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  1. Surveys
  2. 2015
  3. March
  4. M
  5. Military/Veteran Suicide
0%
Exit Survey
 
 
Hello: Thank you for taking time to participate in my survey on suicide. The purpose of the survey is to collect data for the book I'm writing on Suicide an Epidemic in America. The book is being written to help bring awareness to the epidemic at hand. The desire was put in me to help bring people out of darkness into the light. My goal is to shed light where there is no light, bring hope where there is no hope, and show love where there is no love.
Your participation in this study is completely voluntary. If you feel uncomfortable answering any questions, you can withdraw from the survey at any point. Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.
 
 
 
Have you served in the military?
 
Yes
 
No
 
 
 
Did you go to war?
 
Yes
 
No
 
 
 
What would you say is the difference between the wars of old and the wars of today?
   
 
 
 
How are you transitioning from a military lifestyle to a civilian lifestyle?
   
 
 
 
Have you ever felt: (Select all that apply)?
 
Depressed
 
Anxious
 
Sad
 
Worthless
 
Unloved
 
Broken on the inside
 
Like no one understands you
 
Hopeless

 
 
 
Have you suffered from a trauma?
 
Yes
 
No
 
 
 
What does suicide mean to you?
   
 
 
 
Do you have a means to hurt yourself?
   
 
 
 
Do you use alcohol or substance to self-medicate?
 
Yes
 
No
 
 
 
Are there recent stressors in your life (Select all that apply)?
 
Job loss
 
disappointment
 
hurt
 
eviction
 
family problems
 
substance abuse
 
homeless
 
finance problems
 
abuse (physical or mental)
 
care taker for mentally challenged or disabled child
 
care taker for elderly parent/grandparent

 
 
 
Do you hear voices or see things? (Audio/Visual Hallucinations) 
 
Yes
 
No
 
 
 
Have you ever been diagnosed with an incurable disease?
 
Yes
 
No
 
 
 
Is suicide your last resort? if yes, what else have your tried?
   
 
 
 
Tell me your story:
   
 
 
 
Gender
 
Male
 
Female
 
 
 
Ethnicity
 
Caucasian
 
African American
 
Hispanic
 
Asian
 
Native American
 
Multi-race
 
 
 
Age range
 
25-29
 
30-34
 
35-39
 
40-44
 
45-49
 
50-54
 
55-59
 
60-64
 
65=69
 
70+