Form Justification and Justification and Justification and Survey

REQUEST FOR OMB CLEARANCE OF THE AD COUNCIL STRATEGIC CONCEPTS FOR THE SUICIDE PREVENTION CAMPAIGN

April 2007

I Background

The Substance Abuse and Mental Health Services Administration (SAMHSA) has contracted with The Advertising Council to create a suicide prevention public service advertising (PSA) campaign. The Ad Council is a private, non-profit organization with a rich history of marshalling volunteer talent from the advertising and media industries to deliver critical messages to the American public. The Ad Council has produced thousands of PSA campaigns that address the most pressing social issues of the day and has reached millions of Americans to create positive change by raising awareness, inspiring action, and saving lives.

The goal of the suicide prevention PSA campaign is to promote awareness that suicide is a public health problem that is preventable. The Ad Council has secured the expertise of volunteer advertising agency DDB New York to create and produce the PSAs on behalf of the Ad Council and SAMHSA. The campaign will include television, radio, print and out-of-home creative products for distribution to over 20,000 major media outlets nationwide. The ads will strive to prevent suicide among teens by reaching out to peers who can help them.

II Objectives

Exploratory Discussion

While there is a strong literature base on the topic of teen suicide, the existing studies do not address some of the key insights that the Ad Council will need to develop an effective public service campaign. For instance, very few (if any) studies provide information on how teens react to friends who disclosed that they are depressed and/or want to physically hurt themselves. Most importantly, there are currently no studies (quantitative or qualitative) that identify key messages that would motivate teens to help prevent teen suicide.

In order to understand how teens think and talk about these types of issues, it is important to explore this topic among the target audience through one-on-one and small focus group discussions. Interviews with teens will be used to help the volunteer advertising agency, DDB NY, develop a “campaign strategy.” This campaign strategy document will facilitate the focus and direction of the public service campaign and provide recommendations for how to emotionally connect and speak to our target audience through an advertising campaign. This process is utilized to ensure that the most motivating and effective public service advertising is produced.

The objectives of the exploratory discussions are:

• To garner a deep, insights-based understanding of how teens are impacted by teen suicide

• To understand how friends handle the role they play in the life of a teen at risk

• To understand specific language and tone that effectively connects with the target audience

III Data Collection Methodology

While large focus group discussions are designed to capture general thoughts and themes regarding suicide, they will not allow for in-depth probing and examination of specific circumstances and feelings. In order to understand how teens have been impacted by suicide and how they would handle a situation where a friend was as risk of suicide, a trained interviewer will conduct dyad focus groups with “non-affected” teens and one-on-one interviews with “affected” teens.

“Affected” teens who have had experience with suicide (i.e. someone they know has died by suicide or has disclosed suicidal thoughts), will be interviewed by themselves so that they could feel comfortable discussing their experiences and feelings without the social pressure that a group dynamic could bring to a discussion. This method will also ensure respondents that any sensitive information they shared with the interviewer will be confidential and not shared with their peers.

“Non-affected” teens, who have not had any experience with suicide (i.e. no one in their life has ever died by suicide or expressed thoughts of suicide), will be interviewed with one or more of their friends. This friendship group setting encourages a dialogue between friends which encourages respondents to speak truthfully about how they think they would feel or act if they found out a friend was experiencing suicidal thoughts rather than providing an interviewer with any socially desirable answers.

Both the group discussions and one-on-one interviews will last 90 minutes and will be conducted in the homes of the teens. Conducting studies in these settings, where teens feel most comfortable, will invite an intimate discussion where respondents can openly discuss their experiences and opinions while avoiding any socially desirable responses that often accompany discussions held in a more formal setting.

Because the topic of suicide is extremely sensitive, a trained mental health expert will accompany the interviewer to each discussion in order to ensure a safe environment for the respondents. The mental health expert will be able to answer any questions that respondents have concerning suicide and will follow through with proper protocol should a teen disclose that they themselves are or know someone who is being abused and/or has intent to self-harm.

Focus groups and interviews will be conducted in three markets: Baltimore, MD; Cheyenne, WY and the suburbs of Los Angeles, CA. Each of these cities was selected because they represent a different geographic region in the U.S. The suburbs of Los Angeles will provide respondents from a diverse, west coast, suburban population that has higher Hispanic representation than some other parts of the country. Baltimore will provide respondents from the mid-Atlantic, east coast region which has higher representation of low income and minority populations. Cheyenne, which is located in the Rocky Mountain region, will provide respondents from a more rural, mid-western population where there are higher rates of suicide.

Due to the large amount of time spent with each respondent and limited resources, only 10 respondents will be recruited per market. Specifications for focus groups and interviews in each market include:

• Two focus groups consisting of two male respondents who are non-affected (i.e. no one in their life has ever died by suicide or expressed thoughts of suicide)

• Two focus groups consisting of two female respondents who are non-affected (i.e. no one in their life has ever died by suicide or expressed thoughts of suicide)

• Two one-on-one interviews with affected teens (i.e. someone they know has died by suicide or has disclosed suicidal thoughts)

All respondents will be recruited in each market by research facilities who maintain databases of respondents who have agreed to be contacted and recruited for market studies. Adults will be screened via telephone interview to determine if they have a 15 or 16 year-old teenager living in their household and asked if they would be willing to provide consent for their child to participate in a one-on-one interview with a trained moderator or a focus group with one of their friends. Should a parent consent, their teenager will be screened to determine if they have been affected or non-affected by suicide and if they are willing and comfortable to discuss the topic of suicide. If successfully recruited for a focus group discussion, we will ask the teen and/or their parent to provide contact information for a friend to join them in the discussion.

Participants for both the focus groups and interviews will be screened to ensure that they have not been nor are currently being treated for a mental health problem. Each respondent and their parent will be required to sign a consent form which will disclose the specifications of the study, a confidentiality agreement and an explanation of the respondent’s rights. A copy of the screener, parent consent form and respondent consent form can be found in Attachments 1-4.

A total of 30 participants will be recruited for a small group or one-on-one discussion (24 respondents for group discussions and 6 individual respondents for one-on-one discussions). Each participant from this hard-to-reach and hard-to-engage group will receive a $75.00 incentive to participate in the focus group or one-on-one discussion. This incentive reflects the Ad Council standard.

A professional market researcher will facilitate the recruitment effort and moderate each of the group and one-on-one discussions. A copy of each discussion guide can be found in attachment 5-6. Each discussion and interview will be audio taped so that the interviewer will not have to take notes. Each respondent and their parent will be advised of the audio taping in their respective consent forms. Should a respondent or their parent, object to their interview being recorded, we will not record the discussion and/or interview. Representatives from SAMHSA, DDB NY and the Ad Council will review the audio tapes in order to provide their analysis and feedback. Once all of the interviews and discussions are completed, the interviewer will write a summary report which will remove any identifying information of the teen respondents.

Confidentiality

Respondent confidentiality will be maintained through several methods throughout the study process:

• All respondents and their parent/guardian will be informed of their rights when recruited on the phone.

• All respondents and their parents will be permitted to sign and date an informed consent form prior to the start of each group or interview. Both the parent and respondent consent forms state that all information divulged in the focus group will be kept confidential and they may refuse to participate or discontinue participation in the group at any time.

• Respondents and parents will be asked if they are willing to have their discussion audio taped. They will be informed that the tapes will be listened to by people from DDB NY, SAMHSA, and Ad Council who are working on the public service campaign and their names will be removed from the tapes before sharing them with anyone.

• At the start of each conversation, the interviewer will verbally remind all participants that their responses will not be used by anyone except the advertising agency, and for the sole purpose of guiding and enhancing the creative concepts for a public service campaign. The summary report will reference the participants’ responses, but will not refer to the participants’ specific personal information in any way.

• Once the final report is written by the interviewer and approved by SAMHSA and the Ad Council, any information collected from the interviews, such as written notes and audio tapes, will be filed at the Ad Council and marked as confidential information.

Analytic Plan:

After the moderator interviews all affected and non-affected teen, he/she will write a report summary by reviewing his/her written notes and audio tapes. The report will summarize the responses from the questions outlined in each discussion guide (see attachments 5-6). Based on the study findings, the moderator and advertising agency DDB NY will make recommendations for a campaign strategy. This information will be used to develop key insights and a main message for the public service campaign. This campaign strategy will then be approved by SAMHSA and the Ad Council.

IV Burden Estimate

It is estimated that the screening process will require market research facilities to contact 120 respondents in order to recruit 30 individuals to take part in an interview or group discussion. Each screening survey will last approximately 6 minutes. The estimated response burden for the screening process will be 6 minutes x 120 respondents, which equals 720 minutes or 12 hours.

It is estimated that the response burden for the interviews and group discussions will be approximately two hours per individual participant. Thus, the total response burden will be 2 hours x 30 respondents, which equals 60 total hours. The exploratory discussion groups will involve no startup or operational costs to respondents.

Activity	Number of Respondents	Responses per Respondent	Burden per Response (Hrs.)	Total Burden
Parent Screener	120	1	.10	12
Teen Screener	120	1	.10	12
Group Discussions	30	1	2	60
TOTALS	240			84

V Contact Information

The Ad Council contact who will manage the project and communicate with SAMHSA personnel is Katie VanLangen, Campaign Director.

The SAMHSA contact person responsible for approving all campaign materials is Mark Weber, Associate Administrator for Communications.

VI Report Schedule

The contractor anticipates that the message testing focus groups will take place in April 2007. The data analysis and review will occur during the week following the focus groups, and a final summary report will be available two weeks after the focus groups are conducted. The final report will be disseminated to DDB NY, the Ad Council, and SAMHSA by the last day of May.

VII Attachments

Attachment 1: Draft Screener for Recruiting – Parent/Guardian

Attachment 2: Draft Screener for Recruiting – Teens

Attachment 3: Consent Form for Participants

Attachment 4: Parental Consent Form for Participants

Attachment 5: Ono-on-One Interview Discussion Guide (to follow)

Attachment 6: Focus Group Discussion Guide (to follow)

ATTACHMENTS

OMB No. 0930-0196

Expiration Date: 6/30/07

Public Burden Statement: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  The OMB control number for this project is 0930-0196.  Public reporting burden for this collection of information is estimated to average 6 minutes per client per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 7-1044, Rockville, Maryland, 20857.

ATTACHMENT 1

TELEPHONE SCREENING QUESTIONNAIRE FOR DYAD DISCUSSION GROUPS AND ONE-ON-ONE INTERVIEWS

Friendship Groups Qualifying Characteristics

• Male or Females

• Ages 15 or 16

• Does not have a history of mental illness

• Has not thought about or attempted suicide

• Has not ever had a friend of relative talked to them about hurting or killing themselves

• Has not ever felt or known that one of their friends was at risk of killing themselves

• Has not had a friend or relative die from suicide

One-on-One Qualifying Characteristics

• Male or Females

• Ages 15 or 16

• Does not have a history of mental illness

• Has not thought about or attempted suicide

• Has had a friend of relative talked to them about hurting or killing themselves, OR

• Has felt or known that one of their friends was at risk of killing themselves, OR

• Has had a friend or relative die from suicide

Market	Group/Interview	Description
Los Angeles, CA	A	Two females (within same friendship circle) who have not been affected by suicide
	B	Two males (within same friendship circle) who have not been affected by suicide
	C	One female who has been affected by suicide
	D	One male who has been affected by suicide
Cheyenne, WY	E	Two females (within same friendship circle) who have not been affected by suicide
	F	Two males (within same friendship circle) who have not been affected by suicide
	G	One female who has been affected by suicide
	H	One male who has been affected by suicide
Baltimore, MD	I	Two females (within same friendship circle) who have not been affected by suicide
	J	Two males (within same friendship circle) who have not been affected by suicide
	K	One female who has been affected by suicide
	L	One male who has been affected by suicide

Parent/Guardian Screener

Hello, my name is _________________[RECRUITER NAME]. I am calling you about a study we are conducting for the Ad Council, a not-for-profit organization that produces public service announcements. All of the information that you provide today will be kept confidential and will be used for study purposes only. This call is not an attempt to sell you anything. Can I speak with either the male or female head of the household?

 Male  Female RECORD

If I may, I’d like to ask you a few questions…

1. Do you have a child aged 15 or 16 living in your household?

 Yes CONTINUE  No Terminate

2. Could you please tell me the gender of your 15/16 year old child/children?

• Male

• Female

Thank you so much. We are conducting a study of a sensitive nature and would like to share the topic area with you before speaking with your 15 / 16 year old {son or daughter}.

We are partnering with the Ad Council who is currently developing a public service campaign to help prevent teen suicides in the U.S. In order to understand how teens feel about and deal with these types of issues, the Ad Council is interested in talking to 15 and 16 year-old teens. The goal is better understand the issues surrounding teen suicide and determine the most effective way to deliver a message that will encourages teens to seek help if they are concerned about a friend hurting himself or herself .

The study is not with or about teens that have considered suicide, rather it’s about the information and resources teens would find useful if a friend ever came to them with his or her own thoughts of suicide.

3. Has your child ever been diagnosed or treated for a mental illness, such as depression, bipolar disorder or schizophrenia?

 Yes TERMINATE  No CONTINUE

If your teen qualifies for the study, we would ask that the interview take place in your home to create a more comfortable environment. In the course of the interview, a professional moderator will ask your child a variety of questions about their family, friends, and school. The moderator will also ask about your child’s awareness, experiences and opinions about suicide. While we would ask that you not be present in the same room during the interview, as it may cause some distraction to the interviewer and child, your child will be able to stop the interview at any point during the discussion.

Your child’s name and opinions during the discussion will be kept confidential except in the case of disclosure of child abuse or intention to self-harm where adults are required by law to report these incidents to the state. Your child may refuse to participate or discontinue participation in the discussion at any time and they would receive $75.00 for participating in our discussion. Would you be willing to allow your child to participate?

 Yes CONTINUE

 No Thank and Terminate

In order to determine if your son/daughter is interested in participating in the study, I’ll need to ask him/her a few questions directly. Should they qualify for the study we will ask that you and your child sign a consent form prior to our interview with him/her. Do we have your permission to ask him/her a few questions directly? You can listen in as we speak, if you’d like, but I’ll need him/her to answer them him/herself.

 Yes CONTINUE

 No Thank and Terminate CALL

REQUEST CALL BACK TIME IF PARENT IS WILLING BUT TEEN IS NOT AVAILABLE AT THE TIME

OMB No. 0930-0196

Expiration Date: 6/30/07

Public Burden Statement: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  The OMB control number for this project is 0930-0196.  Public reporting burden for this collection of information is estimated to average 6 minutes per client per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 7-1044, Rockville, Maryland, 20857.

ATTACHMENT 2

SCREENING QUESTIONNAIRE FOR DISCUSSION GROUPS AND ONE-ON-ONE INTERVIEWS

Teen Screener

Hi. My name is _________, and I’m calling about a study my company is doing in _______ with teens like you. It may be possible for you to participate in the study and to be paid for your time. But first, I have a couple of quick questions for you. First, could you tell me your name?

RECORD ___________________________________

4. And how old are you, ________?

• 15

• 16

MUST MATCH PARENT’S ANSWER TO CONTINUE

Thank you so much. We are conducting a study of a sensitive nature, so I have a couple more questions to see if you’d be comfortable talking about it. Is that OK?

 Yes CONTINUE  No THANK AND TERMINATE

If at any point you are uncomfortable with the questions I am asking, please let me know. You do not have to answer any of these questions if you do not want to.

5. How comfortable would you feel talking about the following issues with someone who came to your house to interview you? Would you say you feel very comfortable, somewhat comfortable, not too comfortable or not at all comfortable talking about…

	Very comfortable	Somewhat comfortable	Not too comfortable	Not at all comfortable
Drug and Alcohol Use
Reckless Driving
Suicide			TERMINATE	TERMINATE
Dropping out of high school

TERMINATE ANY RESPONDENT WHO ANSWERS NOT TOO OR NOT AT ALL COMFORTABLE TO THE ISSUE OF SUICIDE

12. Have you ever found yourself in a situation where a friend or relative your

age has talked to you about hurting themselves or even killing themselves?

 Yes

 No

13. Have you ever felt or known that one of your friends or relatives your age was at risk of killing themselves?

 Yes

 No

14. Have any of your friends or relatives your age died by suicide?

 Yes

 No

IF RESPONDENT ANSWERS YES TO ANY IN Q12 – 14, RECRUIT FOR INTERVIEWS C,D,G,H,K OR L (BASED ON GENDER) – And INVITE FOR ONE-ON-ONE INTERVIEWS

IF RESPONDENT ANSWERS NO TO ALL IN Q12 – 14, RECRUIT FOR GROUPS A,B,E,F,I OR J (BASED ON GENDER) – And INVITE FOR GROUPS

16. Have you ever been severely depressed or thought about hurting or killing yourself?

 Yes THANK AND TERMINATE  No

INVITATION FOR One-on-One (AFFECTED TEENS)

Thank you for your honest answers to such sensitive questions. If you are interested in helping us out further, we would like to come to interview you. The interview will take place at your house for about two hours on _________ INSERT DATE from _____ to _____ INSERT TIME. In the course of the interview, a professional interviewer will ask you a variety of questions about you, your family, friends, and school. The interviewer will also ask about your experiences and opinions about suicide.

Your name and opinions will be kept confidential. You may refuse to participate or discontinue participation in the discussion at any time.

You’ll be paid $ ___ for the two hours the discussion will take. Does that sound like something you would be interested in doing? We would really appreciate your help!

 Yes CONTINUE  No THANK AND TERMINATE

Thanks so much. Can you pass the phone back to your mom/dad, please?

Your son/daughter has qualified to participate in the study we are going to be

conducting in your area on _______ INSERT DATE from ____ to ______ INSERT TIME.

So that the discussion can be casual and comfortable, the study is designed to take place at your home. The discussion will last approximately two hours. Would you be willing to allow the interview to take place in your home?

Your son/daughter’s opinions will be very valuable, and s/he will receive _____ as a thank-you for participating. Is this something you would allow your son/daughter to participate in?

 Yes CONTINUE  No THANK AND TERMINATE

Thank you so much for your time. We look forward to meeting you and your son/daughter.

CONFIRM ADDRESS AND GET DIRECTIONS

INVITATION FOR GROUP DISCUSSION (NON-AFFECTED TEENS)

Thank you for your honest answers to such sensitive questions. If you are interested in helping us out further, we would like to come to interview you and one of your friends. The interview will take place at your’s or your friend’s house for about two hours on _________ INSERT DATE from _____ to _____ INSERT TIME. In the course of the interview, a professional interviewer will ask you a variety of questions about you, your family, friends, and school. The interviewer will also ask about your experiences and opinions about suicide.

Your name and opinions will be kept confidential. You may refuse to participate or discontinue participation in the discussion at any time.

You’ll be paid $ ___ for the two hours the discussion will take. Does that sound like something you would be interested in doing? We would really appreciate your help!

 Yes CONTINUE  No THANK AND TERMINATE

Thanks so much. Can you stick around for the rest of this call but pass the phone back to your mom/dad, please?

Your son/daughter has qualified to participate in the study we are going to be conducting in your area on _______ INSERT DATE from ____ to ______ INSERT TIME. We would like to interview your son/daughter with one or their friends. Would you be willing to give us the names and numbers of some of your son/daughter’s good friends?

 Yes CONTINUE  No THANK AND TERMINATE

Can I have the name of your child’s friends and their parent’s contact information?

Thank you. So that the discussion can be casual and comfortable, the study is designed to take place at your or your child’s friend’s home. The discussion will last approximately two hours. If one of your son/daughter’s friends qualify and are willing to participate in the discussion, would you be willing to allow the interview to take place in your home?

Your son/daughter’s opinions will be very valuable, and s/he will receive _____ as a thank-you for participating. Is this something you would allow your son/daughter to participate in?

 Yes CONTINUE  No THANK AND TERMINATE

Thank you so much for your time. We look forward to meeting you and your son/daughter.

CONFIRM ADDRESS AND GET DIRECTIONS

ATTACHMENT 3

YOUTH RESPONDENT CONSENT FORM

INFORMED CONSENT

Youth Participant Approval

The Ad Council, in partnership with the Substance Abuse and Mental Health Services Administration is sponsoring a national public service campaign on teen suicide prevention. We are asking your permission to participate in a 90-minute face-to-face interview with a trained interviewer who will ask a set of questions about your family, friends, and school. The moderator will also ask about your awareness, experiences and opinion about suicide. If you decide to participate, here are some things you should know:

• A trained mental health expert will be present during the interview to answer any specific questions that you may have.

• Any audio tapes or written notes collected from this interview will be used for marketing purposes only. Any audio recorded during this interview will not be used for any commercial purposes.

• Your participation is completely his/her choice.

• Your name will not be used in any reports from this interview and no quotes will be attributed to you. The information provided by you is strictly confidential except in the case of disclosure of child abuse or intention to self-harm where adults are required by law to report these incidents to the state.

• You may stop the interview at any time and for any reason or choose to not answer a question, without penalty or loss of benefits.

• You will receive $75 and will not receive any further compensation after today.

• Other than the payment, there will be no direct benefit to you from participating in this interview. You may feel uncomfortable when expressing your opinions or talking about your experiences.

• Any questions you have about this interview and the study will be answered before the interview begins. If you have questions after the interview, you may contact _____ at ______,

• Your signature below indicates that you understand the above and agree to participate. You will be provided with a copy of this consent form.

Participant Printed Name ____________________________________________________________

Participant Signature ________________________________________________________________

Today’s Date ________________________________________________________________

ATTACHMENT 4

PARENT CONSENT FORM

INFORMED CONSENT

Parent/Guardian Approval for Youth Participant

The Ad Council, in partnership with the Substance Abuse and Mental Health Services Administration is sponsoring a national public service campaign on teen suicide prevention. We are asking your permission to have your child participate in a 90-minute face-to-face interview with a trained interviewer who will ask a set of questions about their family, friends, and school. The moderator will also ask about your child’s awareness, experiences and opinion about suicide. If you decide to allow your child to participate, here are some things you should know:

• A trained mental health expert will be present during the interview to answer any specific questions that you or your child may have.

• Any audio tapes or written notes collected from this interview will be used for marketing purposes only. Any audio recorded during this interview will not be used for any commercial purposes.

• Your child’s participation is completely his/her choice.

• Your child’s name will not be used in any reports from this interview and no quotes will be attributed to your child. The information provided by you and your child is strictly confidential except in the case of disclosure of child abuse or intention to self-harm where adults are required by law to report these incidents to the state.

• Your child may stop the interview at any time and for any reason or choose to not answer a question, without penalty or loss of benefits.

• Your child will receive $75 and will not receive any further compensation after today.

• Other than the payment, there will be no direct benefit to your child from participating in this interview. Some youth may feel uncomfortable when expressing their opinions or talking about their experiences.

• Any questions you or your child has about this interview and the study will be answered before the interview begins. If you have questions after the interview, you may contact _____ at ______,

• Your signature below indicates that you understand the above and agree to have your child participate. You will be provided with a copy of this consent form.

Parent Printed Name ____________________________________________________________

Parent Signature ________________________________________________________________

Today’s Date ________________________________________________________________

Attachment 5

Affected Teen Discussion Guide Outline

Note: Interview to begin upon receipt of signed parent and respondent consent forms.

1. Introductions & Warm-Up (10 minutes)

Moderator will explain that:

• The purpose of the discussion is to understand the respondent’s experiences with teen suicide so the learning can be used to create effective messages to teens about preventing teen suicide.

• We are incredibly grateful that the respondent is willing to discuss such a sensitive topic and hope they realize that their participation will help address this public health issue.

• Any and all information that is shared will be considered private and confidential.

• Recordings of the conversation will be used solely for reporting purposes and their names will be removed from the tapes and any written notes before sharing them with anyone.

• The respondent is entitled to stop the discussion at any point if they are uncomfortable w/o loss of incentive. Likewise, the respondent is free to refuse to answer any questions they do not want to answer.

Moderator will have participant introduce themselves:

• Name

• Age/grade

• Favorite subjects in school

• Interests & hobbies

2. Personal Experiences With Teen Suicide (50 minutes)

“You were asked to participate in this project because you indicated (on the phone) that you have been in a situation where a friend or close relative:

• has talked to you about hurting or killing themselves,

• was at risk of hurting or killing themselves, or

• Has died from suicide

I would like to talk with you about this experience.

Note: Questions with regard to this experience include, but are not limited to:

Description of Friend

• Tell me a little bit about the person?

  • What relation are you (e.g.: friend, relative)?

  • How long have you known him or her?

• How long ago did he or she (talk to you about hurting themselves) or kill themselves)?

Level of Concern

• Prior to the incident (e.g. friend disclosed thoughts of suicide or suicide), were you ever concerned about him/her being depressed?

• Did he/she ever talk to you about being depressed or wanting to hurt him/herself?

• What did this person say to you?

• Were you expecting for him/her to say/do something like this? Or was it a complete surprise?

• How did you feel?

• Did anyone else in your life express any concern?

• Did you talk about your concern with anyone (e.g. other friends or family)

Reaction to friend’s incident

• Can you talk a little bit about what you did after the incident?

  • Did you feel comfortable talking to your friend/relative who disclosed suicidal thoughts? What did you say?

  • What did you do?

  • Did you talk about the incident with anyone (e.g. other friends or family)? If so, who?

  • Did you tell an adult about the situation? If so, who and why? If not, why not?

  • How comfortable did you feel telling someone about the incident?

Feeling Prepared for the situation?

• How prepared did you feel to deal with something like this?

  • Did you know what to say/do?

  • Did you feel like you needed help? If so,

    • Did you feel like you had someone to ask about what to do? Who?

    • Did you talk to someone else about the issue?

      • What did they say?

    • Did you get information from another source (e.g.: the Internet)?

  • How did you feel?

  • Looking back on the experience, what would you have done differently?

  • What do you know now that you wish you’d known then?

3. Messaging Ideas (30 minutes)

“Given what you’ve been through, no one is more qualified to help figure out what teens need in terms of support and resources if they were ever faced with the same situation. Let’s spend some time talking about what you think should be offered to teens.”

Questions will include, but are not limited to:

• What point(s) in your experience do you think were critical moments for you to have the support and info to help your friend/relative/yourself?

  • At each of these points, what would you have liked to have known?

    • What form would you have liked that information to come in (e.g.: website, peer counselor, adult counselor)?

  • What kind of emotional support would you have found useful?

  • Looking back, at the time of the incident, how comfortable would you feel:

    • calling a hotline?

    • Telling your friend to call a hotline?

    • Chatting online with a mental health expert?

    • Telling a counselor at school about the situation?

• What’s the one most important thing you think teens need to know if they are concerned that one of their friends may hurt or kill themselves?

  • Where do you think this message would be communicated most effectively? (probe: online? TV? Radio?)

    • What approach would you take?

    • Who would you like to hear this message from? (probe: adult, teen)

Attachment 6

Non-Affected Teen Discussion Guide Outline

1. Introductions & Warm-Up (10 minutes)

Moderator will explain that:

• The purpose of the discussion is to understand the respondents’ thoughts and feelings about teen suicide so the learning can be used to create effective messages to teens about preventing teen suicide.

• We are incredibly grateful that the respondents are willing to discuss such a sensitive topic and hope they realize that their participation will help address this public health issue.

• Any and all information that is shared will be considered private and confidential.

• Recordings of the conversation will be used solely for reporting purposes and their names will be removed from the tapes and any written notes before sharing them with anyone.

• The respondent is entitled to stop the discussion at any point if they are uncomfortable. Likewise, the respondent is free to refuse to answer any questions they do not want to answer.

Moderator will have participant introduce themselves:

• Name

• Age/grade

• Favorite subjects in school

• Interests & hobbies

“Based on our phone conversation we understand that you have not been in a situation where a friend or close relative has talked to you about or died by suicide. So today we are going to talk about what you think you might do if you were in that sort of situation.”

• Have you ever thought about what you would do if a close friend or relative told you they were thinking about hurting or killing themselves?

• What do you think you would do?

• What do you think you would say to your friend?

• if the situation arose, do you think you would know how to help?

• Would you turn to other people for help and guidance? Who? (probe specifically: parents? Counselors? Friends? Other adults?)

• What kind of information or resources would you want? How likely are you to: visit a website? Call a hotline? Chat online with a mental health professional?

• How would you know whether or not a friend was serious when they told you they were thinking about killing themselves? Would it matter in terms of how you reacted?

• How do you think your friend would react or feel if you told someone else? If they would be angry or upset, do you think that would prevent your from telling someone? Would you be afraid your friend would get in trouble?

3. Messaging Ideas (60 minutes)

“Let’s spend some time talking about what kind of support and resources you would want if you were ever really faced with the situation.

Questions will include, but are not limited to:

• Is teen suicide an issue that you and your friends ever talk about?

  • Do you think it’s a problem where you’re from? What about the rest of the country?

  • Is it something that you’ve ever learned about at school?

• What do you think most teens think about teen suicide?

  • How do you think they feel about it?

• If you were ever faced with this situation, what do you think you would need to know?

  • What form would you want that information to come in (e.g.: website, peer counselor, adult counselor)?

  • What kind of emotional support would you find useful?

4. Creative Exercise (20 minutes)

“Let’s do a creative exercise. I want each of you to create your own teen suicide prevention commercial by doing/answering the following:”

• Based on the conversation we had today, what is the one most important thing you think teens need to know if they are concerned that one of their friends may hurt or kill themselves?

• How do you think we can best get this message out? (Probe: online? TV? Schools? Radio?)

3. Wrap Up & Thanks

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