1b. Please explain your rating.
2. What suicide prevention programs or services are available in our community?
3. Do you know how long have these programs or services been available?
4. Do you know of any suicide prevention programs or services that are being planned for our community?
5. What mental health treatment options or services are available in our community?
6. Do you know how long the treatment services have been available?
7. Do you know of any mental health treatment efforts or services that are being planned for our community?
8. Generally, do people in the community use these services? Are there plans to expand additional services or efforts? Please explain.
9. What services do you feel will benefit our youth?
10. Can you describe efforts to involve the community, including youth and elders, in the planning of prevention programs or mental health services?
11. Are you aware of policies related to suicide or mental health are in place in the community?
1. Based on your knowledge, what does the community know about efforts for suicide prevention and the treatment of mental illness? Include information such as the name of programs, the services provided, how to access services, who they serve (such as youth, adults, males, females), whether they treat both mental health problems and alcoholism, etc.
2b. Please explain your rating.
3. What are the strengths of the available prevention programs and treatment services?
4. What are the limitations of the available prevention programs and treatment services?
1b. Please explain your rating.
2b. Please explain your rating.
3. How are these leaders (elected or informal) involved in efforts regarding suicide prevention in our community? In other words, what are they doing?
4. Would the leadership (elected or informal) support additional efforts to address suicide prevention planning in our community? Please explain.
1. How would you describe our community?
2. What are the community’s feelings about suicide prevention?
3. What are the community’s feelings about substance use disorders?
4. How does the community support the prevention and treatment efforts?
5. What are the primary obstacles to obtaining or adding more suicide prevention programs or mental health treatment services in our community?
1. How knowledgeable are community members about the issue of suicide? Please explain.
2. How knowledgeable are community members about the issue of substance use disorders?
3. In our community, what types of information are available about suicide prevention?
4. In our community, what types of information are available about substance use disorders?
5. Is local data on suicide prevention or substance use disorders available in our community? If so, from where?
1. To whom or where would a person turn to first for help if they were thinking about suicide?
2. To whom or where would a person turn to first for help if they have a substance use disorder problem?
3. Do you know where people go for substance use disorder related services?
Select all that apply
4. How are youth supported in the community who are in need of mental health or substance use disorder services?
Select one
5. What do you feel are the primary challenges for the community to access needed mental health or substance use disorder problems?
Select all that apply
6. How important are the following services to you?
Access to culturally based services is important.
To have American Indian/Alaska Native Professional staff is important.
On-site behavioral health counseling and therapy is a must.
It is important to have behavioral health counseling and therapy that I can access privately.
Transportation to and from counseling and treatment services is important.
7. What are the community’s feelings about getting involved in suicide or substance use disorder prevention efforts (e.g., talking to a person thinking about suicide, volunteering time, financial donations, providing space)?
9a. What is your gender?
Select one:
9b. Gender self-description:
If none of the above gender descriptions fit you, feel free to describe yourself here:
10. Please provide additional comments in the space below:
