Greetings in St. Lasalle!

We, Guido Maria De Los Angeles, Kiana Kauline Gacias, Ryca Laeane Matro, Mark

John Paul Superio, Josef Renzo Pangilinan, and Gabriel Cyan Valderrama, students under the

program Bachelor of Arts major in Development Studies in De La Salle University, are

conducting the a study on the perception of students on mental illnesses. By answering this

survey form, you would be helping the researchers in their data gathering part of their study.

With that said, this survey will not provide you with any feedback about your score. Results of

this survey will be kept confidential and will only be used for this research.

This questionnaire consists of two parts that will require 10-20 minutes of your free time.

The first part of the test will require you to answer basic information about yourself. A set of

scenarios will be presented to you on the next part which you will indicate how each statement

is descriptive of you. To answer the questionnaire, a respondent must be a college student of at

least eighteen (18) years of age, and must be able to read and understand English.

If you choose to part in this study, here are your rights as participants:

● The researcher will and must ensure the well-being of the participants while the study is

ongoing.

● The participant is not forced to do anything that he/she has not agreed to or anything

that will be possibly harmful to the participant. Participation in this study is purely

voluntary.

● The participant is allowed to stop and discontinue with the study if he/she wishes to, the

researchers cannot stop you from doing so.

● The participant’s name and any other information is not required in this study, thus it will

not be asked of you. Any information that the participant gives will be kept confidential

Taking part in this questionnaire certifies that you have read and understood all
conditions and requirements stated previously. This also certifies that you will practice honesty

and accuracy in answering this test, and that your participation in this survey is based on your

own informed consent.

For other concerns, you may contact any of the members using the information provided below:

Guido Maria De Los Angeles (guido_delosangeles@dlsu.edu.ph)

Kiana Kauline Gacias (kiana_gacias@dlsu.edu.ph)

Ryca Laeane Matro (ryca_matro@dlsu.edu.ph)

Mark John Paul Superio (mark_john_superio@dlsu.edu.ph)

Josef Renzo Pangilinan (josef_pangilinan@dlsu.edu.ph)

Gabriel Cyan Valderrama (gabriel_valderrama@dlsu.edu.ph)

Thank you for your kind consideration.

 I. Demographic

Directions: Fill-out the basic information needed before starting the survey.

1. Age: ______

2. Gender: _____Male _____Female _____Others, (Please specify, ______)

3. Course:________

4. College:

____ College of Liberal Arts

____ College of Business

____ College of Education

____ College of Engineering

____ School of Economics

____ College of Science

____ College of Computer Science

II. Survey Proper

A. Directions: People, at times, find that they face mental health problems. This can

bring up reactions about what mental illness would mean. Please use the 5-point

scale to rate the degree to which each item describes how you might react if you

were to have a mental illness (Tucker et al., 2013).

1. I would feel incompetent if I had a mental illness.

Strongly Disagree 1 2 3 4 5 Strongly Agree

2. My security and self-confidence would not be intimidated if I had a mental illness.

Strongly Disagree 1 2 3 4 5 Strongly Agree

3. Having a mental illness would make me feel less smart.

Strongly Disagree 1 2 3 4 5 Strongly Agree

4. My self-confidence would boost if I had mental illness.

Strongly Disagree 1 2 3 4 5 Strongly Agree

 5. My perception of myself would not change just because I have a mental illness.

Strongly Disagree 1 2 3 4 5 Strongly Agree

6. Having a mental illness would make me feel lesser.

Strongly Disagree 1 2 3 4 5 Strongly Agree

7. I would feel okay about myself even if I had mental illness.

Strongly Disagree 1 2 3 4 5 Strongly Agree

8. If I had mental illness, I would be less pleased with myself.

Strongly Disagree 1 2 3 4 5 Strongly Agree

9. My self-esteem would still be the same if I had a mental illness.

Strongly Disagree 1 2 3 4 5 Strongly Agree

10. I would feel worse about myself if I had a mental illness.

Strongly Disagree 1 2 3 4 5 Strongly Agree

B. Kathy is a 20 year-old 2nd year college student with schizophrenia. Most often

she hears voices and becomes upset. She lives alone in her condo and studies

accountancy at DLSU. She has been hospitalized five times because of her

illness. Please answer the following questions about Kathy, and select the best

answer for each question:

1. I would feel unsafe around Kathy.

Not at all 1 2 3 4 5 6 7 8 9 Very Much

2. If it was up to me, I would require Kathy to take her medications.

Not at all 1 2 3 4 5 6 7 8 9 Very Much

3. I think Kathy is a threat to her blockmates/neighbors unless she is hospitalized?

Not at all 1 2 3 4 5 6 7 8 9 Very Much

4. If I were her classmate, I would ask her to be my groupmate.

Not likely 1 2 3 4 5 6 7 8 9 Very likely

5. How dangerous (to herself or to others) would you feel Kathy is?
Not at all 1 2 3 4 5 6 7 8 9 Very Much

6. Do you agree that Kathy should be coerced into treatment with her doctor, even if she

doesn't want it?

Not at all 1 2 3 4 5 6 7 8 9 Very Much

7. I think it is best for Kathy’s blockmates/neighbors if she was sent away to a psychiatric

hospital.

Not at all 1 2 3 4 5 6 7 8 9 Very Much

8. I would share a carpool with Kathy everyday.

Not likely 1 2 3 4 5 6 7 8 9 Very likely

9. Do you think that an asylum is the best place for Kathy?

Not at all 1 2 3 4 5 6 7 8 9 Very Much

10. I would feel threatened by Kathy.

Not at all 1 2 3 4 5 6 7 8 9 Very Much

11. If it was up to me, I would force Kathy to have treatment and live in a group home.

Not at all 1 2 3 4 5 6 7 8 9 Very Much

12. If I were a landlord, I probably would rent a condo to Kathy.

Not likely 1 2 3 4 5 6 7 8 9 Very likely

13. People with mental illness are dangerous (harm to themselves or others)

Not at all 1 2 3 4 5 6 7 8 9 Very Much

14. People with mental illness can face with life adversities.

Not at all 1 2 3 4 5 6 7 8 9 Very Much

15. People with mental illness must seek for professional help.

Not at all 1 2 3 4 5 6 7 8 9 Very Much

16. People with mental illness are usually treated differently by others.

Not at all 1 2 3 4 5 6 7 8 9 Very Much