SECTION SU: SUICIDE
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Time
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SU1. Has there ever been a time when you thought more than usual about death or dying? |
YES 01 NO 02 |
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SU2. Have you ever wished you were dead? |
YES 01 NO 02 |
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SU3. Have you ever thought about suicide or killing yourself? |
YES 01 NO 02 |
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SU4. Have you ever in your whole life tried to kill yourself? By this I mean actually did something to try to commit suicide, not just talked about it. |
YES 01 NO 02 |
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IF ANY OF THE ABOVE ARE ANSWERED "YES" GO TO SU5 IF ALL OF THE ABOVE ARE ANSWERED "NO" GO TO LIFETIME SUBSTANCE ABUSE, CIDI |
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SU5. Have you ever felt that life was hopeless and that there was nothing good for you in the future? |
YES 01 NO (GO TO SU6) 02 |
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SU5a. Has there been a period of 2 weeks or more in the past 6 months where this was mostly true? |
YES 01 NO 02 |
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SU6. Have you ever thought that life wasn’t worth living? |
YES 01 NO (GO TO SU7) 02 |
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SU6a. Has there been a period of 2 weeks or more in the past 6 months where this was mostly true? |
YES 01 NO 02 |
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SU7. Have you ever had repeated thoughts about killing yourself for at least 2 weeks or more? |
YES 01 NO (GO TO SU8) 02 |
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SU7a. Has there been a period of 2 weeks or more in the past 6 months where this was mostly true? |
YES 01 NO 02 |
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SU8. Have your ever had a specific plan for how you would kill yourself? |
YES 01 NO (GO TO SU9) 02 |
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SU8a. Has there been a period of 2 weeks or more in the past 6 months where this was mostly true? |
YES 01 NO 02 |
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SU8b. What was that plan? |
________________________________ ________________________________ |
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IF QUESTION SU4 IS "NO", CODE 99 AND GO TO SECTION F IF QUESTION SU4 IS "YES", CONTINUE |
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SU9. How many times have you attempted suicide? |
|___|___| # TIMES |
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SU10. How old were you when you made (each/the) suicide attempt? IF SU9=1 How old were you when you made the 1st suicide attempt? IF SU9=2 How old were you when you made the 2nd suicide attempt? IF SU9=3 How old were you when you made the 3rd suicide attempt? IF SU9=4 How old were you when you made the 4th suicide attempt? IF SU9=5 How old were you when you made the 5th suicide attempt? IF SU9=6 How old were you when you made the 6th suicide attempt? IF SU9=7 How old were you when you made the 7th suicide attempt? IF SU9=8 How old were you when you made the 8th suicide attempt? IF SU9=9 How old were you when you made the 9th suicide attempt? IF SU9=10 How old were you when you made the 10th suicide attempt? IF SU9=11 How old were you when you made the 11th suicide attempt? IF SU9=12 How old were you when you made the 12th suicide attempt? IF SU9=13 How old were you when you made the 13th suicide attempt? IF SU9=14 How old were you when you made the 14th suicide attempt? IF SU9=15 How old were you when you made the 15th suicide attempt? IF SU9=16 How old were you when you made the 16th suicide attempt? IF SU9=17 How old were you when you made the 17th suicide attempt? IF SU9=18 How old were you when you made the 18th suicide attempt? IF SU9=19 How old were you when you made the 19th suicide attempt? IF SU9=20 How old were you when you made the 20th suicide attempt? |
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SU11. Was the (most recent) suicide attempt within the past 6 months? |
YES 01 NO 02 |
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SU12. What method did you use to attempt suicide (the most recent time)? IF OVERDOSE, NOTE DRUG AND AMOUNT INGESTED IF CUT, NOTE HOW SERIOUS AND IF SUTURES WERE WARRANTED |
________________________________ ________________________________ ________________________________ ________________________________ |
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SU13. Did you receive any medical treatment for the (most recent) suicide attempt? |
YES (GO TO SU13a) 01 NO (GO TO SU13b) 02 |
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SU13a. Describe the treatment you received (Specify) |
________________________________ ________________________________ ________________________________ ________________________________ |
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SU13b. Should you have had medical treatment, even if you did not get it? |
YES 01 NO 02 |
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SU14. During the (most recent) suicide attempt, did you tell anyone what you had done immediately after the suicide attempt, or time the attempt so that you could be discovered by someone? |
YES 01 NO 02 |
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SU15. Did you intend to die? |
YES 01 NO 02 |
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IF MORE THAN 1 SUICIDE ATTEMPT, CONTINUE WITH ITEM SU16. OTHERWISE, GO TO LIFETIME SUBSTANCE ABUSE. |
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SU16. Did you receive medical attention for any other suicide attempt? |
YES (GO TO SU16a) 01 NO 02 |
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SU16a. Please describe the methods you used for (any/the) attempt that required medical attention, and the medical treatment you received. |
________________________________ ________________________________ |