The Directory of Consumer-Driven Services (CDS), a project of the National Mental Health Consumers’ Self-Help Clearinghouse, offers essential information on consumer-run programs across the country, and provides links to education, training and technical assistance resources for these throughout the nation.
To apply for inclusion in the directory please fill out the program survey below, or download the application and return it to The Clearinghouse.
For questions regarding the CDS Directory and to obtain application/information materials please contact us by e-mail at info@cdsdirectory.org .
To download the word version of the application form please click here .
To download the .pdf version of the application form please click here .
Contact us by mail, phone, fax or e-mail:
1211 Chestnut Street, Suite 1100info@mhselfhelp.org Directory of Consumer Driven Services: Program Survey Please fill in every field except those marked with * which are optional.
Contact Information (Information for The Clearinghouse only, will not be public)
Contact Person:
First Name:
Title:
Street Address:
City:
State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
ZIP Code:
Telephone #:
*Fax #:
E-mail Address:
Program Information (Information to be printed in the CDS Directory)
Program Name:
Is this part of a larger Agency or Organization?
If Yes, Agency Name:
Year the Program was Started:
Before 1965 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
*Public Contact Person (if any):
First Name:
Street Address:
City:
State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
ZIP Code:
Telephone #:
*Fax #:
E-mail Address:
*Website URL:
Program Category: maximum of three that best describes your program)
*Target Participants:
Program Setting:
Select Program Owned or Leased Facility (leased store front, community residence) Borrowed Space (church, school, community center) Mobile/Transitional General hospital or healthcare facility Correctional facility Inpatient psychiatric treatment facility Outpatient psychiatric treatment facility Other
Annual Program Budget:
Select None Under $10,000 $10,000-$40,000 $40,000-$70,000 $70,000-$100,000 $100,000-$200,000 $200,000-$400,000 Over $400,000
Number of staff:
Paid Full-Time Select None 1-2 3-5 5-10 10-20 20+ Paid Part-Time Select None 1-2 3-5 5-10 10-20 20+ Volunteers Select None 1-2 3-5 5-10 10-20 20+
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