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Training
Skills Assessment- Follow-up 
(TSA-F6/TSA-F12)
As
part of the Evaluation of GLS suicide prevention programs across the
country, we are inviting participants of GLS funded training
activities to complete the following brief survey. This survey will
assess your knowledge, attitudes and behaviors related to youth
suicide prevention [6 months OR 12 months] after the initial training
to assess long term changes. The survey will take approximately 20
minutes to complete.  
Rights Regarding
Participation: Your input is important; however, your
participation in this survey is completely voluntary. There are no
penalties or consequences for not participating. You can choose to
stop the survey at any time, or not answer a question for whatever
reason. 
Privacy: Your
name will never appear in any report that summarizes the findings of
the National Outcomes Evaluation. All findings will be reported in
aggregate; that is, they will be combined with responses from other
individuals. If you are selected to participate in follow-up surveys
your responses across administration will be linked with a unique
identifier—your name and responses will not be linked. Your
individual responses will not be shared with the trainer or other
grantee-funded staff. 
Risks:
Completing this survey poses few, if any, risks to you. Some
questions may make you feel uncomfortable. You can choose not to
answer any question for any reason. You may choose to stop the survey
at any time, or not answer a question for whatever reason. You will
not be penalized for stopping. You can contact the principal
investigator of the project at any time. 
Benefits:
Your participation will not result in any direct benefits to you.
However, your input will contribute to a national effort to prevent
suicide. 
Compensation:
You will receive a $20 gift card for your participation in today’s
survey. 
Contact
Information: If you have any concerns about completing this
survey or have any questions about the study, please contact
Christine Walrath, principal investigator, at (646) 695-8154 or
[email protected]
	- Do you agree to
	participate in this survey? 
	- Can you confirm
	that you are over 18 years of age? 
	
	
	
		| 
			SC1. Please verify that you attended the following training | Yes, this is the training I
				attended.No, this is not the training I attended
 | 
Section
1: Training Utilization
	
	
	
	
		| In the last 3 months, have you used your training to
				do any of the following? Select all that apply
 | Screen
				youth for suicidal behaviors (i.e., using a screening
				tool)Formally publicize information
				about suicide prevention or mental health resourcesHave informal conversations
				about suicide and suicide prevention with youth and othersIdentify youth who might be at
				risk for suicide 
				Provide direct services to
				youth at risk for suicide and/or their familiesTrain other staff members to
				intervene with youth at risk for suicideMake referrals to mental health
				services for at-risk youthWork with adult at-risk
				populations 
				Other, please specify:None of the above
 | 
	
		| In the last 3 months, how many trainings
				or presentations about suicide or suicide prevention have you
				attended? Please do not include booster or refreshers of
				the training in which you consented to participate in this
				survey. 
				
 | None  [Go to 3]1   [Continue to 2a]    
				        
				2-5   [Continue to 2a]6-10   [Continue to 2a]10+   [Continue to 2a]
 | 
	
		| 
			
 | 
				Which training(s) about suicide or suicide
					prevention have you received? Select all that apply.
 | 
			Gatekeeper 
 Screening or suicide risk
			assessment 
				AMSR (Assessing and Managing
				Suicide Risk) 
				CASE Approach (Chronological
				Assessment of Suicide Events) 
				Commitment to Living 
				Columbia Suicide Severity
				Rating Scale (C-SSRS) 
				QPRT Suicide Risk Assessment
				and Management Training (not basic QPR training) 
				RRSR (Recognizing and
				Responding to Suicide Risk) 
				suicide to Hope 
				An in-service or webinar
				training at my organization 
				An in-service or webinar
				training at a former organization 
				A different training on
				screening or suicide risk assessment, please specify: 
 Suicide-specific evidence-based
			treatment approaches 
				CAMS (Collaborative Assessment
				and Management of Suicide) 
				CBT-SP (Cognitive Behavior
				Therapy for Suicide Prevention) 
				DBT (Dialectical Behavior
				Therapy) 
				Another training, please specify: __________ | 
	
		| In the last 3 months, have you received
				any booster or refresher sessions directly related to
				the original training in which you consented to participate in
				this survey?
 |  | 
	
		| Since participating in the original
				training in which you consented to participate in this survey,
				have you used any online tools or applications (apps) to support
				what you learned from the training? 
				
 | Yes [Continue to 4a]No [Go to 5]Don’t know [Go to 5]
 | 
	
		| 
			
 | If yes, what tools or apps have you used:
 | 
			
 | 
Section
2: Knowledge About Suicide Prevention
Please read the
following statements and use the rating scale to indicate your
knowledge of the following items.
	
	
	
	
	
	
	
		| 
			
 | 
			Very High | 
			High | 
			Low | 
			Very Low | 
			Don’t Know | 
	
		| My organization’s policies and
				procedures that define each employee’s role in preventing
				suicide.
 | 
			
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		| Warning signs of suicide.
 | 
			
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		| How to ask someone about suicide.
 | 
			
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		| Persuading someone to get help.
 | 
			
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		| Local referral services.
 | 
			
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Section
3: Confidence in Identifying and Managing Suicidal Thoughts and
Behaviors
Please read the
following statements and use the rating scale to indicate the degree
to which you agree or disagree with each statement. It is important
that you answer all statements according to your beliefs and not what
you think others may want you to believe.
	
	
	
	
	
	
	
		| 
			
 | 
			Strongly Agree | 
			Agree | 
			Disagree | 
			Strongly Disagree | 
			Don’t Know | 
	
		| If someone I knew was showing signs of
				suicide, I would directly raise the question of suicide with
				them.
 | 
			
 | 
			
 | 
			
 | 
			
 | 
			
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		| If a person’s words and/or behavior
				suggest the possibility of suicide, I would ask the person
				directly if he/she is thinking about suicide.
 | 
			
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		| If someone told me they were thinking of
				suicide, I would intervene.
 | 
			
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		| I feel confident in my ability to help a
				suicidal person.
 | 
			
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		| I don’t think I can prevent someone
				from suicide.
 | 
			
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		| I don’t feel competent to help a
				person at risk of suicide.
 | 
			
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 | 
How confident
do you feel in your ability to…
	
	
	
	
	
	
		| 
			
 | 
			Very Confident | 
			Confident | 
			Somewhat Confident | 
			Not at all confident | 
	
		| 
				
					
						Recognize suicidality (including warning
							signs)
 | 
			
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		| 
				
					
						Conduct a suicide risk assessment
 | 
			
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		| 
				
					
						Engage and connect with the suicidal
							person
 | 
			
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		| 
				
					
						Identify appropriate response to the
							person in crisis
 | 
			
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		| 
				
					
						Make appropriate referrals and
							connections
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		| 
				
					
						Counsel on access to lethal means
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		| 
				
					
						Help someone to create a collaborative
							safety plan
 | 
			
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Section
4: Behavior
The next set of
questions asks about your experiences with youth at risk for suicide
	
	
	
		| Earlier, you selected that in the last 3
				months you used your suicide prevention training to identify
				youths you thought might be at risk for suicide. About how
				many youths have you identified in the last 3 months?
 |  | 
	
		| Thinking about all the youths you
				identified, about how many did you refer for further assistance
				or support?
 |  | 
	
		| Thinking about the one youth you
				identified most recently, did you ask the youth whether they were
				considering suicide?
 |  | 
	
		| Thinking about the one youth you
				identified most recently, in what setting were they identified?
 | School or School Based
				Health Center Social Service Agency 
				Juvenile Justice Agency 
				Law Enforcement Agency (e.g.,
				police, jail or detention center) Community based organization,
				recreation or after school activity 
				Physical Health Agency (e.g.,
				pediatrician, primary care, hospital) Mental Health Setting (e.g.,
				private MH provider, psychiatric hospital, outpatient clinic) Home Emergency Response Unit or
				Emergency Department College or University (e.g.,
				campus health center, classroom) Digital or social media (e.g.,
				Snapchat, TikTok, Instagram, text message to a friend)Other, please specify:
 | 
	
		| Thinking about the one youth you
				identified most recently, did you refer the youth you identified
				to get further assistance or support?
 |  | 
	
		| To what services, resources, or
				individuals did you refer the youth? Select all that
				apply.
 | Public Mental Health Agency
				or Provider (e.g., tribal or state sponsored mental health
				agency)  Private Mental Health Agency or
				Provider  Psychiatric Hospital/ Unit  Emergency department  Substance abuse treatment
				center  School counselor (e.g., K-12 or
				college or university staff)  Mobile crisis unit  School Based Health Clinic  Tribal or cultural services
				(e.g., traditional healing practices, talking circles, sweat
				lodge)  Youth was not referred to
				mental health services Non-hospital Crisis
				stabilization unit  Don’t Know  Other, please specify 
 | 
	
		| Thinking about the one youth you
				identified most recently, did you take the youth to any of the
				services or resources you were recommending?
 |  | 
	
		| Thinking about the one youth you
				identified most recently, did the youth receive the services to
				which they were referred?
 |  | 
	
		| Thinking about the one youth you
				identified most recently, have you personally followed up with
				them to see how they are doing?
 |  | 
Section
5: Personal Background
	
	
	
	
	
		| Has the primary setting in which you
				interact with youth changed in the last 6 months?
 | Yes [Go to 32a]No [Go to 33]Don’t know [Go to 33]
 | 
	
		|  | 
				
					
						Please indicate the primary setting in
							which you now interact with youth…
 | Child welfareEducation (K-12)Emergency responseHigher education
				(college/university)Juvenile justice/ProbationLaw enforcementMental HealthPrimary health care (other than
				mental health)Substance abuse treatmentTribal services/Tribal
				governmentOther community settingsDon’t know
 | 
	
		| You previously indicated that the role
				that best describes you is [pipe from TSA-P/TSA-F6]. Has your
				role changed?
 | Yes [Go to 33a]No [Go to 34]Don’t know [Go to 34]
 | 
	
		|  | 
				
					
						If yes, please select the ONE ROLE that
							you feel best describes you.
 | 
	
		|  | 
			If child welfare 
			 
				Program/System administratorMental health
				clinician/Counselor/ PsychologistSocial worker/Case worker/Care
				coordinatorEmergency/Crisis care workerProgram evaluatorAdministrative
				assistant/Clerical support personnel 
 If education (K–12) 
				Teacher 
				School administratorMental health
				clinician/Counselor/ PsychologistSocial worker/Case worker/Care
				coordinatorEmergency/Crisis care workerProgram evaluatorAdministrative
				assistant/Clerical support personnelAcademic advisorTutor 
 If emergency response 
 If higher education
			(college/university) 
				Faculty/Professor/ ResearcherAdministrator (e.g., dean’s
				office, vice president, provost)Residential life staffMental health
				clinician/Counselor/ PsychologistSocial worker/Case worker/Care
				coordinatorEmergency/Crisis care workerProgram evaluatorAdministrative
				assistant/Clerical support personnelStudent 
 If juvenile justice/probation 
				Program/System administratorProbation officerSocial worker/Case worker/Care
				coordinatorDetention facility guardProgram evaluatorAdministrative
				assistant/Clerical support personnel 
 | 
			If law enforcement 
				Police officer or other law
				enforcement staffProgram/System administratorProgram evaluatorAdministrative
				assistant/Clerical support personnel 
 If mental health 
				Program/System administratorMental health
				clinician/Counselor/ PsychologistSocial worker/Case worker/Care
				coordinatorEmergency/Crisis care workerProgram evaluatorAdministrative
				assistant/Clerical support personnel 
 If primary health care (other
			than mental health) 
				Program/System administratorPhysician 
				NurseNursing assistant/Health
				technicianProgram evaluatorAdministrative
				assistant/Clerical support personnel 
 If substance abuse 
				Program/System administratorMental health
				clinician/Counselor/ PsychologistSocial worker/Case worker/Care
				coordinatorEmergency/Crisis care workerProgram evaluatorAdministrative
				assistant/Clerical support personnel 
 If tribal services/tribal
			government 
				Traditional tribal healerTribal elderElected tribal officialProgram/System administratorMental health
				clinician/Counselor/ PsychologistSocial worker/Case worker/Care
				coordinatorCommunity outreach workerEmergency/Crisis care workerProgram evaluatorAdministrative
				assistant/Clerical support personnel 
 If other community settings 
				Parent or foster/Resource
				parentOther caregiverRelativeYouth mentorVolunteer (i.e., Big Brother
				Big Sister, CASA)Youth advocateClergy/Religious educatorOther, please specify: | 
	
		| What is the nature of your interactions
				or work with youth?
 | TeachingCounseling/AdvisingProviding mental health
				servicesCase management (e.g., child
				welfare, juvenile justice)Volunteer/Mentoring (e.g., big
				brother/big sister, volunteer)No formal work; interactions
				with youth are intermittent within the community settingChurch/Spiritual advisorNeighborOther, please specify:
 | 
Section 6:
Organizational Policies
	
	
	
		| Thinking about the primary setting in
				which you interact with youth, about how many other
				peers/colleagues in that setting have received training in
				suicide prevention?
 | AllMostSomeNoneDon’t know
 | 
	
		| In the setting where you interact with
				youth, is there an established, shared protocol regarding
				steps that should be followed after a youth is identified as at
				risk for suicide?
 |  | 
	
		| In the setting where you interact with
				youth, are there clear, widely used steps that should be followed
				after a referral is made to make sure the
				youth received the services?
 |  | 
Section
7: Re-contact Consent (only
for 6 month FU)
	
	
	
		| Are you still willing to be contacted
				again in 6 months to answer some further follow-up questions
				about how you’ve used the information and skills you
				learned in the training?
 |  | 
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| File Modified | 0000-00-00 | 
| File Created | 0000-00-00 |