or other):  

*This question is required.
9. If you answered yes to the question above, how many times?
10. Are you able to commit to four meetings (two hours in length) between the end of June, 2022 and the end of March, 2023?  *This question is required.
11. Do you identify as someone with a disability?  *This question is required.
16.

We would love for you to help us map out the system here in Ottawa, and to find out where people go to seek help. Are you willing to attend a workshop during which a skilled facilitator will help to unpack your journey through the mental health/substance use system?  

*This question is required.
17. Please upload resume / references here: 
0%