Form 1 Questionnaire

Generic Clearance for Questionnaire Pretesting Research

NSP-1_111418_D20

National Survey of Psychiatrists Cognitive Testing

OMB: 0607-0725

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2019 NATIONAL
SURVEY OF PSYCHIATRISTS

Start Here

Section A.
Eligibility

Respond online today at:
https://respond.census.gov/nsp

A1.

OR

Are you currently licensed to practice medicine
in the U.S.?
Yes

Complete this form and mail it back
as soon as possible.
The 2019 National Survey of Psychiatrists (NSP)
is being conducted by the United States Census
Bureau on behalf of the Substance Abuse and
Mental Health Services Administration of the U.S.
Department of Health and Human Services.
We appreciate your help with this important
survey. If you need help or have questions about
completing this form, please call 1-888-369-3615
or email us at NSP@census.gov.

No ➔ If No, you do not need to complete the
rest of this questionnaire. Please mark
“No” and return this questionnaire in
the envelope provided so we know you
are not eligible.
A2.

Did you complete your residency in psychiatry?
Yes
No ➔ If No, you do not need to complete the
rest of this questionnaire. Please mark
“No” and return this questionnaire in
the envelope provided so we know you
are not eligible.

FORM NSP-1
(11/14/2018) Draft 20

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A3.

A4.

Are you currently providing direct clinical care
as a psychiatrist?

A9.

When do you think you will provide direct
clinical care as a psychiatrist in the future?

Yes ➔ SKIP to Section B

In less than a year

No

1 to 2 years
In more than two years

Have you provided direct clinical care as a
psychiatrist within the PAST TWO YEARS?

Don’t know

Yes ➔ SKIP to Section C on page 7

SKIP to Section E on page 12

No
A5.

Section B.
Current Employment in
Direct Clinical Care

Have you EVER provided direct clinical care
as a psychiatrist?
Yes ➔ SKIP to Question A7
No

A6.

A7.

A8.

B1.

Why have you never provided direct clinical
care as a psychiatrist? Mark all that apply.

Which area(s) of clinical care do you specialize
in? Mark all that apply.
Addiction Psychiatry

Did not enjoy clinical care

Administrative Psychiatry

Wanted to pursue alternate career

Child and Adolescent Psychiatry

Clinical care did not pay well enough

Community Psychiatry

Other

Consultation-Liaison Psychiatry
Emergency Psychiatry

What is your current employment status?
Mark one box only.

Forensic Psychiatry

Employed ➔ SKIP to Section D on page 11

Gender Identity Issues

Looking for work

General Psychiatry

Retired

Geriatric Psychiatry

Other

Intellectual Disability Psychiatry
Military Psychiatry

Do you think you will provide direct clinical
care as a psychiatrist in the future?

Psychiatric Research
Yes
Psychiatric Informatics
No ➔ SKIP to Section E on page 12
Psychoanalysis
Don’t know ➔ SKIP to Section E on page 12
Sexual Orientation Issues
Other
B2.

During a typical week, how many different
employment settings do you work in?
Settings

2

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B3.

What setting(s) do you provide direct clinical
care within? Mark all that apply.

B5.

Community Mental Health Center (CMHC)

During a typical week, what percentage of time
do you spend providing services to clients in
each of the following age groups? Do not use
decimals.

Criminal justice setting

a. Children aged 17 or younger

%

b. Adults aged 18 to 64

%

c. Adults aged 65 and older

%

Federally Qualified Health Center (FQHC)
Health Maintenance Organization (HMO)
Hospital - General
Hospital - Private psychiatric

Total

Hospital - State psychiatric

B6.

Long term care
Primary care office or clinic

100%

During a typical week, what percentage of time
do you spend providing services to clients of the
following sexes? Do not use decimals.
a. Male

%

b. Female

%

Private practice (solo or group)
Residential setting - Mental Health (MH)
or Substance Use Disorder (SUD)

B7.

Other
B4.

100%

Total

VA or military medical center

What percentage of time do you spend on each
of the following types of work activities during
a typical week? Do not use decimals.
a. Direct patient care
Include all time spent
directly interacting with
patients, in-person or
by telehealth, and
collaborative care

Yes
No ➔ SKIP to Question B9 on page 4

%
B8.

b. Documentation and
follow-up related to
patient care

%

c. Programs/services
leadership

%

d. Teaching

%

Are you currently able to provide psychiatric
services to patients in a language other than
English WITHOUT using an interpreter or
translator?

In which language(s) other than English are
you able to provide psychiatric services to
patients WITHOUT using an interpreter or
translator? Mark all that apply.
Spanish
Chinese (including Mandarin and
Cantonese)
Tagolog (including Filipino)
Vietnamese

e. Research

%

f. Other

%

Arabic
French
American Sign Language

Total

100%

Other

3

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B9.

B14b. About how many patients for whom you
prescribe Clozapine do you see during a
typical week?

Are you currently able to provide psychiatric
services to patients in a language other than
English USING an interpreter or translator?
Yes

1 to 5

No ➔ SKIP to Question B11

6 to 10
11 to 20

B10.

In which language(s) other than English are
you able to provide psychiatric services to
patients USING an interpreter or translator?
Mark all that apply.

21 to 50
More than 50

Spanish

B15a.

Chinese (including Mandarin and
Cantonese)

Are you currently treating any patients with
long acting injectable antipsychotics?
Yes

Tagolog (including Filipino)

No ➔ SKIP to Question B16

Vietnamese
B15b. About how many patients that you treat using
long acting injectible antipsychotics do you
see during a typical week?

Arabic
French

1 to 5

American Sign Language

6 to 10

Other
B11.

11 to 20

During a typical week, do you personally use
telehealth in your workplace(s)?

21 to 50
More than 50

Yes
B16.

No
B12.

Are you currently treating any patients for
Opioid Use Disorder using Methadone?
Yes

Do you have any patients in your current
caseload for whom you are providing specific
services related to gender identity?

No

Yes

B17.

Are you currently treating any patients for
Opioid Use Disorder using Naltrexone?

No
Yes
B13.

Do you have any patients in your current
caseload for whom you are providing specific
services related to sexual orientation?

No
B18.

Yes

Yes

No
B14a.

Have you obtained a waiver authorizing you
to prescribe Buprenorphine?

No ➔ SKIP to Question B21a on page 5

Are you currently treating any patients with
Clozapine?

B19.

Yes

Are you currently treating any patients for
Opioid Use Disorder using Buprenorphine?
Yes

No ➔ SKIP to Question B15a

No ➔ SKIP to Question B21a on page 5

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B20.

B24.

How many individual patients do you treat
using Buprenorphine during a typical week?

How satisfied or dissatisfied are you with each
of the following dimensions of your work in
direct clinical care?

Patients
B21a.

Very
Very
Satisfied Dissatisfied
dissatisfied
satisfied

N/A

a. Amount of

As part of your clinical practice, are you
currently providing therapy, psychotherapy,
or counseling?

time for
documentation

b. Amount of time
doing prior
authorizations

Yes

c. Amount of

No ➔ SKIP to Question B22

time spent
on electronic
health records

B21b. Which of the following treatment methods are
you currently providing? Mark all that apply.

d. Ease of using

the electronic
health record
system

Psychotherapy

e. Amount of

Cognitive Behavioral Therapy

time allotted
to see patients

Cognitive Remediation Therapy

f. Ability of

team to work
together
effectively

Dialectical Behavioral Therapy
Psychoanalysis

g. Amount

of stress
associated with
patient acuity

Psychoeducation
Health Education

h. Availability of
psychosocial
resources for
my patients

Other:

i. Amount of
B22.

responsibility

Are you providing court-mandated outpatient
treatment to any patients in your current
caseload?

j. Financial

compensation

Yes
B25.
No
B23.

Which of the following best describes your
current employment arrangement?
Mark all that apply.

Do you work in an Integrated Care Model for
primary care and behavioral health during a
typical week? An Integrated Care Model is
defined as tightly integrated, on-site teamwork
with a unified care plan as a standard approach
to care for designated populations. Connotes
organizational integration as well, often
involving social and other community services.

Self-employed
Yes
Salaried employment
No
Hourly employment
Temporary employment
Other

5

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B26.

Answer the following questions in regard to the
setting you provide direct clinical care in only. If
you provide direct clinical care in more than one
setting, please answer in reference to the setting in
which you most recently worked.

Do you use Electronic Health Records for the
following tasks? Mark Yes or No for each of the
tasks below.
Yes
No
a. Prescribing medication

B31.

b. Dispensing medication
c. Storing patient health records

Yes ➔ SKIP to Question B33

d. Maintaining patient health
records

No

e. Storing patient treatment
records

B32.

f. Maintaining patient treatment
records
B27.

Which of the following are reasons that setting
does not accept insurance? Mark all that apply.
Administrative burden

Are you currently accepting new patients?

Low reimbursement rates

Yes

High demand for behavioral health services

No
B28.

Does the setting in which you provided care
most recently accept insurance?

It’s a free clinic

On average, how long is a new patient intake
session? Please include any time required for
documentation in addition to patient time.

Other

SKIP to Section E on page 12

Less than 20 minutes
B33.
20 to 39 minutes

What types of insurance are accepted by the
setting in which you most recently provided
clinical care? Mark all that apply.

40 to 59 minutes
Commercial insurance
60 minutes or more
Medicare
B29.

On average, how long are sessions with existing
patients? Please include any time required for
documentation in addition to patient time.

Medicaid
VA

Less than 20 minutes
Tricare
20 to 39 minutes
Other
40 to 59 minutes

SKIP to Section E on page 12

60 minutes or more
B30.

Approximately when do you plan to retire from
providing direct clinical care?
Already retired
In less than a year
In 1 to 2 years
In 3 to 5 years
More than 5 years from now
Don’t know

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Section C.
Previous Employment in
Direct Clinical Care

C3.

Community Mental Health Center (CMHC)
Criminal justice setting

Answer the following questions only if you have
worked in direct clinical care during the past two
years, but are not currently doing so. Otherwise,
please SKIP to Section E on page 12.
C1.

What setting(s) did you provide direct clinical
care within? Mark all that apply.

Federally Qualified Health Center (FQHC)
Health Maintenance Organization (HMO)

Which area(s) of clinical care did you specialize
in? Mark all that apply.

Hospital - General
Hospital - Private psychiatric

Addiction Psychiatry
Hospital - State psychiatric
Administrative Psychiatry
Long term care
Child and Adolescent Psychiatry
Primary care office or clinic
Community Psychiatry
Private practice (solo or group)
Consultation-Liaison Psychiatry
Emergency Psychiatry

Residential setting - Mental Health (MH)
or Substance Use Disorder (SUD)

Forensic Psychiatry

VA or military medical center

Gender Identity Issues

Other

General Psychiatry

C4.

Geriatric Psychiatry

a. Direct patient care
Include all time spent
directly interacting with
patients, in-person or
by telehealth, and
collaborative care

Intellectual Disability Psychiatry
Military Psychiatry
Psychiatric Research

%

%

Psychoanalysis

b. Documentation and
follow-up related to
patient care

Sexual Orientation Issues

c. Programs/services
leadership

%

d. Teaching

%

e. Research

%

f. Other

%

Psychiatric Informatics

Other
C2.

What percentage of time did you spend on
each of the following types of work activities
during a typical week? Do not use decimals.

During a typical week, how many different
employment setting(s) did you work in?
Settings

Total

7

100%

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C5.

During a typical week, what percentage of time
did you spend providing services to clients in
each of the following age groups? Do not use
decimals.

C9.

Yes

%

a. Children aged 17 or younger

Were you able to provide psychiatric services
to patients in a language other than English
USING an interpreter or translator?

No ➔ SKIP to Question C11
b. Adults aged 18 to 64

%
C10.

c. Adults aged 65 and older

Total
C6.

%

100%

In which language(s) other than English were
you able to provide psychiatric services to
patients USING an interpreter or translator?
Mark all that apply.
Spanish
Chinese (including Mandarin and
Cantonese)

During a typical week, what percentage of time
did you spend providing services to clients of
the following sexes? Do not use decimals.
a. Male

%

b. Female

%

Tagolog (including Filipino)
Vietnamese
Arabic
French

Total
C7.

100%

American Sign Language

Were you able to provide psychiatric services
to patients in a language other than English
WITHOUT using an interpreter or translator?

Other
C11.

Yes
No ➔ SKIP to Question C9
C8.

During a typical week, did you personally use
telehealth in your workplace(s)?
Yes
No

In which language(s) other than English were
you able to provide psychiatric services to
patients WITHOUT using an interpreter or
translator? Mark all that apply.

C12.

Did you have any patients in your caseload
for whom you provided specific services
related to gender identity?

Spanish
Yes

Chinese (including Mandarin and
Cantonese)

No

Tagolog (including Filipino)
C13.
Vietnamese
Arabic

Did you have any patients in your caseload
for whom you provided specific services
related to sexual orientation?
Yes

French

No

American Sign Language
C14a.

Did you treat any patients with Clozapine?

Other
Yes
No ➔ SKIP to Question C15a on page 9.

8

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C14b. About how many patients for whom you
prescribed Clozapine did you see during a
typical week?

C20.

How many individual patients did you treat
using Buprenorphine during a typical week?
Patients

1 to 5
6 to 10

C21a.

11 to 20

Yes

21 to 50

No ➔ SKIP to Question C22

More than 50
C15a.

As part of your clinical practice, were you
providing therapy, psychotherapy, or counseling?

C21b. Which of the following treatment methods were
you providing? Mark all that apply.

Did you treat patients using long acting
injectable antipsychotics?
Yes

Psychotherapy

No ➔ SKIP to Question C16

Cognitive Behavioral Therapy
Cognitive Remediation Therapy

C15b. About how many patients that you treated
using long acting injectable antipsychotics did
you see during a typical week?

Dialectical Behavioral Therapy

1 to 5

Psychoanalysis

6 to 10

Psychoeducation

11 to 20

Health Education

21 to 50

Other:

More than 50
C22.
C16.

C17.

Did you treat patients for Opioid Use Disorder
using Methadone?

Were you providing court-mandated outpatient
treatment to any patients in your most recent
caseload?

Yes

Yes

No

No

Did you treat patients for Opioid Use Disorder
using Naltrexone?

C23.

Which of the following best describes the
employment arrangement of your most recent
clinical care work? Mark all that apply.

Yes
Self-employed
No
Salaried employment
C18.

C19.

Did you obtain a waiver authorizing you to
prescribe Buprenorphine?

Hourly employment

Yes

Temporary employment

No ➔ SKIP to Question C21a

Other

Did you treat patients for Opioid Use Disorder
using Buprenorphine?
Yes
No ➔ SKIP to Question C21a

9

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C24.

C26.

How satisfied or dissatisfied were you with each
of the following dimensions of your work in
direct clinical care?
Very
Very
Satisfied Dissatisfied
dissatisfied
satisfied

N/A

Did you use Electronic Health Records for the
following tasks? Mark Yes or No for each of the
tasks below.
Yes
No
a. Prescribing medication

a. Amount of

b. Dispensing medication

time for
documentation

c. Storing patient health records

b. Amount of time
doing prior
authorizations

d. Maintaining patient health
records

c. Amount of

e. Storing patient treatment
records

time spent
on electronic
health records

f. Maintaining patient treatment
records

d. Ease of using

the electronic
health record
system

C27.

e. Amount of

time allotted
to see patients

f. Ability of

On average, how long was a new patient
intake session? Please include any time
required for documentation in addition to
patient time.
Less than 20 minutes

team to work
together
effectively

20 to 39 minutes

g. Amount

40 to 59 minutes

of stress
associated with
patient acuity

60 minutes or more

h. Availability of
psychosocial
resources for
my patients

C28.

i. Amount of

responsibility

On average, how long were sessions with
existing patients? Please include any time
required for documentation in addition to
patient time.
Less than 20 minutes

j. Financial

compensation

20 to 39 minutes
C25.

Did you work in an Integrated Care Model for
primary care and behavioral health during a
typical week? An Integrated Care Model is
defined as tightly integrated, on-site teamwork
with a unified care plan as a standard approach
to care for designated populations. Connotes
organizational integration as well, often
involving social and other community services.

40 to 59 minutes
60 minutes or more

Yes
No

10

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Section D.
Current Employment
NOT in Direct Clinical Care

Answer questions C29 - C31 in regard to the
setting(s) you provided direct clinical care in only.
If you provided direct clinical care in more than one
setting, please answer in reference to the setting in
which you most recently worked.
C29.

C30.

D1.

Did the setting in which you provided care
most recently accept insurance?
Yes ➔ SKIP to Question C31

Yes

No

No ➔ SKIP to Question D4

Which of the following are reasons that setting
did not accept insurance? Mark all that apply.

D2.

Administrative burden

Which of the following best describes your
profession within the healthcare field? Mark
one box only.
Business

Low reimbursement rates

Administrative

High demand for behavioral health services

Research

It was a free clinic

Other

Other

SKIP to Question C32
C31.

Do you work in healthcare or a healthcare
related field?

D3.

What types of insurance were accepted by the
setting in which you most recently provided
clinical care? Mark all that apply.

During a typical week, how many different
employment settings do you work in?
Settings ➔ SKIP to Question D5
on page 12

Commercial insurance

D4.

In what field are you currently employed?
Mark one box only.

Medicare
Active Duty Military
Medicaid

C32.

VA

Agriculture, Forestry, Fishing, Hunting
and Mining

Tricare

Arts, Entertainment, Recreation,
Accommodation, and Food Services

Other

Construction and Manufacturing
Educational Services, Health Care and
Social Assistance

What is your current employment status?

Finance, Insurance, Real Estate, and
Rental and Leasing

Employed ➔ Continue to Section D
Looking for work ➔ SKIP to Section E
on page 12

Information
Professional, Scientific, Management,
Administrative, and Waste Management
Services

Retired ➔ SKIP to Section E on page 12
Other ➔ SKIP to Section E on page 12

Public Administration
Transportation and Warehousing, and
Utilities
Wholesale and Retail Trade
Other

11

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D5.

D6.

Do you think you will provide direct clinical
care as a psychiatrist in the future?

E4.

Yes

Department of Veterans Affairs employer
tuition plan

No ➔ SKIP to Section E

Employer tuition reimbursement plan

Don’t know ➔ SKIP to Section E

Mental Health Service Corps

When do you think you will provide direct
clinical care as a psychiatrist in the future?

Military funding
Self-financed (personal savings, earnings
from employment, money from spouse or
family members, etc.)

In less than a year
In 1-2 years

Student loan(s) - Federal

In more than two years

Student loan(s) - Other

Don’t know

Scholarship(s), grant(s), or
traineeship(s) - Federal

Continue to Section E

Scholarship(s) or grant(s) - State/local
government

Section E.
Education and Credentials
E1.

How did you finance your medical degree?
Mark all that apply.

Scholarship(s) or grant(s) - Non-government
Other resources

Are you a Medical Doctor (MD) or a Doctor of
Osteopathy (DO)?

E5.

What year did you complete your residency?

E6.

How much debt did you have upon completing
your residency?

MD
DO
E2.

What year did you graduate from medical
school?

$25,000 or less
$25,001 to $100,000

E3.

$100,001 to $150,000

Where was your medical program located?

$150,001 to $200,000

In the U.S.
Print state abbreviation. ➔

$200,000 to $250,000

Outside the U.S.
Print name of foreign country or
U.S. territory. C

More than $250,000
E7.

Are you currently ABPN board certified?
Yes
No ➔ SKIP to Question E9 on page 13

12

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E8.

Section F.
Demographics

Which specialties are you currently ABPN
board certified in? Mark all that apply.
Addiction Medicine
F1.
Addiction Psychiatry
Brain Injury Medicine

No additional languages

Child and Adolescent Psychiatry

Spanish

Child Neurology

Chinese (including Mandarin and
Cantonese)

Clinical Neurophysiology

Tagolog (including Filipino)

Consultation-Liaison Psychiatry (formerly
Psychosomatic Medicine)

Vietnamese

Epilepsy

Arabic

Forensic Psychiatry

French

Geriatric Psychiatry

American Sign Language

Hospice and Palliative Medicine

Other

Neurodevelopmental Disabilities

F2.

Are you of Hispanic, Latino, or Spanish origin?

Neurology

Yes

Neuromuscular Medicine

No

Pain Medicine

F3.

Psychiatry

What is your race? Mark all that apply.
White

Sleep Medicine

Black or African American

Vascular Neurology

Asian

Other
E9.

What languages do you speak fluently,
other than English? Mark all that apply.

American Indian or Alaska Native

Are you currently certified by a board other
than the ABPN?

Native Hawaiian or Other Pacific Islander

Yes

F4.

What year were you born?

F5.

What is your sex?

No

Continue to Section F

Male
Female

13

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F6.

What sex were you assigned at birth, on your
original birth certificate?
Male
Female
Don’t know

F7.

Do you currently describe yourself as male,
female or transgender?
Male
Female
Transgender
None of these

F8.

Which of the following best represents how
you think of yourself?
Lesbian or Gay

Thank you for your
participation.

Straight, that is, not gay
Bisexual

Please return this survey in the enclosed,
postage-paid envelope.

Something else:
I don’t know the answer
I prefer not to answer
F9.

Including employment earnings, investment
earnings, and other income, what was your
2017, pre-tax annual income?
Less than $50,000
$50,001 to $100,000
$100,001 to $150,000
$150,001 to $200,000
$200,001 to $250,000
$250,001 to $300,000
$300,001 to $350,000
$350,001 to $400,000
More than $400,000

14

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