Youth Suicide Prevention Pre and Post Survey

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

Youth Suicide Prevention post-survey Attachment B

Youth Suicide Prevention Pre and Post Survey

OMB: 0970-0401

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Youth Suicide Prevention Post-Test


Dear Training Participant,
  The purpose of the survey is to assess knowledge and perceptions of Youth Suicide Prevention and participant satisfaction after 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.


Click the forward button to begin this survey.



Q1 As a result of participating in this workshop, rate your level of knowledge on:


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 As a result of participating in this workshop, rate your level of comfort with:


Not Comfortable (1)

Somewhat Comfortable (2)

Comfortable (3)

Very Comfortable (4)

Approaching a student you are concerned about (1)

Helping a student at risk of suicide (2)

Asking a student about suicide (3)




Q3 Per the WHO, suicide is the ___ leading cause of death for ages 10-18.

  • 1st (1)

  • 2nd (2)

  • 3rd (3)

  • 4th (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 (7)

  • 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 such as firearms, prescription medications, and ropes (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 directly ask a student if they are thinking of 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.

  • True (1)

  • False (2)




Q10 How would you rate today's facilitator/facilitators? 

  • Poor (1)

  • Fair (2)

  • Good (3)

  • Very good (4)

  • Excellent (5)



Q11 What did you learn that will be useful in your work? 

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

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Q12 What changes would you make to this workshop? 

________________________________________________________________

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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleYouth Suicide Prevention Post-Test
AuthorQualtrics
File Modified0000-00-00
File Created2023-08-02

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