Mental Landscapes: Interview Intake Form
Thank you for your interest in Mental Landscapes: How the Psychology of Loneliness and Depression Can Shape Parks and Public Space Design Towards Healing.  I'm so happy you're here!  The goal of this project is to begin understanding how mental health can inform design principles for park and public space design.

Due to existing stigmas around and barriers to accessing medical or psychiatric care, for the purposes of this research participants may self-identify as experiencing depression and do not need to have a formal medical diagnosis to participate.

By submitting this form, you agree to be contacted about scheduling an interview, for which you will be sent questions in advance.  The submittal of this form and participating in the interview are voluntary, and you may elect to withdraw from the process at any time.   Participant consent will be required during the interview and all identifying information will be removed in final documentation to protect privacy.

If you'd like additional information on this project, you can visit: https://www.kelseyzlevor.com/social-design-research.
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Have you experienced depression, either currently, or in the recent past (last 2-3 years)?  Depression can be defined as at least two of the following for at least two weeks: feeling sad or having a low mood; loss of interest or pleasure in activities once enjoyed; feeling worthless or guilty; difficulty thinking, concentrating or making decisions. *
Have you experienced feelings of loneliness, either currently or in the recent past (last 2-3 years)?  Loneliness can be defined as: a negative emotional state, marked by a sense of isolation. One feels that something is missing. *
If you marked yes to either of the above, have you visited a park or other public recreation space (trail, plaza, etc.) while experiencing depression or loneliness? *
Please describe your living environment. *
Please select the option that best describes your home occupancy. *
Do you live with a pet? *
Name and Pronouns *
Email/Contact *
Age *
Race/Ethnicity *
Is there anything else I should know about, or that you'd like to add?
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