Suicide Questionnaire
Questionnaire 1. What age group do you belong to? a) 11-20 b) 21-30 c) 31-50 d) 51 and over
2. What is your marital status? a) Single b) Married c) In a relationship d) Divorce
3. What is your employment status? a) Employed b) Unemployed c) Seeking employment d) Other
4. What is your occupation? a) Teacher b) Student c) Engineer d) Other
5. To which gender do you belong? a) Male b) Female
6. What do you think is the main cause of suicide in teens? a) Peer pressure b) Parental stress c) Mental Illness d) Drug abuse
7. Which of the following do you believe to be a sign of a suicidal teen? a) Abnormal eating and sleeping patterns b) Saying goodbye to people as if they won’t be seen again c) Talking about suicide d) Having mood swings; changing from moments of extreme happiness to extreme depression
8. Do you think personal/family problems put teens at a greater risk of being suicidal? [ ] Yes [ ] No
9. Why do you think teens would turn to suicide instead of someone first? a) Feelings of loneliness and neglect b) To seek attention c) It is their last and only resort d) Paranoia
10. Has any teen you know/are acquainted with started talking about death, how horrible his/her life is or how hopeless he/she is feeling? [ ] Yes [ ] No
11. What are some ways in a teenager’s behavior that would make you think that will try to commit suicide? a) More outgoing than usual b) Isolation from family members and society c) Overly affectionate d) Having extreme manias ( highs and lows)
12. To add to question 11, if your best friend/ teen relative tried to commit suicide what could you do to prevent it? a) Watch them closely b) Continuously remind them that they are loved and adored c) Leave them alone to make their own
2. What is your marital status? a) Single b) Married c) In a relationship d) Divorce
3. What is your employment status? a) Employed b) Unemployed c) Seeking employment d) Other
4. What is your occupation? a) Teacher b) Student c) Engineer d) Other
5. To which gender do you belong? a) Male b) Female
6. What do you think is the main cause of suicide in teens? a) Peer pressure b) Parental stress c) Mental Illness d) Drug abuse
7. Which of the following do you believe to be a sign of a suicidal teen? a) Abnormal eating and sleeping patterns b) Saying goodbye to people as if they won’t be seen again c) Talking about suicide d) Having mood swings; changing from moments of extreme happiness to extreme depression
8. Do you think personal/family problems put teens at a greater risk of being suicidal? [ ] Yes [ ] No
9. Why do you think teens would turn to suicide instead of someone first? a) Feelings of loneliness and neglect b) To seek attention c) It is their last and only resort d) Paranoia
10. Has any teen you know/are acquainted with started talking about death, how horrible his/her life is or how hopeless he/she is feeling? [ ] Yes [ ] No
11. What are some ways in a teenager’s behavior that would make you think that will try to commit suicide? a) More outgoing than usual b) Isolation from family members and society c) Overly affectionate d) Having extreme manias ( highs and lows)
12. To add to question 11, if your best friend/ teen relative tried to commit suicide what could you do to prevent it? a) Watch them closely b) Continuously remind them that they are loved and adored c) Leave them alone to make their own