In the past 12 months, have you spoken to No 0 SUIDISC anyone about thinking about or attempting to [go to next section] Yes 1 take your own life? To whom have you spoken? Friend / neighbour 1 SUIDISC_ _FRIEND (Circle all that apply) Spouse/partner 2 _SPOUSE Anyone else? _OFAM Other family member 3 _EMPL Employer/co-worker 4 Traditional healer 5 _REL Health care worker (e.g. 6 _HCWORK _OTHER nurse/doctor, specialist) Religious or spiritual 7 advisor Other (specify) 77 SUIDISCO ✍ Did you receive any treatment for thinking No 0 SUITX about or attempting to take your own life? [go to next section] Yes 1 know 888 Don’t [go to next section] What treatment did you receive? SUITXO ✍ [go to next section] Selection for full individual interview <Cut-off score Go to next question AUDIT total >=Cut-off score Go to C1 <=Cut-off score Go to next question PHQ9 total > Cut-off score Go to C1 =0 Go to next question B44 (Recent depression) =1 Go to C1 0 Go to Record end time Random selection table 1 Go to C1 T1 [Record end time] HH : MM
In the past 12 months, have you spoken to anyone about thinking about or attempting to take your own life? No [go to next section] 0 SUIDISC Yes 1 To whom have you spoken? (Circle all that apply) Anyone else? Friend / neighbour 1 SUIDISC_ _FRIEND _SPOUSE _OFAM _EMPL _REL _HCWORK _OTHER SUIDISCO Spouse/partner 2 Other family member 3 Employer/co-worker 4 Traditional healer 5 Health care worker (e.g. nurse/doctor, specialist) 6 Religious or spiritual advisor 7 Other (specify) ✍ 77 Did you receive any treatment for thinking about or attempting to take your own life? No [go to next section] 0 SUITX Yes 1 Don’t know [go to next section] 888 What treatment did you receive? ✍ [go to next section] SUITXO Selection for full individual interview AUDIT total <Cut-off score Go to next question >=Cut-off score Go to C1 PHQ9 total <=Cut-off score Go to next question > Cut-off score Go to C1 B44 (Recent depression) =0 Go to next question =1 Go to C1 Random selection table 0 Go to Record end time 1 Go to C1 [Record end time] HH : MM T1
PRIME%20Community%20Survey%20Questionnaire_FINAL.docx