0704-XXXX_SFIS_Survey Instrument_1.11.2023

OMB CONTROL NUMBER: 0704-XXXX

OMB EXPIRATION DATE: XX/XX/XXXX

AGENCY DISCLOSURE NOTICE

The public reporting burden for this collection of information, 0704-XXXX, is estimated to average 15 minutes per response, 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 the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at [email protected]. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

Background

.	What is your marital status?

		Married
		Separated
		Divorced
		Widowed

.	[Ask if Q1 = “Married” OR “Separated”] How many years have you been married to your current spouse?

.	Which of the following best describes where you live?

		Military housing, on base
		Military housing, off base
		Civilian housing

.	[Ask if Q3 = “Military housing, off base” OR “Civilian housing”] How close do you live to a military base/installation?

		Less than 30 minutes
		30 minutes to less than 1 hour
		1 to 2 hours
		More than 2 hours

.	Are you Spanish/Hispanic/Latino?

		No, not Spanish/Hispanic/Latino
		Yes, Mexican, Mexican-American, Chicano, Puerto Rican, Cuban, or other Spanish/Hispanic/Latino

.	What is your race? Mark one or more races to indicate what you consider yourself to be.

		American Indian or Alaska Native
		Asian (e.g., Asian Indian, Chinese, Filipino, Japanese, Korean, or Vietnamese)
		Black or African American
		Native Hawaiian or other Pacific Islander (e.g., Samoan, Guamanian, or Chamorro)
		White

.	Are you currently serving in the military?

		Yes, on active duty (but not a member of the National Guard/Reserve)
		Yes, as a member of the National Guard or Reserve in a full-time active duty program (AGR/FTS/AR)
		Yes, as a traditional National Guard/Reserve member (e.g., drilling unit, IMA, IRR)
		No
		No, but former active duty and/or former member of the National Guard or Reserve

.	What is the highest degree or level of school that you have completed?

		12 years or less of school (no diploma)
		High school graduate—high school diploma or equivalent (e.g., GED)
		Vocational or technical diploma
		Associate's degree
		Bachelor's degree
		Master's degree
		Doctoral or professional school degree

Per Section 1072(2) of Tile 10, U.S. Code, a dependent child is defined as unmarried and under the age of 21; or physically or mentally incapable of self-support (regardless of age); or enrolled in full-time course of study at an institution of higher learning; dependent on the member for over one-half of their support; and under the age of 23)

.	Do you or your spouse have any dependent children living at home either part-time or full-time?

		Yes
		No

.	[Ask if Q9= “Yes”] What is the number of children/dependents living with you?

.	What, if any, special medical and/or educational needs to you or your family members have? Mark one answer in each row.

	None
	Medical only
	Educational only
	Both medical and educational
	a.	Self
	b.	[Ask if Q1 = “Married” OR “Separated”] Spouse
	c.	[Ask if Q9 = “Yes”] Child(ren)
	d.	Other

.	Is your family enrolled in the Exceptional Family Member Program (EFMP)?

		Yes
		No, and I was not aware of this program
		No, but I am aware of this program

.	Overall, how satisfied are you with the military way of life?

		Very satisfied
		Satisfied
		Neither satisfied nor dissatisfied
		Dissatisfied
		Very dissatisfied

.	Within the past 12 months, has your spouse been on deployment for more than 30 consecutive days?

		Yes
		No

.	[Ask if Q14 = “Yes”] During your spouse’s most recent deployment cycle, how satisfied were you with the… Mark one answer in each row.

	Very dissatisfied
	Dissatisfied
	Neither satisfied nor dissatisfied
	Satisfied
	Very satisfied
	a.	Pre-deployment support you received?
	b.	Support you received during the deployment?
	c.	Post-deployment support you received?

.	In the past 12 months did you relocate due to military orders (e.g. PCS move), or move to be closer to family/friends?

		Yes
		No

financial issues

.	Compared to 12 months ago, is your financial situation better, worse, or has it stayed the same?

		Much better
		Somewhat better
		Stayed the same
		Somewhat worse
		Much worse

.	Taking things altogether, how satisfied are you with your financial situation right now?

		Very satisfied
		Satisfied
		Neither satisfied nor dissatisfied
		Dissatisfied
		Very dissatisfied

.	[Ask if Q17 = "Somewhat worse" OR "Much worse"] Which of the following are reasons why your financial situation is worse than it was 12 months ago?

		Changed related to your employment (e.g., lost job, between jobs, could not find job)
		Change related to your spouse's employment
		Change in your family situation
		Change in education-related situation (e.g., paying for your, your spouse's, or your children's education)
		Change in health-related situation (e.g., no health care coverage, illness)
		Increased debt (e.g., unplanned expenses, student loan deferment ended)
		Financial management problems (e.g., used savings, no budget)
		Increase in family size (e.g. new baby at home, or taking care of another family member)
		Change in childcare situation
		Other

.	From which of the following resources have you received information, training, or counseling on any financial topic? Mark “Yes” or “No” for each item.

			Yes	No
	a.	Military financial training, class, or seminar (online or classroom)
	b.	Military financial counseling (in-person, by telephone, or virtually)
	c.	Military aid society (e.g., Army Emergency Relief, Navy-Marine Corps Relief Society, Air Force Aid Society, Coast Guard Mutual Assistance)
	d.	On-base financial institution (e.g., bank or credit union)
	e.	Online military resource(s) (e.g., Office of Financial Readiness, Sen$e app, Military OneSource, Service or installation financial readiness program)
	f.	Professional/certified financial counselor, planner, or advisor outside of the military
	g.	Other off-base, non-military providers (e.g. off-base financial institutions, state and federal government resources, community service providers)
	h.	Family/friends/peers
	i.	Online non-military resources (e.g., online search, blogs, articles)

.	In the past 12 months, did any of the following happen to you (and/or your spouse)? Mark “Yes” or “No” for each item.

			Yes	No
	a.	Failed to make a monthly/minimum payment on your credit card, including the Military Star Card
	b.	Failed to make a rent or mortgage payment
	c.	Had one or more debts referred to a collection agency
	d.	Had telephone, cable, or Internet shut off
	e.	Had water, heat, or electricity shut off
	f.	Failed to make a car payment
	g.	Had a car repossessed
	h.	Filed for personal bankruptcy
	i.	Had to pay overdraft fees to your bank or credit union two or more times
	j.	Borrowed money from family and/or friends to pay bills
	k.	Took money out of a retirement fund or investment to pay living expenses
	l.	Had personal relationship problems with your partner due to finances
	m.	Had your (or your spouse's) security clearance affected due to your financial condition
	n.	Used a charitable organization's food pantry or food bank
	o.	Had adverse personnel action due to financial condition
	p.	Provided unplanned financial support to a family member who did not live with you.

childcare

.	[Ask if Q9 = “Yes”] Do you have child(ren) who routinely use child care arrangements so you and/or your spouse can work or attend school?

		Yes
		No

.	[Ask if Q9 = “Yes”] How satisfied are you with each of the following aspects of your child care? Mark one answer in each row.

	Very dissatisfied
	Dissatisfied
	Neither satisfied nor dissatisfied
	Satisfied
	Very satisfied
	a.	Availability of childcare
	b.	Quality of childcare
	c.	Affordability of childcare
	d.	Location of childcare
	e.	Operating hours of childcare

.	Taking things altogether, how satisfied are you with your childcare situation right now?

		Very satisfied
		Satisfied
		Neither satisfied nor dissatisfied
		Dissatisfied
		Very dissatisfied

employment

.	What is your current employment status?

		Not working, not looking for work
		Not working, looking for work
		Working part time (less than 35 hours per week)
		Working full-time (35 hours or more per week)

.	[Ask if Q25 = “Not working, looking for work”] What is the primary reason why you are still looking for work?

		I cannot find any work that matches my skills
		I lack the necessary schooling, training, or skills for the work that is available
		I lack the necessary work experience
		I cannot afford childcare
		I cannot find any work that provides a flexible work schedule
		I am overqualified for the work that is available
		The pay is not commensurate with my level of education and/or work experience
		I am unable to transfer my licensure, credentials, or other certificates to a new State or jurisdiction following a move

.	[Ask if Q25 = “Working part time (less than 35 hours per week)” OR “Working full-time (35 hours or more per week)”] Taking things altogether, how satisfied are you with your employment situation right now?

		Very satisfied
		Satisfied
		Neither satisfied nor dissatisfied
		Dissatisfied
		Very dissatisfied

.	[Ask if Q25 = “Not working, not looking for work”] Why have you not been looking for work in the last four weeks?

		I cannot find any work that matches my skills
		I am preparing for/recovering from a PCS move
		I lack the necessary schooling, training, or skills
		I lack the necessary work experience
		Child care is too costly
		I do not have child care available to me
		I am not physically able to work due to illness or another physical or health concern
		I am pregnant and taking time off from work voluntarily
		I am pregnant and unable to find a job or employer that will make accommodations for me
		I am unable to work while my spouse is deployed
		There are no jobs in my career field where I currently live
		I am a caregiver to my spouse (e.g., wounded warrior)
		I am a caregiver to a family member other than my spouse
		I do not want or need to work

help-seeking

.	How much do you agree or disagree with the following statements? Mark one answer in each row.

	Strongly disagree
	Disagree
	Neither agree nor disagree
	Agree
	Very strongly agree
	a.	These days, I feel like I belong.
	b.	These days, I feel that there are people I can turn to in times of need
	c.	These days, I think I make things worse for the people in my life.

.	[Ask if Q1 = “Married” OR “Separated”] Taking things altogether, how satisfied are you with your marriage right now?

		Very satisfied
		Satisfied
		Neither satisfied nor dissatisfied
		Dissatisfied
		Very dissatisfied

.	[Ask if Q1 = “Married” OR “Separated”] How much do you agree or disagree with the following statements about your relationship with your spouse? Mark one answer in each row.

	Strongly disagree
	Disagree
	Neither agree nor disagree
	Agree
	Very strongly agree
	a.	We have a good relationship
	b.	My relationship with my partner is very stable
	c.	My relationship with my partner is strong
	d.	My relationship with my partner makes me happy
	e.	I really feel like part of a team with my partner
	f.	I think my marriage might be in trouble.
	g.	I or my spouse seriously suggested the idea of divorce within the past year.
	h.	I discussed divorce or separation with a close friend.
	i.	I thought of getting a divorce or separation crossed my mind in the past year.
	j.	I talked about consulting an attorney about a divorce or separation.

.	What is your level of awareness of each of the following support services? Mark one answer in each row.

	I have heard of this service, but I have not used because I am not in need of this support service
	I have heard of this service and have used it in the past, but not within the past year
	I have heard of this service and have used it within the past year
	I have heard of this service, but I do not really know what it is
	I have never heard of this service
	a.	Military OneSource
	b.	Embedded Mental/Behavioral Health Provider (e.g. uniformed providers attached to a military unit)
	c.	Installation Community Counseling Center or Family Service Centers
	d.	Military and Family Life Counseling (MFLC) Program
	e.	Veterans Crisis Line/Military Crisis Line
	f.	National Suicide Prevention Lifeline
	g.	Chaplain
	h.	Family Support (e.g., Deployment/Family Readiness Coordination, Key Spouse)
	i.	Military treatment facility provider
	j.	Civilian mental health provider

.	[Ask if Q32 a = “I have heard of this service and have used it within the past year”] You indicated that you used Military OneSource within the past year. Which of these would you consider to be the main issue or concern you addressed or sought help for?

		Coping with stress
		Identifying and using problem-solving skills
		Dealing with family separations
		Deployment and reunion
		Mental health concerns for self (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Mental health concerns for family member (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Dealing with family/interpersonal conflicts
		Something else

.

[Ask if Q32 b = “I have heard of this service and have used it within the past year”] You indicated that you used Embedded Mental/Behavioral Health Provider (e.g. uniformed providers attached to a military unit) within the past year. Which of these would you consider to be the main issue or concern you addressed or sought help for?

		Coping with stress
		Identifying and using problem-solving skills
		Dealing with family separations
		Deployment and reunion
		Mental health concerns for self (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Mental health concerns for family member (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Dealing with family/interpersonal conflicts
		Something else

.

[Ask if Q32 c = “I have heard of this service and have used it within the past year”] You indicated that you used Installation Community Counseling Center or Family Service Centers within the past year. Which of these would you consider to be the main issue or concern you addressed or sought help for?

		Coping with stress
		Identifying and using problem-solving skills
		Dealing with family separations
		Deployment and reunion
		Mental health concerns for self (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Mental health concerns for family member (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Dealing with family/interpersonal conflicts
		Something else

.	[Ask if Q32 d = “I have heard of this service and have used it within the past year”] You indicated that you used Military and Family Life Counseling (MFLC) Program within the past year. Which of these would you consider to be the main issue or concern you addressed or sought help for?

		Coping with stress
		Identifying and using problem-solving skills
		Dealing with family separations
		Deployment and reunion
		Mental health concerns for self (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Mental health concerns for family member (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Dealing with family/interpersonal conflicts
		Something else

.	[Ask if Q32 e = “I have heard of this service and have used it within the past year”] You indicated that you used Veterans Crisis Line/Military Crisis Line within the past year. Which of these would you consider to be the main issue or concern you addressed or sought help for?

		Coping with stress
		Identifying and using problem-solving skills
		Dealing with family separations
		Deployment and reunion
		Mental health concerns for self (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Mental health concerns for family member (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Dealing with family/interpersonal conflicts
		Something else

.	[Ask if Q32 f = “I have heard of this service and have used it within the past year”] You indicated that you used National Suicide Prevention Lifeline within the past year. Which of these would you consider to be the main issue or concern you addressed or sought help for?

		Coping with stress
		Identifying and using problem-solving skills
		Dealing with family separations
		Deployment and reunion
		Mental health concerns for self (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Mental health concerns for family member (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Dealing with family/interpersonal conflicts
		Something else

.	[Ask if Q32 g = “I have heard of this service and have used it within the past year”] You indicated that you used Chaplain within the past year. Which of these would you consider to be the main issue or concern you addressed or sought help for?

		Coping with stress
		Identifying and using problem-solving skills
		Dealing with family separations
		Deployment and reunion
		Mental health concerns for self (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Mental health concerns for family member (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Dealing with family/interpersonal conflicts
		Something else

.

[Ask if Q32 h = “I have heard of this service and have used it within the past year”] You indicated that you used Family Support (e.g., Deployment/Family Readiness Coordination, Key Spouse) within the past year. Which of these would you consider to be the main issue or concern you addressed or sought help for?

		Coping with stress
		Identifying and using problem-solving skills
		Dealing with family separations
		Deployment and reunion
		Mental health concerns for self (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Mental health concerns for family member (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Dealing with family/interpersonal conflicts
		Something else

.	[Ask if Q32 i = “I have heard of this service and have used it within the past year”] You indicated that you used Military treatment facility provider within the past year. Which of these would you consider to be the main issue or concern you addressed or sought help for?

		Coping with stress
		Identifying and using problem-solving skills
		Dealing with family separations
		Deployment and reunion
		Mental health concerns for self (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Mental health concerns for family member (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Dealing with family/interpersonal conflicts
		Something else

.	[Ask if Q32 j = “I have heard of this service and have used it within the past year”] You indicated that you used Civilian mental health provider within the past year. Which of these would you consider to be the main issue or concern you addressed or sought help for?

		Coping with stress
		Identifying and using problem-solving skills
		Dealing with family separations
		Deployment and reunion
		Mental health concerns for self (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Mental health concerns for family member (e.g., PTSD, depression, anxiety, alcohol or substance use, suicidal thoughts)
		Dealing with family/interpersonal conflicts
		Something else

.	[Ask if Q32 a = “I have heard of this service and have used it within the past year”] You indicated that you used Military OneSource within the past year. How helpful was this resource in addressing your needs?

		Extremely helpful
		Very helpful
		Somewhat helpful
		Slightly helpful
		Not at all helpful

.	[Ask if Q32 b = “I have heard of this service and have used it within the past year”] You indicated that you used Embedded Mental/Behavioral Health Provider (e.g. uniformed providers attached to a military unit) within the past year. How helpful was this resource in addressing your needs?

		Extremely helpful
		Very helpful
		Somewhat helpful
		Slightly helpful
		Not at all helpful

.	[Ask if Q32 c = “I have heard of this service and have used it within the past year”] You indicated that you used Installation Community Counseling Center or Family Service Centers within the past year. How helpful was this resource in addressing your needs?

		Extremely helpful
		Very helpful
		Somewhat helpful
		Slightly helpful
		Not at all helpful

.	[Ask if Q32 d = “I have heard of this service and have used it within the past year”] You indicated that you used Military and Family Life Counseling (MFLC) Program within the past year. How helpful was this resource in addressing your needs?

		Extremely helpful
		Very helpful
		Somewhat helpful
		Slightly helpful
		Not at all helpful

.	[Ask if Q32 e = “I have heard of this service and have used it within the past year”] You indicated that you used Veterans Crisis Line/Military Crisis Line within the past year. How helpful was this resource in addressing your needs?

		Extremely helpful
		Very helpful
		Somewhat helpful
		Slightly helpful
		Not at all helpful

.	[Ask if Q32 f = “I have heard of this service and have used it within the past year”] You indicated that you used National Suicide Prevention Lifeline within the past year. How helpful was this resource in addressing your needs?

		Extremely helpful
		Very helpful
		Somewhat helpful
		Slightly helpful
		Not at all helpful

.	[Ask if Q32 g = “I have heard of this service and have used it within the past year”] You indicated that you used Chaplain within the past year. How helpful was this resource in addressing your needs?

		Extremely helpful
		Very helpful
		Somewhat helpful
		Slightly helpful
		Not at all helpful

.	[Ask if Q32 h = “I have heard of this service and have used it within the past year”] You indicated that you used Family Support (e.g., Deployment/Family Readiness Coordination, Key Spouse) within the past year. How helpful was this resource in addressing your needs?

		Extremely helpful
		Very helpful
		Somewhat helpful
		Slightly helpful
		Not at all helpful

.	[Ask if Q32 i = “I have heard of this service and have used it within the past year”] You indicated that you used Military treatment facility provider within the past year. How helpful was this resource in addressing your needs?

		Extremely helpful
		Very helpful
		Somewhat helpful
		Slightly helpful
		Not at all helpful

.	[Ask if Q32 j = “I have heard of this service and have used it within the past year”] You indicated that you used Civilian mental health provider within the past year. How helpful was this resource in addressing your needs?

		Extremely helpful
		Very helpful
		Somewhat helpful
		Slightly helpful
		Not at all helpful

.	Suppose you found yourself in a situation where you thought you needed help with personal problems, how likely or unlikely is it that you would use each of the following? Mark one answer in each row.

	Very unlikely
	Unlikely
	Neither likely nor unlikely
	Likely
	Very likely
	a.	Veterans Crisis Line (VCL)/Military Crisis Line (MCL)
	b.	National Suicide Prevention Lifeline
	c.	Military OneSource
	d.	Embedded Mental/Behavioral Health Provider (e.g. uniformed providers attached to a military unit)
	e.	Installation Community Counseling Center or Family Service Centers
	f.	Military and Family Life Counseling (MFLC) Program
	g.	Chaplain
	h.	Family Support (e.g., Deployment/Family Readiness Coordination, Key Spouse)
	i.	Your spouse
	j.	Military treatment facility provider
	k.	Civilian mental health provider
	l.	Another military spouse
	m.	Non-military family/friends

.	Please indicate whether, in the past year, any of the following concerns prevented you from seeking, or made it hard for you to access, support for personal problems (e.g. relationship, financial, mental health, or other stresses). Mark all that apply.

		I feared a negative impact on my career
		I feared a negative impact on my spouse’s career
		I feared loss of privacy/confidentiality
		I was worried about being perceived as broken by others
		I was worried about being stigmatized for seeking help within the military community
		I was not sure my situation can be helped with the resources available
		My spouse/partner refused or was unwilling to seek help
		I didn't know who to turn to
		I wasn't sure what resources exist
		I did not think it would help
		I did not know where to get help
		It was too difficult to schedule an appointment
		It was too difficult to get time off work
		It was too difficult to get childcare
		It was too difficult to reach the location where the services are offered
		Not applicable. I did not have concerns that prevented me from seeking help

Suicide attitudes and beliefs

.	How much do you agree with each of the following statements? Mark one answer in each row.

	Strongly disagree
	Disagree
	Neither agree nor disagree
	Agree
	Strongly agree
	a.	Firearms should be stored in a firearm safe
	b.	Firearms should be stored locked and unloaded with ammunition stored separately when they are not in use
	c.	Having a firearm in the house makes it a safer place to be
	d.	Service members and their families who live on a military installation should be required to register their firearms.
	e.	If somebody wants to die by suicide and you prevent them from using a firearm they will simply find another way to die
	f.	Having a firearm in the home increases the risk of suicide
	g.	Suicide risk is related to how a firearm is stored

.	In general, the hazards in my living space that may be deliberately or accidentally used to harm others or myself, such as poisons, medications, and firearms, are safely stored (for example, locked in a cabinet, unloaded).

		Strongly agree
		Agree
		Neither agree nor disagree
		Disagree
		Strongly disagree

.	Suppose you felt trapped or stuck in a stressful situation. How likely or unlikely is it that you would use each of the following ways to deal with or cope with the situation? Mark one answer in each row.

	Very unlikely
	Unlikely
	Neither likely nor unlikely
	Likely
	Very likely
	a.	Ignore the situation
	b.	Avoid the situation
	c.	Deal with the situation on your own to try and fix it
	d.	Ask someone to help you try and fix the situation
	e.	Seek out self-help resources via the Internet or books
	f.	Use alcohol or another harmful substance to cope with the situation
	g.	Seek help from a support service (e.g. Military OneSource)
	h.	Seek help from a family member or friend

.	Have you ever received training on suicide prevention (i.e., identifying warning signs, what support services to turn to for help, or how to intervene more effectively, etc.)? Mark one.

		No
		Yes, I have received suicide prevention training, but not within the past two years
		Yes, I have received suicide prevention training within the last two years, but the none of the training I received was offered through the military community (for example, you had training through your employer, school, church, or another non-military resource)
		Yes, I have received suicide prevention training within the last two years, and it included (but may not have been limited to) training offered through the military community (for example, you might have received training from a family readiness program, military community counseling center, or other military program)

.

[Ask if 58 = “Yes, I have received suicide prevention training, but not in the last year” OR “Yes, I have received suicide prevention training within the last two years, but the none of the training I received was offered through the military community” OR “Yes, I have received suicide prevention training within the last two years, and it included (but may not have been limited to) training offered through the military community”] How helpful was the training you received on suicide prevention?

		Extremely helpful
		Very helpful
		Somewhat helpful
		Slightly helpful
		Not at all helpful

.	Please indicate how much you agree with the following statements: Mark one answer in each row.

	Strongly disagree
	Disagree
	Neither agree nor disagree
	Agree
	Very strongly agree
	a.	I am familiar with local emergency/crisis resources available for people who might be at an increased risk for suicide or self-harm (for example: local crisis line, psychiatric emergency response team contact information, or location of local emergency departments)
	b.	I am familiar with national/international emergency/crisis resources available for people who might be at an increased risk for suicide or self-harm (for example: Military/Veterans Crisis line, National Suicide Prevention Lifeline, OCONUS/overseas crisis lines)
	c.	I am confident that I can identify when someone is at an increased risk for suicide or self-harm
	d.	I am confident that I can help identify, and steer someone who might be at an increased risk for suicide or self-harm toward appropriate helping resources
	e.	I feel comfortable utilizing the helping resources available to me and my family

postvention support

.	In your lifetime, have you known someone (family member, friend, coworker) who died by suicide?

		Yes
		No

.	[Ask if Q61 = “Yes”] What was your relationship with the person(s) who died? Mark all that apply.

		Parent
		Child
		Sibling
		Spouse/Partner
		Other relative/family
		Friend
		Coworker
		Classmate
		Other

[Ask if Q61 = “Other”] Please specify the other type of relationship with the person(s) who died.

.	[Ask if Q61 = “Yes”] Did this person’s death by suicide occur within the past year?

		Yes
		No

.	[Ask if Q61 = “Yes”] Did you receive support or counseling to help you with this loss?

		No
		Yes, from someone outside the military community
		Yes, from someone within the military community (for example, a Chaplain, Casualty Assistance Officer, Unit Commander or Leader, military mental health provider, Military and Family Life Counseling (MFLC), or other counselor)

.	[Ask if Q64 = “Yes, from someone outside the military community”] How helpful was the support or counseling you received?

		Extremely helpful
		Very helpful
		Somewhat helpful
		Slightly helpful
		Not at all helpful

.	In the past 12 months, did any of your children know someone who died by suicide?

		Yes
		No
		Don’t know

.	[Ask if Q66= “Yes”] How helpful was the support or counseling your child received?

		Extremely helpful
		Very helpful
		Somewhat helpful
		Slightly helpful
		Not at all helpful

.	Have you ever wished you were dead or wished you could go to sleep and never wake up?

		Yes, within the last year
		Yes, not within the last year
		No

.	Have you actually had any thoughts of killing yourself?

		Yes, within the last year
		Yes, not within the last year
		No

.	[Ask if Q 69= “Yes”] Have you thought about how you might do this?

		Yes, within the last year
		Yes, not within the last year
		No

.	[Ask if Q 69= “Yes”] Have you had any intention of acting these thoughts of killing yourself, as opposed to you have the thoughts, but you definitely would not act on them?

		Yes, within the last year
		Yes, not within the last year
		No

.	[Ask if Q 69= “Yes”] Have you started to work out, or actually worked out, the specific details of how to kill yourself, and did you actually intend to carry out the details of this plan?

		Yes, within the last year
		Yes, not within the last year
		No

.	Have you ever done anything, started to do anything, or prepared to do anything to end your life?

		Yes, within the last year
		Yes, not within the last year
		No

.	[Ask if Q9= “Yes”] Have any of your children under age 18 living at home expressed any thoughts of killing themselves, wanting to die, or wanting to go to sleep and never wake up?

		Yes, within the last year
		Yes, not within the last year
		No

.	[Ask if Q9= “Yes”] Have any of your children under age 18 living at home attempted suicide?

		Yes, within the last year
		Yes, not within the last year
		No
		Not sure

.	Have you ever intentionally hurt yourself (e.g., cut or hit yourself) to relieve stress, feel better, or get something else to happen without any intention of killing yourself?

		Yes, within the last year
		Yes, not within the last year
		No
		Not sure

.	[Ask if Q9= “Yes”] Have any of your children ever intentionally hurt themselves to relieve stress, feel better, or get something else to happen without any intention of killing themselves?

		Yes, within the last year
		Yes, not within the last year
		No
		Not sure