No barrier			Major barrier
1.	Psychiatric treatment is stigmatizing	1	2	3	4
2.	Patients will reject psychotherapy	1	2	3	4
3.	Co-morbidity in depressed elderly	1	2	3	4
4.	Reluctance to discuss emotional problems	1	2	3	4
5.	Access to mental health care is a problem in our community	1	2	3	4
6.	Insurance coverage of mental care is inadequate	1	2	3	4
7.	Low confidence in treatment with counseling	1	2	3	4
8.	Appointment time is too short	1	2	3	4
9.	Patients are concerned about medication side effects	1	2	3	4
	Which one of the above choices do you consider the most significant barrier? (Please choose a number 1–9):___
	What other barriers do you experience? (please list):___________________________