Community Needs Survey: Zero Suicide Initiative
Help the Zero Suicide Initiative Committee understand community needs and improve suicide prevention efforts in St Lucie, Martin, Indian River, and Okeechobee counties.
Introduction to the Zero Suicide Initiative Survey
This survey aims to gather valuable insights from the community to support the Zero Suicide Initiative Committee's efforts in suicide prevention. The Zero Suicide Initiative is a commitment to systematically reduce suicide deaths through evidence-based practices in health and behavioral health care systems. Your participation is vital and appreciated. Please answer the following questions honestly and thoughtfully.
Which county do you primarily reside in?
*
Please Select
St Lucie
Martin
Indian River
Okeechobee
Other
What is your age group?
*
Please Select
Under 18
18-24
25-34
35-44
45-54
55-64
65 or older
Prefer not to say
What is your gender?
*
Female
Male
Non-binary/Third gender
Prefer not to say
Other
What is your relationship to the community? (Select all that apply)
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Resident
Healthcare provider
Mental health professional
Educator/School staff
Student
Family member of someone affected by suicide
Community leader
Other
In your opinion, what are the most important needs for suicide prevention groups and services in your community? (Select up to 3)
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More support groups
Increased awareness/education
Access to crisis intervention services
Access to mental health professionals
Support for families and caregivers
Youth-focused programs
Culturally appropriate services
Other
Have you ever personally experienced suicidal thoughts?
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Yes
No
Prefer not to say
Have you lost a family member or close friend to suicide?
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Yes
No
Prefer not to say
Are you aware of any suicide prevention resources, organizations, or support groups in your community?
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Yes
No
If yes, please list any resources, organizations, or support groups you know of and are willing to share.
What barriers, if any, make it difficult to access suicide prevention services or support groups in your community? (Select all that apply)
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Lack of information/awareness
Cost/affordability
Transportation issues
Stigma/shame
Limited availability of services
Language or cultural barriers
No barriers
Other
How easy is it to access support groups or suicide prevention resources in your area?
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Very easy
Somewhat easy
Somewhat difficult
Very difficult
Not sure
What types of support groups would be most helpful in your community? (Select all that apply)
*
Groups for youth/teens
Groups for adults
Groups for families/caregivers
Groups for survivors of suicide loss
Groups for LGBTQ+ individuals
Other
Are you interested in collaborating with the Zero Suicide Initiative Committee or participating in suicide prevention activities?
*
Yes, I am interested in joining the Committee
Yes, I am interested in volunteering or collaborating
No, not at this time
If you are interested in joining the Committee or collaborating, please provide your contact information below.
This section is optional and only for those who wish to be contacted.
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
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