Screen Reader Mode Icon Check SCREEN READER MODE to make this survey compatible with screen readers. Connections Link Life Monitoring & Baseline Evaluation Private and Confidential Question Title * 1. What date are you attending your training? Date / Time Date OK Question Title * 2. Please enter your 4 digit Session code OK Question Title * 3. How is your course being delivered? Online In person/ Face to Face OK Question Title * 4. What Trust Area area you based in? Northern Trust Belfast Trust Western Trust Southern Trust South Eastern Trust OK Question Title * 5. What is Your Age? 13-15 16-17 18-24 25-34 35-44 45-54 55-64 66-74 75+ OK Question Title * 6. What is Your Country of birth? N. Ireland England Republic of Ireland Scotland Wales Elsewhere Prefer not to say OK Question Title * 7. What is Your Ethnic group? White Black African Black Other Chinese Filipino Indian Irish Traveller Roma Other Ethnic Group Mixed Ethnic Group Prefer not to say OK Question Title * 8. What is your gender? Male Female Other Prefer not to say OK Question Title * 9. Is the gender you identify with the same as your sex registration at birth? Yes No Prefer not to say OK Question Title * 10. What is your Sexual Orientation Heterosexual Bisexual Gay Lesbian Other Prefer not to say OK Question Title * 11. What is your marital status Cohabiting Divorced? dissolved Civil Partnership Married/ Civil Partnership Separated Single Widowed Other Prefer not to say OK Question Title * 12. What are you caring responsibilities? Child/children under 18 An order person A person with a disability None Prefer not to say OK Question Title * 13. Please indicate your Religion Buddhist Catholic Hindu Jewish Muslim Protestant Sikh Prefer not to say None Other OK Question Title * 14. Please indicate your political opinion Broadly Nationalist Broadly Unionist Other Prefer not to say OK Question Title * 15. Disability. In accordance with the Disability Discrimination Act 1995, a disability is defined as a physical or mental impairment which has a substantial and long-term effect on a person's ability to carry out normal day-to-day activities. Under this definition, do you consider yourself as having a disability? Yes No Prefer not to say OK Question Title * 16. If yes, please indicate which type of impairment(s) applies to you. Please tick all that apply. N/A Physical Impairment, e.g. difficulty using arms or requiring a wheelchair or crutches Sensory Impairment, such as blind/ visual impairment or deaf /hearing impairment Mental health condition, e.g. depression or schizophrenia Autism Spectrum Disorder; Dyslexia; Cognitive Impairment; Learning Disability Long Standing Illness such as cancer, HIV, diabetes, chronic heart disease or epilepsy. Other Prefer not to say OK Question Title * 17. Home/Volunteer/Work Detals (Tick all that apply) Community/Voluntary Sector Public Sector Private Sector Sports Sector Church/Faith Parent/Guardian living with someone with a mental health concern / disorder Health Primary Care Health Secondary Care Education Youth Organisation - - OK Question Title * 18. If you answered Health Primary Care or Health Secondary Care please provide your job role: OK Question Title * 19. Describe the range of people/issues you support in your role? (Tick all that apply) Young men or women (under 25) Young people in care Pregnant women / new mothers / parents Vulnerable adults Adults Section 75 Groups Poverty Suicide / Self Harm Drugs / Alcohol Unemployment Bereavement Low self esteem, confidence, life skills Homelessness or supported housing Health Problems Domestic Violence Crime Isolation Trauma All of the Above OK Question Title * 20. Please rate your current awareness of suicide and its prevention? 1 Low - 5 High 1 2 3 4 5 Please rate your current awareness of suicide and its prevention? Please rate your current awareness of suicide and its prevention? 1 Please rate your current awareness of suicide and its prevention? 2 Please rate your current awareness of suicide and its prevention? 3 Please rate your current awareness of suicide and its prevention? 4 Please rate your current awareness of suicide and its prevention? 5 Please rate your awareness of the importance of nurturing emotional health in preventing suicide? Please rate your awareness of the importance of nurturing emotional health in preventing suicide? 1 Please rate your awareness of the importance of nurturing emotional health in preventing suicide? 2 Please rate your awareness of the importance of nurturing emotional health in preventing suicide? 3 Please rate your awareness of the importance of nurturing emotional health in preventing suicide? 4 Please rate your awareness of the importance of nurturing emotional health in preventing suicide? 5 OK DONE
