Youth Suicide Prevention Pre and Post Survey

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

Youth Suicide Prevention pre-survey - Attachment A

Youth Suicide Prevention Pre and Post Survey

OMB: 0970-0401

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Youth Suicide Prevention Pre-Test




Dear Training Participant,
  The purpose of the survey is to assess knowledge and perceptions of youth suicide prevention before completing the Center for School Behavioral Health (CSBH) Youth Suicide Prevention Module. This information is used to measure impact and to guide quality improvement efforts. Thank you for taking time to complete this survey.   Please note that your name and individual responses are confidential. This information is seen only by the CSBH Evaluation team. Survey results are de-identified (name and contact information are removed) and aggregated before sharing.

Q1 Rate your level of knowledge about:


Poor (1)

Fair (2)

Good (3)

Very Good (4)

Excellent (5)

The actions to take when a student is at-risk of suicide. (1)

The signs and symptoms of suicide risk in students. (2)




Q2 Rate your level of comfort with:


Not Comfortable (1)

Somewhat Comfortable (2)

Comfortable (3)

Very Comfortable (4)

Approaching a student whom you believe may be suicidal. (1)

Helping a student at risk of suicide. (2)

Asking a student about suicide. (10)



Q3 Per the World Health Organization (WHO), suicide is the ___ leading cause of death for youth ages 10-18.

  • 1st (1)

  • 2nd (2)

  • 3rd (3)

  • 6th (4)





Q4 The items an educator needs as a first responder include all of the following EXCEPT:

  • To be aware of warning signs (1)

  • To convey concern appropriately (2)

  • To take action, if needed (3)

  • To be able to diagnose a mental health condition (4)



Q5 Protective factors to prevent youth suicide include (check the correct choices):

  • Participation in school activities (1)

  • Allowing unrestricted social media access (8)

  • Positive self-esteem (2)

  • Access to and care for mental/physical/substance disorders (3)

  • Support for seeking help (4)

  • Restricted access to highly lethal means of suicide (5)

  • Connection with a caring adult (6)



Q6 According to the Mayo Clinic, LGBTQ youth are considered to be at a lower risk for suicide than their heterosexual peers.

  • True (1)

  • False (2)


Q7 It is important to ask a student directly if he/she is thinking about suicide.

  • True (1)

  • False (2)



Q8 'You'll be okay, life only gets better' is a helpful response to a student who is thinking about suicide.

  • True (1)

  • False (2)


Q9 Suicidal ideation must be taken seriously each time it's expressed by youth.

  • True (1)

  • False (2)


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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleYouth Suicide Prevention Pre-Test
AuthorQualtrics
File Modified0000-00-00
File Created2023-08-24

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